A cyproheptadine fatality.

A 28-year-old man was found dead by his girlfriend. No anatomic cause of death was identified at autopsy. The heart-blood ethanol concentration was 0.09 g/dL. Comprehensive testing for abused and therapeutic drugs in the blood and urine identified cyproheptadine, a serotonin and histamine antagonist. This was one of the medications prescribed for the girlfriend, who admitted that several tablets were missing from the vial. The heart blood contained 0.46 mg/L of cyproheptadine. A review of the literature indicated that only trace amounts of parent drug are identified in the blood following therapeutic use of cyproheptadine. Therefore, the medical examiner concluded that the cause of death in this case was ethanol and cyproheptadine intoxication.