Alprazolam is one of the most widely prescribed benzodiazepines in the United States. It is generally considered a safe and effective drug for the treatment of anxiety disorders and panic attacks. Few overdoses that are due to the sole ingestion of alprazolam have been reported. This paper documents a fatality due to alprazolam intoxication and describes the distribution of alprazolam and an active metabolite, alpha-hydroxyalprazolam, in tissues obtained at autopsy. Qualitative identification of the drugs was achieved by full-scan gas chromatography-mass spectrometry, and quantitative analysis was performed by high-performance liquid chromatography. High concentrations of alprazolam were found in all specimens analyzed, but the metabolite was detected only in subclavian blood, urine, bile, and liver. A postmortem heart blood alprazolam concentration of 2.1 mg/L is the highest reported in the literature to date.
Rogers WO, Hall MA, Brissie RM, Robinson CA. Rogers WO, et al. J Forensic Sci. 1997 Jan;42(1):155-6. J Forensic Sci. 1997. PMID: 8988593
Michaud K, Augsburger M, Romain N, Giroud C, Mangin P. Michaud K, et al. Forensic Sci Int. 1999 Nov 8;105(3):185-9. doi: 10.1016/s0379-0738(99)00118-8. Forensic Sci Int. 1999. PMID: 10643652
Hall MA, Robinson CA, Brissie RM. Hall MA, et al. J Anal Toxicol. 1995 Oct;19(6):511-3. doi: 10.1093/jat/19.6.511. J Anal Toxicol. 1995. PMID: 8926747
Isbister GK, O'Regan L, Sibbritt D, Whyte IM. Isbister GK, et al. Br J Clin Pharmacol. 2004 Jul;58(1):88-95. doi: 10.1111/j.1365-2125.2004.02089.x. Br J Clin Pharmacol. 2004. PMID: 15206998 Free PMC article. Review.
Garzone PD, Kroboth PD. Garzone PD, et al. Clin Pharmacokinet. 1989 Jun;16(6):337-64. doi: 10.2165/00003088-198916060-00002. Clin Pharmacokinet. 1989. PMID: 2567646 Review.
Fairman K, Choi MK, Gonnabathula P, Lumen A, Worth A, Paini A, Li M. Fairman K, et al. Toxics. 2023 Jan 28;11(2):126. doi: 10.3390/toxics11020126. Toxics. 2023. PMID: 36851001 Free PMC article. Review.
Øiestad EL, Øiestad ÅML, Middelkoop G, Brochmann GW, Thaulow CH, Vindenes V. Øiestad EL, et al. J Anal Toxicol. 2023 Mar 24;47(3):287-298. doi: 10.1093/jat/bkac106. J Anal Toxicol. 2023. PMID: 36542823 Free PMC article.
Giorgetti A, Sommer MJ, Wilde M, Perdekamp MG, Auwärter V. Giorgetti A, et al. Forensic Toxicol. 2022 Jan;40(1):180-188. doi: 10.1007/s11419-021-00591-w. Epub 2021 Aug 11. Forensic Toxicol. 2022. PMID: 36454486 Free PMC article.
Corkery JM, Guirguis A, Chiappini S, Martinotti G, Schifano F. Corkery JM, et al. J Psychopharmacol. 2022 Sep;36(9):1020-1035. doi: 10.1177/02698811221104065. Epub 2022 Aug 1. J Psychopharmacol. 2022. PMID: 35912873 Free PMC article.
Rossi B, Freni F, Vignali C, Stramesi C, Collo G, Carelli C, Moretti M, Galatone D, Morini L. Rossi B, et al. Molecules. 2021 Dec 24;27(1):112. doi: 10.3390/molecules27010112. Molecules. 2021. PMID: 35011344 Free PMC article.