Death from asthma associated with sertraline overdose

The authors report a case of a young woman for whom autopsy confirmed the c ause of death to be due to an acute asthma attack. In addition, she had hig h serum levels of sertraline hydrochloride (Zoloft). The decedent had a rec ent prescription for sertraline filled, from which most of the pills were m issing, suggesting a large consumption of medication. She was found dead at home, immersed in a bath. Autopsy revealed anatomic evidence of a severe r ecent asthma attack. Quantitative brood assay for sertraline was very high (620 ng/ml). Fatalities from sertraline alone are virtually nonexistent. Th e effects of sertraline on asthma, however, are not well-studied. Why the p atient ingested so much sertraline is unclear. However, it is possible that , in a variant of the serotonin syndrome, a large dose of a selective serot onin reuptake inhibitor participated in precipitating an asthma attack or p revented her from being aware of the evolution of such an exacerbation. Add itional observations in the future will be useful in assessing the role of this class of drugs in patients with asthma.