Skip to main content
Log in

Distribution of zolpidem in body fluids and organ tissues in five autopsy cases

  • Short Communication
  • Published:
Forensic Toxicology Aims and scope Submit manuscript

Abstract

We investigated the distribution of zolpidem throughout femoral vein blood, urine, stomach contents, the brain, lung, liver, and kidney in five autopsy cases using gas chromatography-mass spectrometry. Four out of the five cases showed toxic levels of zolpidem. Only one case showed a lethal blood level. The zolpidem concentrations in solid organ tissues were generally several times higher than that in blood. Among four solid organ tissues, the differences in concentration were not drastic; they were similar or within the same order of magnitude except for one case. These results suggested that measurements of zolpidem concentrations in multiple solid organ tissues are useful for estimating whether zolpidem poisoning is related to the cause of death, especially when blood cannot be collected.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Baselt RC (2004) Disposition of toxic drugs and chemicals in man, 7th edn. Biomedical Publications, Foster City, pp 1212-1214

    Google Scholar 

  2. Garnier R, Guerault E, Muzard D, Azoyan P, Chaumet-Riffaud A, Efthymiou M (1994) Acute zolpidem poisoning—analysis of 344 cases. Clin Toxicol 32:391–404

    CAS  Google Scholar 

  3. Arbilla S, Depoortere H, George P, Langer Z (1985) Pharmacological profile of the imidazopyridine zolpidem at benzodiazepine receptors and electrocorticogram in rats. Naunyn-Schmiedeberg’s Arch Pharmacol 330:248–251

    Article  CAS  Google Scholar 

  4. Depoortere H, Zivkovic B, Lloyd KG, Sanger DJ, Perrault G, Langer SZ, Bartholini G (1986) Zolpidem, a novel nonbenzodiazepine hypnotic. I. Neuropharmacological and behavioral effects. J Pharmacol Exp Ther 237:649–658

    PubMed  CAS  Google Scholar 

  5. Nicholson AN, Pascoe PA (1986) Hypnotic activity of an imidazo-pyridine (zolpidem). Br J Clin Pharmacol 21:205–211

    PubMed  CAS  Google Scholar 

  6. Ascalone V, Flaminio L, Guinebault P, Thenot JP, Morselli PL (1992) Determination of zolpidem, a new sleep-inducing agent, and its metabolites in biological fluids: pharmacokinetics, drug metabolism and overdosing investigations in humans. J Chromatogr B 581:237–250

    Article  CAS  Google Scholar 

  7. Pichard L, Gillet G, Bonfils C, Domergue J, Thenot J, Maurel P (1995) Oxidative metabolism of zolpidem by human liver cytochrome P450s. Drug Metab Dispos 23:1253–1262

    PubMed  CAS  Google Scholar 

  8. von Moltke LL, Greenblatt DJ, Granada BW, Duan S, Grassi JM, Venkatakrishnan K, Harmatz JS, Shader RI (1999) Zolpidem metabolism in vitro: responsible cytochromes, chemical inhibitors, and in vivo correlations. Br J Clin Pharmacol 48:89–97

    Article  Google Scholar 

  9. Lheureux P, Debailleul G, De Witte O, Askenasi R (1990) Zolpidem intoxication mimicking narcotic overdose: response to flumazenil. Hum Exp Toxicol 9:105–107

    Article  PubMed  CAS  Google Scholar 

  10. Lichtenwalner M, Tully R (1997) A fatality involving zolpidem. J Anal Toxicol 21:567–569

    PubMed  CAS  Google Scholar 

  11. Levine B, Eu SC, Smialek JE (1999) Zolpidem distribution in postmortem cases. J Forensic Sci 44:369–371

    PubMed  CAS  Google Scholar 

  12. Gock SB, Wong SHY, Nuwayhid N, Venuti SE, Kelley PD, Teggatz JR, Jentzen JM (1999) Acute zolpidem overdose—report of two cases. J Anal Toxicol 23:559–562

    PubMed  CAS  Google Scholar 

  13. Takayasu T, Kondo T (2005) Assessment of a drug screening kit Instracheck for human samples. Jpn J Forensic Toxicol 23:209–213

    CAS  Google Scholar 

  14. Ohshima T, Takayasu T, Ohtsuji M, Sato Y, Kondo T (1998) Suicide due to multiple-drug overdose caused mainly by amitriptyline, nortriptyline and amobarbital. Jpn J Forensic Toxicol 16:75–84

    Google Scholar 

  15. Takayasu T, Kondo T, Sato Y, Ohshima T (2001) A fatal intoxication case due to haloperidol, biperidin and levomepromazine: their distribution in body fluids and organs. Jpn J Forensic Toxicol 19:58–64

    Google Scholar 

  16. Takayasu T, Hayashi T, Ishida Y, Nosaka M, Mizunuma S, Miyashita T, Kawaguchi M, Kimura A, Kondo T (2008) A fatal intoxication from ingestion of 2-methyl-4-chlorophenoxyacetic acid (MCPA). J Anal Toxicol 32:187–191

    PubMed  CAS  Google Scholar 

  17. Tracqui A, Kintz P, Mangin P (1993) A fatality involving two unusual compounds—zolpidem and acepromazine. Am J Forensic Med Pathol 14:309–312

    Article  PubMed  CAS  Google Scholar 

  18. Meeker JE, Som CW, Macapagal EC, Benson PA (1995) Zolpidem tissue concentrations in a multiple-drug related death involving Ambien. J Anal Toxicol 19:531–534

    PubMed  CAS  Google Scholar 

  19. Winek CL, Wahba WW, Janssen JK, Rozin L, Rafizadeh V (1996) Acute overdose of zolpidem. Forensic Sci Int 78:165–168

    Article  PubMed  CAS  Google Scholar 

  20. Keller T, Schneider A, Tutsuch-Bauer E (1999) GC/MS determination of zolpidem in postmortem specimens in a voluntary intoxication. Forensic Sci Int 106:103–108

    Article  PubMed  CAS  Google Scholar 

  21. Winek CL, Wahba WW, Winek CLJr, Balzer TW (2001) Drug and chemical blood-level data 2001. Forensic Sci Int 122:107–123

    Article  PubMed  CAS  Google Scholar 

  22. Pelissier-Alicot AL, Gaulier JM, Champsaur P, Marquet P (2003) Mechanisms underlying postmortem redistribution of drugs: a review. J Anal Toxicol 27:533–544

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Tatsunori Takayasu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Takayasu, T., Ishida, Y., Kimura, A. et al. Distribution of zolpidem in body fluids and organ tissues in five autopsy cases. Forensic Toxicol 26, 80–84 (2008). https://doi.org/10.1007/s11419-008-0055-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11419-008-0055-9

Keywords

Navigation