Four Cases of Fatal Doxepin Poisoning

Four cases of fatal doxepin poisoning are described. Reports on the cases and relevant autopsy findings are mentioned. Toxicological data on the concentrations of cis- and trans-doxepin and its metabolite, demethyldoxepin, in body fluids and tissues are presented, and a comparison of these results with previously published data has been made. Another metabolite, doxepin-N-oxide, has been detected in all fluids and tissues investigated, but quantitation was not possible because the standard was not available.