SOFT 2004 Meeting Abstracts - Society of Forensic Toxicologists

PI
NEW GENERATIONS OF ANTIDEPRESANTS IN FATAL INTOXICATIONS
Marie Stankova*, Petr Kurka, 1. DvoraCek
Institute of Forensic Medicine, University Hospital, Ostrava, Czech Republic
New generations of antidepresants are widely used for treatment of various types of depressive and other
disorders. These drugs have a relatively low toxicity, and fatalitiesexclusively from these newer drugs are
uncommon.
The authors describe six cases of fatal intoxications with a combination of some newer antidepresant with
other drugs. Although these newer antidepresants are relatively safe, in combination with other drugs
(especially with psychoactive drugs) they can cause death.
There drugs were isolated from biological specimes using either a diethyl ether extraction for qualitative
analysis or by solid phase extraction for quantitative analysis.
Detection of drugs in biological specimes (urine, gastric contents, liver, kidney) was performed by thin
layer chromatography/colour reactions (TLC/CR) and confirmed by gas chromatography/mass
spectrometry method (GC/MS). Concentrations of drugs in postmortem bloods (subclavian artery blood)
were determined using GC/MS method.
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The results are presented in the table:
case gender/age antidepressant blood lev. other drugs blood lev.
1. F/41 citaloprarn 0.80 Promethazine 10.20
2. F/47 moclobemide 18.20 7.44
3. M/50 mianserin 1.33 0.51
Dosulepin 2.76
4. M/38 moclobemide 32.00 Promethazine 19.00
Alcohol
5. M/51 citalopram 1.24 Levomepromazine
ketamine
6. M/37 citaloprarn 2.39 Morphine
blood (subclavian artery) level: mg/I - drugs, g/kg - alcohol
NQ - no quantification
Keywords: new antidepresants, overdose, GCMS
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