A fatal clomipramine intoxication case of a chronic alcoholic patient: Application of postmortem hair analysis method of clomipramine and ethyl glucuronide using LC/APCI/MS
✍ Scribed by Małgorzata Kłys; Mariusz Ścisłowski; Sebastian Rojek; Jan Kołodziej
- Book ID
- 104039920
- Publisher
- Elsevier Science
- Year
- 2005
- Tongue
- English
- Weight
- 132 KB
- Volume
- 7
- Category
- Article
- ISSN
- 1344-6223
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✦ Synopsis
Toxicological investigations of postmortem specimens of a 26-year-old man were performed with the use of LC/APCI/MS. They revealed in the blood of the deceased clomipramine (9.49 microg/g) and its main metabolite norclomipramine (1.10 microg/g) at concentrations explaining the fatal outcome. The presence of these xenobiotics in a 12-cm-long strand of hair (clomipramine, 7.60 ng/mg in I segment; 4.19 ng/mg in II segment; 1.86 ng/mg in III segment; norclomipramine, 5.71 ng/mg in I segment; 9.71 ng/mg in II segment; 4.13 ng/mg in III segment) confirmed the fact obtained from the medical history that the deceased had been receiving clomipramine as an antidepressant for 1 year prior to his death. The analysis demonstrated ethanol in autopsy blood (2.5mg/ml) and urine (3.2mg/ml); ethyl glucuronide as a marker of chronic alcohol abuse was detected in the deceased's hair (0.44 ng/mg in I segment; 0.07 ng/mg in II segment; n.d. in III segment). These findings may suggest the contribution of alcohol in the mechanism of drug-ethanol interaction, which in consequence might have affected the biotransformation of clomipramine in the final period of his life and evoked the ultimate toxic effect.