DECISION MAKING DIFFICULTIES IN FORENSIC TOXICOLOGY: AMISULPRIDE CASE

Yıl 2017, Cilt: Volume 2 Sayı: İssue 1 (1) - 2.İnternational Congress Of Forensic Toxicology, 222 - 222, 16.02.2017

Aykut Lale Mahmut Şerif Yıldırım Ramazan Akçan

Öz

Amisulpride is a
neuroleptic drug used to improve the negative symptomatology of schizophrenia
with dopaminergic activity in high doses.

A 41-year-old
female was found dead at home. Her medical records were unknown but only one of
her relative gave information that she had a psychiatric disorder and took
medications with unknown dosage. An autopsy was performed. No remarkable injuries
or pathologies were observed in macroscopic and microscopic examination.
Samples of full stomach content, femoral blood, urine and bile were collected
and analyzed with LC-MS/MS. In the stomach content, bile and urine amisulpride,
quetiapine and metabolite of quetiapine were found. In blood analysis (70ng/ml)
quetiapine and (1330ng/ml) amisulpride were detected.

In decision
making process to toxic death, blood drug concentrations and sampling
localizations, postmortem redistribution, available concentration – toxicity
relationship in literature, drug dosing interval, dose levels, drug tolerance
must be considered according to experts.

Amisulpride
lethal dose is over 9300-41700ng/ml and toxic dose is over 640ng/ml in the
review of Martin Schulz and colleagues. Although our decedent’s amisulpride
levels in blood were above toxic limit, no available data about postmortem
redistribution of amisulpride was found. On the other hand, decedent’s drug
dosig interval and dose levels are unknown to determine occurrence of
tolerance.

As a conclusion
in spite of no remarkable cause of death was found in our case, death was not
associated to amisulpride toxicity because of lack of decedent’s medical
history and inadequate data about postmortem destiny of amisulpride.

 

Anahtar Kelimeler

DECISION MAKING DIFFICULTIES IN FORENSIC TOXICOLOGY: AMISULPRIDE CASE

Kaynakça

• Aykut LALE, Mahmut Şerif YILDIRIM, Ramazan AKÇAN
• Hacettepe University Medical Faculty Department of Forensic Medicine Ankara, Turkey