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Antipsychotics - Postmortem fatal and non-fatal reference concentrations

Söderberg, Carl; Wernvik, Emma; Tillmar, Andreas; Spigset, Olav; Kronstrand, Robert; Reis, Margareta LU ; Jönsson, Anna K. and Druid, Henrik (2016) In Forensic Science International 266. p.91-101
Abstract

Making the diagnosis fatal intoxication is a challenging task for the forensic pathologist and toxicologist, particularly when the cases involve substances where reference information is scarce or not at all available. This study presents postmortem femoral blood concentrations for 24 antipsychotic substances, based on samples collected and analyzed from 4949 autopsy cases in Sweden during 1992-2010. In addition our study provides information about the prevalence of different antipsychotics in accidental, suicidal, homicidal and uncertain deaths.The data have been selected and evaluated according to strict inclusion and exclusion criteria as well as a manual, multi-reviewer, case-by-case evaluation. The reference information is... (More)

Making the diagnosis fatal intoxication is a challenging task for the forensic pathologist and toxicologist, particularly when the cases involve substances where reference information is scarce or not at all available. This study presents postmortem femoral blood concentrations for 24 antipsychotic substances, based on samples collected and analyzed from 4949 autopsy cases in Sweden during 1992-2010. In addition our study provides information about the prevalence of different antipsychotics in accidental, suicidal, homicidal and uncertain deaths.The data have been selected and evaluated according to strict inclusion and exclusion criteria as well as a manual, multi-reviewer, case-by-case evaluation. The reference information is subdivided into intoxications by one specific substance only (group A, n = 259), multi-substance intoxications (group B, n = 614) and postmortem controls, consisting of deaths not involving incapacitation by substances (group C, n = 507). Moreover, the results are compared with data based on therapeutic drug monitoring, and data collected from driving under the influence cases.Median concentrations in group A were significantly higher than in group C for all substances evaluated. For 17 of 24 substances, the median concentrations in group B were significantly higher than in group C. In general, the therapeutic drug monitoring and driving under the influence concentrations were similar to, or lower than, the concentrations in group C.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Antipsychotics, Blood, Forensic toxicology, Intoxication, Postmortem
in
Forensic Science International
volume
266
pages
11 pages
publisher
Elsevier
external identifiers
  • scopus:84969767047
  • wos:000386334600033
ISSN
0379-0738
DOI
10.1016/j.forsciint.2016.05.002
language
English
LU publication?
yes
id
2e4b6b5c-58cc-4c40-82a4-78ca6473dbac
date added to LUP
2016-06-16 14:33:44
date last changed
2017-07-09 04:51:02
@article{2e4b6b5c-58cc-4c40-82a4-78ca6473dbac,
  abstract     = {<p>Making the diagnosis fatal intoxication is a challenging task for the forensic pathologist and toxicologist, particularly when the cases involve substances where reference information is scarce or not at all available. This study presents postmortem femoral blood concentrations for 24 antipsychotic substances, based on samples collected and analyzed from 4949 autopsy cases in Sweden during 1992-2010. In addition our study provides information about the prevalence of different antipsychotics in accidental, suicidal, homicidal and uncertain deaths.The data have been selected and evaluated according to strict inclusion and exclusion criteria as well as a manual, multi-reviewer, case-by-case evaluation. The reference information is subdivided into intoxications by one specific substance only (group A, n = 259), multi-substance intoxications (group B, n = 614) and postmortem controls, consisting of deaths not involving incapacitation by substances (group C, n = 507). Moreover, the results are compared with data based on therapeutic drug monitoring, and data collected from driving under the influence cases.Median concentrations in group A were significantly higher than in group C for all substances evaluated. For 17 of 24 substances, the median concentrations in group B were significantly higher than in group C. In general, the therapeutic drug monitoring and driving under the influence concentrations were similar to, or lower than, the concentrations in group C.</p>},
  author       = {Söderberg, Carl and Wernvik, Emma and Tillmar, Andreas and Spigset, Olav and Kronstrand, Robert and Reis, Margareta and Jönsson, Anna K. and Druid, Henrik},
  issn         = {0379-0738},
  keyword      = {Antipsychotics,Blood,Forensic toxicology,Intoxication,Postmortem},
  language     = {eng},
  month        = {09},
  pages        = {91--101},
  publisher    = {Elsevier},
  series       = {Forensic Science International},
  title        = {Antipsychotics - Postmortem fatal and non-fatal reference concentrations},
  url          = {http://dx.doi.org/10.1016/j.forsciint.2016.05.002},
  volume       = {266},
  year         = {2016},
}