Citation

Neukamm MA, Vogt S, Hermanns-Clausen M, Naue J, Thierauf A, Auwärter V. Forensic Sci. Int. 2013; 227(1-3): 82-84.

Affiliation

Institute of Legal Medicine, University Medical Center, Albertstrasse 9, D-79104 Freiburg im Breisgau, Germany. Electronic address: merja.neukamm@uniklinik-freiburg.de.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.forsciint.2012.08.050

PMID

22999230

Abstract

The differentiation of intoxication courses is one of the most difficult challenges for forensic pathologists and toxicologists. The case of a 52-year-old female inpatient of a psychiatric clinic with multiple medications who died from doxepin intoxication is reported. Concentrations of doxepin metabolites and isomers, pharmacokinetic modelling and genotyping of the doxepin-metabolizing cytochrome P450 (CYP) enzymes led to the following conclusion: the lethal doxepin concentration of 2100ng/mL was more likely to have been reached due to drug interactions and genetic peculiarities leading to a reduction of the metabolic capacity and not by an acute (suicidal) overdose.

Language: en