Tianeptine (Stablon®), although structurally similar to tricyclic antidepressants, acts by enhancing the reuptake of serotonin. A fatal case is presented involving a 26-year-old man, found lying in bed with a "mushroom of foam" around his mouth. Empty blister packs of Stablon® and a suicide note were found next to the body. A liquid-liquid extraction procedure with n-hexane: ethyl acetate and n-hexane: 2-propanol, followed by LC-DAD-MS analysis, using positive mode electrospray ionization was performed. The detection limit was 0.001 [mu]g/mL. The toxicological results revealed the following tianeptine concentrations in the post-mortem samples: blood 5.1 [mu]g/mL; urine 2.0 [mu]g/mL; liver 23 [mu]g/g; stomach contents 22 mg. Femoral blood analyses also revealed an ethanol concentration of 0.53 g/L. The present method was also developed and validated for the other post-mortem specimens, since no previous published data had confirmed the post-mortem distribution of tianeptine. The absence of other suitable direct causes of death (macroscopic or histological) and the positive results achieved with the toxicological analysis led the pathologist to rule that death was due to an intoxication caused by the suicidal ingestion of tianeptine in combination with alcohol.
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机译:Tianeptine(Stablon®)虽然在结构上类似于三环类抗抑郁药,但其作用是增强5-羟色胺的再摄取。一起致命的案子涉及一名26岁的男子,被发现躺在床上,嘴里满是“泡沫蘑菇”。在尸体旁边发现空的Stablon®泡罩包装和一张自杀遗书。使用正模式电喷雾电离,使用正己烷:乙酸乙酯和正己烷:2-丙醇进行液-液萃取程序,然后进行LC-DAD-MS分析。检出限为0.001μg/ mL。毒理学结果表明,死后样品中的噻庚汀浓度为:血液5.1μg/ mL;尿液2.0μg/ mL;肝23微克/克;胃内容物22毫克股血分析还显示乙醇浓度为0.53 g / L。还开发了本方法,并针对其他尸检标本进行了验证,因为以前没有公开的数据可以确认噻庚汀的尸检分布。由于没有其他合适的直接死亡原因(宏观或组织学上的死亡)以及毒理学分析获得的积极结果,病理学家裁定死亡是由于自杀性吞咽噻天汀与酒精联合摄入所引起的中毒。
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