We report the case of a man who died twelve hours after ingesting powdered iboga root, commonly taken for its stimulant and hallucinogenic properties. Ibogaine and ibogamine were quantified in the powder ingested and the victim's body fluids by GC-MS/MS after liquid-liquid extraction (Toxi-tubes A(®)). The concentrations of ibogaine measured in the blood samples taken at the scene and in the peripheral blood, urine, and gastric fluid samples taken during the autopsy were 0.65, 1.27, 1.7, and 53.5 μg/mL, while the iboga content in the powder was 7.2%. Moreover, systematic toxicological analyses of biological samples showed the presence of diazepam and methadone in therapeutic concentrations. Death was attributed to the ingestion of a substantial quantity of iboga in the context of simultaneous methadone and diazepam consumption.
Pregabalin is a drug for treating epilepsy, anxiety disorders and neuropathic pain. Cases of poisoning are rare, though some have been fatal. Concentrations of pregabalin in postmortem human samples and its distribution have very rarely been documented. As the literature is so scarce, we propose to report the concentrations in autopsy samples of 18 people who had been taking Lyrica(®), including one case of a mixed overdose involving pregabalin. Analysis was carried out using an original Hydrophilic Interaction LIquid Chromatography (HILIC) technique coupled with a high-resolution mass spectrometer (m/z 160.1334 ± 5 ppm). The sensitivity of the technique enables a quick and simple treatment of the samples by protein precipitation. The method was validated in the whole blood with detection and quantification limits of 0.025 and 0.060 µg/mL, respectively. Pregabalin was a likely factor in the cause of death in 3 of the 18 cases. In the other individuals, the concentrations ranged from 0.4 to 17.0 in the peripheral blood, 1.5 to 11.1 in the central blood, 126.6 to 2004.6 in the urine and 10.5 to 58.3 µg/mL in the bile, with median values of 5.6, 4.6, 534.6 and 17.7, respectively.
Résumé -Objectif :Tabernanthe iboga, ou iboga est un arbuste issu des régions africaines équatoriales dont la racine est couramment consommée pour ses propriétés stimulantes et hallucinogènes. L'ibogaïne, principal alcaloïde de la plante, est à l'origine de ses effets psychotropes.
Mots clés : Tabernanthe iboga, ibogaïne, ibogamine, CPG-SM/SM, empoisonnementAbstract -Objective: Tabernanthe iboga, or iboga, is a shrub native to equatorial Africa. Its root is commonly taken as a stimulant and hallucinogen. Ibogaine, the principal alcaloid in the plant, is the source of its psychotropic effects. We report the case of a 27-year-old man with a long history of drug addiction who was found dead in 2006, 12 hours after ingesting powdered iboga root as part of a detoxification programme. Ibogaine and ibogamine were identified and quantified in the powder ingested and in the body fluid samples taken at the scene of death and during the autopsy. Methods: Analysis was carried out using GC-MS/MS (electron impact -ion trap) after performing liquid-liquid extraction on the body fluids. Results: The concentrations measured in the post-mortem peripheral blood samples taken at the scene, and in the peripheral blood, urine and gastric juice samples taken during the autopsy were: 0.65, 1.27, 1.71 and 53.5 µg mL -1 for ibogaine; and 0.05, 0.10, 1.12 and 4.34 µg mL -1 for ibogamine. The powder was titrated at 7.2 per cent for ibogaine and 0.6 per cent for ibogamine. Conclusion: The presence of the two molecules in the biological samples was consistent with the recent ingestion of Tabernanthe iboga roots.
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