Comparative Study of Postmortem Concentrations of Antidepressants in Several Different Matrices

Øiestad, Åse Marit Leere; Karinen, Ritva; Rogde, Sidsel; Nilsen, Stian; Eldor, Kari Beate Boye; Brochmann, Gerd-Wenche; Arnestad, Marianne; Øiestad, Elisabeth Leere; Peres, Mariana Dadalto; Kristoffersen, Lena; Vindenes, Vigdis

doi:10.1093/jat/bky030

Cited by 26 publications

(18 citation statements)

References 45 publications

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“…In this study, we have focused our attention on antidepressants and antipsychotics, which are drugs frequently detected in post-mortem samples from forensic toxicology cases [17,18,21]. We have developed a method for detection and quantitation of ADs and APs in dried blood spotted on a paper substrate and in blood stored at −20 °C and submitted to a freeze and thaw cycle during each analytical session.…”

Section: Discussionmentioning

confidence: 99%

“…In post-mortem samples from forensic toxicology cases, it is not infrequent to detect ADs [17,18] and/or APs [19,20,21], but making the diagnosis of fatal intoxication is a challenging task, mainly because the reference information about some substances is scarce or not available [21], and because the potential synergic effects of the different substances found in biological matrices still need to be clarified.…”

Section: Introductionmentioning

confidence: 99%

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Determination of Antidepressants and Antipsychotics in Dried Blood Spots (DBSs) Collected from Post-Mortem Samples and Evaluation of the Stability over a Three-Month Period

et al. 2019

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An LC-MS/MS method for the identification and quantification of antidepressants and antipsychotics was developed on dried blood spots (DBSs). Moreover, analyte stability on DBSs within a 3-month period was monitored. Aliquots of 85 µL of blood from autopsy cases were pipetted onto DBS cards, which were dried and stored at room temperature. DBSs were analyzed in triplicate immediately, within the following 3 weeks, and after 3 months. For each analysis, a whole blood stain was extracted in phosphate buffer and purified using Solid Phase Extraction (SPE) cartridges in order to avoid matrix effects and injected in the LC-MS/MS system. Thirty-nine molecules were screened. Limits of detection (LODs) ranged between 0.1 and 3.2 ng/mL (g) and 0.1 and 5.2 ng/mL (g) for antidepressants and antipsychotics, respectively. Limits of quantification (LOQs) varied from 5 to 10.0 ng/mL for both. Sixteen cases among the 60 analyzed resulted positive for 17 different analytes; for 14 of these the method was fully validated. A general good agreement between the concentrations on DBSs and those measured in conventional blood samples (collected concurrently and stored at −20 °C) was observed. The degradation/enhancement percentage for most of the substances was lower than 20% within the 3-month period. Our results, obtained from real post-mortem cases, suggest that DBSs can be used for routine sample storage.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Determination of Antidepressants and Antipsychotics in Dried Blood Spots (DBSs) Collected from Post-Mortem Samples and Evaluation of the Stability over a Three-Month Period

et al. 2019

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“…These alkaloid drugs are largely neutral and are highly lipid soluble and known to penetrate the blood-brain barrier (27), which may contribute to their ability to cross the blood-retinal barrier. Antidepressants such as trazodone, sertraline and venlafaxine, as well as diazepam, a benzodiazepine, exhibit lower concentrations in vitreous humor compared to peripheral blood (21,28). Relative to opioids, these drugs exhibit a slightly higher polarity, which may contribute to their inability to penetrate the blood-retinal barrier.…”

Section: Discussionmentioning

confidence: 99%

Acidic Drug Concentrations in Postmortem Vitreous Humor and Peripheral Blood

Hubbard

Navarrete

Fitzgerald

et al. 2019

Journal of Analytical Toxicology

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Vitreous humor is a potential alternative matrix for postmortem toxicology drug screens when peripheral blood is unavailable. It is easily and reliably collected and may not suffer from the same postmortem redistribution as seen in blood. Here, we compared the concentrations of 7 acidic drugs (acetaminophen, ibuprofen, naproxen, salicylic acid, carbamazepine, phenobarbital and phenytoin) in peripheral blood and vitreous fluid collected in 89 autopsy cases. Analysis was done by high-performance liquid chromatography with diode-array detection. Overall, we found that vitreous drug concentrations were significantly lower than peripheral blood with median vitreous to peripheral blood (V/PB) ratios ranging from 0.0 to 0.6 (mean, 0.1–0.6). The correlations between the concentrations of over-the-counter analgesics in peripheral blood versus vitreous fluid were poor, with acetaminophen exhibiting the best linearity (R2 = 0.72). The antiepileptic drugs (carbamazepine, phenytoin and phenobarbital) exhibited good correlations between peripheral blood and vitreous humor, with all exhibiting an R2 ≥ 0.95. Overall, we have demonstrated the potential of vitreous fluid as an alternative matrix for the detection of select acidic drugs.

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“…Over the years, VH has been successfully used in forensic casework, for illicit drugs and NPS testing. Several classic drugs of abuse have been detected in authentic VH specimens such as the following examples: ethanol [159,181,190], cocaine and its metabolites [155,164,166,172,176,181,[190][191][192], opioids and/or their metabolites [155,167,168,173,176,177,182,185,190], amphetamine and/ or methamphetamine [164,173,190], MDA derivatives [169], ketamine [172], phencyclidine [154,170], LSD and its metabolites [175], γ-hydroxybutyric acid [193], benzodiazepines [171,173,184,190], antidepressants [173,180,194,195] and barbiturates [196]. On the other hand, VH does not seem to be a good biological matrix for investigating cannabinoids [151].…”

Section: Vitreous Humormentioning

confidence: 99%

Alternative matrices in forensic toxicology: a critical review

et al. 2021

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Purpose The use of alternative matrices in toxicological analyses has been on the rise in clinical and forensic settings. Specimens alternative to blood and urine are useful in providing additional information regarding drug exposure and analytical benefits. The goal of this paper is to present a critical review on the most recent literature regarding the application of six common alternative matrices, i.e., oral fluid, hair, sweat, meconium, breast milk and vitreous humor in forensic toxicology. Methods The recent literature have been searched and reviewed for the characteristics, advantages and limitations of oral fluid, hair, sweat, meconium, breast milk and vitreous humor and its applications in the analysis of traditional drugs of abuse and novel psychoactive substances (NPS). Results This paper outlines the properties of six biological matrices that have been used in forensic analyses, as alternatives to whole blood and urine specimens. Each of this matrix has benefits in regards to sampling, extraction, detection window, typical drug levels and other aspects. However, theses matrices have also limitations such as limited incorporation of drugs (according to physical–chemical properties), impossibility to correlate the concentrations for effects, low levels of xenobiotics and ultimately the need for more sensitive analysis. For more traditional drugs of abuse (e.g., cocaine and amphetamines), there are already data available on the detection in alternative matrices. However, data on the determination of emerging drugs such as the NPS in alternative biological matrices are more limited. Conclusions Alternative biological fluids are important specimens in forensic toxicology. These matrices have been increasingly reported over the years, and this dynamic will probably continue in the future, especially considering their inherent advantages and the possibility to be used when blood or urine are unavailable. However, one should be aware that these matrices have limitations and particular properties, and the findings obtained from the analysis of these specimens may vary according to the type of matrix. As a potential perspective in forensic toxicology, the topic of alternative matrices will be continuously explored, especially emphasizing NPS.

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Comparative Study of Postmortem Concentrations of Antidepressants in Several Different Matrices

Cited by 26 publications

References 45 publications

Determination of Antidepressants and Antipsychotics in Dried Blood Spots (DBSs) Collected from Post-Mortem Samples and Evaluation of the Stability over a Three-Month Period

Determination of Antidepressants and Antipsychotics in Dried Blood Spots (DBSs) Collected from Post-Mortem Samples and Evaluation of the Stability over a Three-Month Period

Acidic Drug Concentrations in Postmortem Vitreous Humor and Peripheral Blood

Alternative matrices in forensic toxicology: a critical review

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