Suicide by hanging under the influence of ketamine and ethanol

Dinis-Oliveira, Ricardo Jorge; Carvalho, Félix; Duarte, José Alberto; Dias, Ricardo; Magalhães, Teresa; Santos, Agostinho

doi:10.1016/j.forsciint.2010.04.047

Cited by 21 publications

(12 citation statements)

References 35 publications

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“…It has been documented that adverse drug events may induce depression or other mental health conditions associated with suicidal thoughts or other forms of self-inflicted damage (Jaga and Dharmani, 2007 ; Andrew and Brenner, 2015 ). The particular case of adverse drug effects conducting to attempts of self inflicted hanging or suffocation has been documented in broad scenarios ranging from narcotics (Dinis-Oliveira et al, 2010 ) to antibiotics (Ahmed et al, 2011 ).…”

Section: Discussionmentioning

confidence: 99%

Comorbidity Networks in Cardiovascular Diseases

et al. 2020

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Background: Cardiovascular diseases are the leading causes of mortality worldwide. One reason behind this lethality lies in the fact that often cardiovascular illnesses develop into systemic failure due to the multiple connections to organismal metabolism. This in turn is associated with co-morbidities and multimorbidity. The prevalence of coexisting diseases and the relationship between the molecular origins adds to the complexity of the management of cardiovascular diseases and thus requires a profound knowledge of the genetic interaction of diseases. Objective: In order to develop a deeper understanding of this phenomenon, we examined the patterns of comorbidity as well as their genetic interaction of the diseases (or the lack of evidence of it) in a large set of cases diagnosed with cardiovascular conditions at the national reference hospital for cardiovascular diseases in Mexico. Methods: We performed a cross-sectional study of the National Institute of Cardiology. Socioeconomic information, principal diagnosis that led to the hospitalization and other conditions identified by an ICD-10 code were obtained for 34,099 discharged cases. With this information a cardiovascular comorbidity networks were built both for the full database and for ten 10-years age brackets. The associated cardiovascular comorbidities modules were found. Data mining was performed in the comprehensive ClinVar database with the disease names (as extracted from ICD-10 codes) to establish (when possible) connections between the genetic associations of the genetic interaction of diseases. The rationale is that some comorbidities may have a stronger genetic origin, whereas for others, the environment and other factors may be stronger. Results: We found that comorbidity networks are highly centralized in prevalent diseases, such as cardiac arrhythmias, heart failure, chronic kidney disease, hypertension, and ischemic diseases. Said comorbidity networks are actually modular on their connectivity. Modules recapitulate physiopathological commonalities, e.g., ischemic diseases clustering together. This is also the case of chronic systemic diseases, of congenital malformations and others. The genetic and environmental commonalities behind some of the relations in these modules were also found by resorting to clinical genetics databases and functional pathway enrichment studies. Conclusions: This methodology, hence may allow the clinician to look up for non-evident comorbidities whose knowledge will lead to improve therapeutically designs. By continued and consistent analysis of these types of patterns, we envisaged that it may be possible to acquire, strong clinical and basic insights that may further our advance toward a better understanding of cardiovascular diseases as a whole. Hopefully these may in turn lead to further development of better, integrated therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

Comorbidity Networks in Cardiovascular Diseases

et al. 2020

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“…If the high dose of KET was accompanied with ALC, the toxicity will be significantly increased. There have been some reports of the lethality from mixed-drug intoxication involving ALC and KET 19 , 20 . However, in most cases, the interplay between ALC and KET has not been fully characterized.…”

Section: Discussionmentioning

confidence: 99%

“…In fact, some KET consumers have been reported to combine KET with ALC. There is evidence for mixed-drug abuse intoxications involving KET and ALC 19 , 20 . In these cases, KET intoxication was considered as the main reason of death.…”

Section: Introductionmentioning

confidence: 99%

Alcohol amplifies ketamine-induced apoptosis in primary cultured cortical neurons and PC12 cells through down-regulating CREB-related signaling pathways

Zuo

Sun

Cui

et al. 2017

Sci Rep

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Recreational use of ketamine (KET) has been increasing worldwide. Previous studies have demonstrated that KET induced neurotoxicity; however, few studies have examined how alcohol (ALC) affects KET-induced neurotoxicity. In light of the fact that some KET abusers combine KET with ALC, the present study was aimed to investigate the effects of ALC on KET-induced neurotoxicity and the underlying mechanism in vitro. Our data revealed that co-treatment with ALC and KET was more detrimental to cell viability than KET single treatment in both PC12 cells and primary cultured rat cortical neurons. Furthermore, ALC exacerbated KET-induced apoptosis characterized by morphological changes and the sub-G1 phase increase, which were mitigated by the pretreatment of CNQX, a known alpha-amino-3-hydroxy-5-methyl-4-isoxazole propionate (AMPA)/kainite (KA) receptor antagonist. In addition, ALC and KET co-treatment led to intracellular Ca2+ overload, down-regulation of p-Akt, p-CREB, PKA, CaMK-IV, Bcl-2 and BDNF expression and up-regulation of cleaved caspase-3 and Bax expression, which can be attenuated by CNQX pretreatment. These results indicate that the potentiation of ALC on KET-induced neurotoxicity was related to the down-regulation of CREB-related pathways. Our present study also indicates that ALC and KET co-abuse might cause serious neurotoxicity which should be conveyed to the public and drew enough attention.

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“…Interestingly, oral dosing of ketamine was devoid of antisuicidal effects in patients with depression and anxiety and receiving hospice care [105]. Moreover, ketamine abuse, which is frequently via the oral route, with or without history of alcohol or drug abuse is known to sometimes lead to suicidal deaths [106][107][108][109]. Ironically, a recent report on the effect of subanaesthetic dose of ketamine on treatment-resistant major or bipolar depression patients suggested that absence of a history of suicide attempt is associated with the durability of antidepressant response [110].…”

Section: Ketamine and Suicidal Ideation In Clinical Studiesmentioning

confidence: 99%