title: Death due to asphyxia linked to antipsychotic drugs.
abstract: A 46-year-old man with schizophrenia, died in hospital. Autopsy revealed numerous facial injuries and the direct cause of death was apparently asphyxia as a large amount of coagulated blood was present in the lower part of the trachea and bronchi. The blood derived from a lacerated wound of the mouth. The question was raised as to why expectoration was impossible and a toxicological analysis was directed to the antipsychotic drugs allegedly prescribed by doctors at the hospital. Using gas chromatography and gas chromatography/mass spectrometry, four different antipsychotic drugs including chlorpromazine, levomepromazine, zotepine and haloperidol were identified in the whole blood and tissues with concentrations being 1.91, 0.75, 0.61 and 0.48 micrograms/g in the blood, respectively. These levels were toxic to the extent that he could not expectorate and blood accumulating in the airway led to asphyxia and death.
authors.affiliation: Department of Forensic Medicine, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
authors.forename: N
authors.initials: N
authors.lastname: Jitsufuchi
authors.forename: T
authors.initials: T
authors.lastname: Nagata
authors.forename: K
authors.initials: K
authors.lastname: Kudo
authors.forename: T
authors.initials: T
authors.lastname: Imamura
authors.forename: H
authors.initials: H
authors.lastname: Tokunaga
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D001237:Asphyxia / Q000139:chemically induced*; D017809:Fatal Outcome; D005554:Forensic Medicine; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D012559:Schizophrenia / Q000188:drug therapy
chemical_list: D014150:Antipsychotic Agents