Suicide by hanging under the influence of ketamine and ethanol.
Psychiatric deviations resulting from alcohol and illegal drug abuse may be considered a major risk factor for suicidal behavior. This report describes a suicide by hanging, under the influence of ketamine and alcohol. The victim was a 29-year-old man, found dead hanging by the neck from a metallic beam in the ceiling of his workplace. Besides characteristic signs of hanging seen at the autopsy, toxicological analysis revealed a femoral blood concentration of ketamine and ethanol of 1.3mg/L and 0.66g/L, respectively. Positive qualitative results for ketamine were also detected, in a powder found near the victim and on the victim's nostrils, which suggests nasal inhaling as administration route. The hallucinogenic effects caused by ketamine, associated with an increased sensitivity of N-methyl-d-aspartate (NMDA) receptors to ketamine as result of the previous history of alcoholism should be considered as potential inducing factors in suicide behaviors.
Dinis-Oliveira
Ricardo Jorge
RJ
Faculty of Medicine, University of Porto, Porto, Portugal. ricardinis@sapo.pt
Carvalho
Félix
F
Duarte
José Alberto
JA
Dias
Ricardo
R
Magalhães
Teresa
T
Santos
Agostinho
A
D000328:Adult; D000778:Anesthetics, Dissociative / Q000009:adverse effects / Q000097:blood; D001237:Asphyxia / Q000473:pathology*; D020212:Carotid Artery Injuries / Q000473:pathology; D017536:Carotid Artery, Common / Q000473:pathology; D002492:Central Nervous System Depressants / Q000009:adverse effects / Q000097:blood; D000431:Ethanol / Q000009:adverse effects* / Q000097:blood; D049429:Forensic Pathology; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D007649:Ketamine / Q000009:adverse effects* / Q000097:blood; D008297:Male; D019838:Neck Injuries / Q000473:pathology*; D019966:Substance-Related Disorders / Q000150:complications; D013405:Suicide
D000778:Anesthetics, Dissociative; D002492:Central Nervous System Depressants; D000431:Ethanol; D007649:Ketamine