Suicide by skull stab wounds: a case of drug-induced psychosis.
Suicide by stabbing to the head and/or driving sharp objects into the skull is of extreme rarity. This article reports the case of a 27-year-old man, who committed suicide by multiple knife stabs and cuts to the head, the torso, one shoulder and the forearms. Autopsy showed a perforating wound of the skull and the 10-cm long broken blade of the knife being still embedded in the right temporal lobe of the brain. The deceased had no history of psychiatric illness but was currently treated by mefloquine, a quinine derivative associated with a high rate of psychiatric adverse effects. Toxicological examination confirmed a recent intake of mefloquine together with chloroquine, another antimalarial drug. To our knowledge, this is the first report of a completed suicide with very strong evidence of mefloquine implication. Discussion focuses upon mefloquine-induced psychiatric disorders and highlights the importance of performing toxicological investigations in cases of unusual suicides.
Service de Médecine Légale, CHU d'Angers, Faculté de Médecine, INSERM U 922 LHEA, Angers Cedex, France.
Nathalie
N
Jousset
Clotilde
C
Rougé-Maillart
Alain
A
Turcant
Michel
M
Guilleux
Anne
A
Le Bouil
Antoine
A
Tracqui
D000328:Adult; D000962:Antimalarials / Q000009:adverse effects* / Q000032:analysis; D001134:Arm Injuries / Q000473:pathology; D002738:Chloroquine / Q000009:adverse effects / Q000032:analysis; D053593:Forensic Toxicology; D005766:Gastrointestinal Contents / Q000737:chemistry; D020197:Head Injuries, Penetrating / Q000473:pathology* / Q000523:psychology; D006801:Humans; D008297:Male; D015767:Mefloquine / Q000009:adverse effects* / Q000032:analysis; D011605:Psychoses, Substance-Induced / Q000150:complications*; D012782:Shoulder / Q000473:pathology; D000070599:Shoulder Injuries; D013405:Suicide; D013702:Temporal Lobe / Q000293:injuries / Q000473:pathology; D014951:Wounds, Stab / Q000473:pathology* / Q000523:psychology
D000962:Antimalarials; D002738:Chloroquine; D015767:Mefloquine