title: Detection of amitriptyline, nortriptyline and bromazepam in liver, CSF and hair in the homicidal poisoning of a one-month-old girl autopsied 8 months after death.
abstract: We reported on the death by poisoning of a one-month-old baby that had followed the death of one of her sister (due to cyamemazine overdose). Exhumation of the corpse was done 8 months after burial and revealed the presence of amitriptyline. Parent drug and its metabolite were analysed by HPLC-MS/MS in positive ionisation mode on a C(18) analytical column using a gradient of acetonitrile and 2mM formate buffer at pH=3. Quantification is based on the main ion m/z=233, the common product ion of nortriptyline (MH(+), m/z 264), amitriptyline (MH(+), m/z 278) and nortriptyline D3 used as internal standard (MH(+), m/z 267). Amitriptyline and nortriptyline in the liver were measured at a concentration of 29.8 and 3.6 μg/g, respectively. Hair analyses revealed the presence of amitriptyline and nortriptyline at concentrations of 1811 and 43 pg/mg, respectively, while complementary analyses showed the presence of bromazepam in the hair at a concentration of 740 pg/mg, thus documenting previous administrations. The mother confessed later having used the drinkable form of the pharmaceutical LAROXYL(®) by pouring the content of a 20 ml bottle (at 40 mg/ml) into the feeding-bottle of her child. The milk was sweet but still bitter and following the testimony of a close relative, the whole family helped to feed the crying baby.
authors.affiliation: LAT LUMTOX: Laboratory of Analytical Toxicology, 800 avenue Marie Curie, 07800 La Voulte sur Rhône, France. y.gaillard@latlumtox.com
authors.forename: Yvan
authors.initials: Y
authors.lastname: Gaillard
authors.forename: Rémi
authors.initials: R
authors.lastname: Breuil
authors.forename: Christophe
authors.initials: C
authors.lastname: Doche
authors.forename: Ludovic
authors.initials: L
authors.lastname: Romeuf
authors.forename: Catherine
authors.initials: C
authors.lastname: Lemeur
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Prevosto
authors.forename: Laurent
authors.initials: L
authors.lastname: Fanton
mesh_terms: D000639:Amitriptyline / Q000032:analysis* / Q000506:poisoning; D014151:Anti-Anxiety Agents / Q000032:analysis / Q000506:poisoning; D000929:Antidepressive Agents, Tricyclic / Q000032:analysis* / Q000506:poisoning; D001960:Bromazepam / Q000032:analysis / Q000506:poisoning; D002853:Chromatography, Liquid; D049249:Exhumation; D005260:Female; D053593:Forensic Toxicology; D006197:Hair / Q000737:chemistry; D006708:Homicide; D006801:Humans; D007231:Infant, Newborn; D008099:Liver / Q000737:chemistry; D013058:Mass Spectrometry; D009661:Nortriptyline / Q000032:analysis / Q000506:poisoning; D011041:Poisoning / Q000175:diagnosis*
chemical_list: D014151:Anti-Anxiety Agents; D000929:Antidepressive Agents, Tricyclic; D000639:Amitriptyline; D009661:Nortriptyline; D001960:Bromazepam