A Fatality Related to Two Novel Hallucinogenic Compounds: 4-Methoxyphencyclidine and 4-Hydroxy-N-methyl-N-ethyltryptamine.
In this case report, we present an evaluation of postmortem concentration distribution of the hallucinogenic compound 4-methoxyphencyclidine (4-MeO-PCP) in a fatality principally attributed to this drug. Another hallucinogen, 4-hydroxy-N-methyl-N-ethyltryptamine was also detected, but was not quantitated. A man--who had a history of recent 'strange' behavior--was found deceased, on his bed, in his locked room. Toxicology testing, which initially screened positive for phencyclidine (PCP) by ELISA, subsequently detected and confirmed the two hallucinogens by gas chromatography-mass spectrometry. 4-MeO-PCP concentrations were then quantified by a specific secondary testing technique. The peripheral blood concentration was 8.2 mg/L compared with the central blood concentration of 14 mg/L. The liver concentration was 120 mg/kg, the vitreous was 5.1 mg/L, the urine was 140 mg/L and the gastric contents contained 280 mg. PCP was not detected, but therapeutic concentrations of venlafaxine, olanzapine, lorazepam and hydroxyzine were confirmed. The cause of death was certified due to acute mixed drug intoxication, and the manner of death was certified as accident.
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA iain.mcIntyre@sdcounty.ca.gov.
Iain M
IM
McIntyre
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA.
Amber
A
Trochta
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA.
Ray D
RD
Gary
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA.
Alina
A
Storey
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA.
Jennifer
J
Corneal
County of San Diego Medical Examiner's Office, 5570 Overland Ave., Suite 101, San Diego, CA 92123, USA.
Bethann
B
Schaber
D001344:Autopsy; D001569:Benzodiazepines / Q000032:analysis; D002423:Cause of Death; D002851:Chromatography, High Pressure Liquid; D062787:Drug Overdose / Q000175:diagnosis*; D017809:Fatal Outcome; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006213:Hallucinogens / Q000032:analysis / Q000506:poisoning*; D006801:Humans; D006919:Hydroxyzine / Q000032:analysis; D013287:Illicit Drugs / Q000032:analysis / Q000506:poisoning; D008140:Lorazepam / Q000032:analysis; D008297:Male; D008875:Middle Aged; D000077152:Olanzapine; D010622:Phencyclidine / Q000032:analysis / Q000506:poisoning*; D015813:Substance Abuse Detection; D000069470:Venlafaxine Hydrochloride / Q000032:analysis
D006213:Hallucinogens; D013287:Illicit Drugs; D001569:Benzodiazepines; D006919:Hydroxyzine; D000069470:Venlafaxine Hydrochloride; D010622:Phencyclidine; D000077152:Olanzapine; D008140:Lorazepam