title: A fatal intoxication related to MDPV and pentedrone combined with antipsychotic and antidepressant substances in Cyprus.
abstract: This is a case report of a fatal intoxication in Cyprus related to 3,4-methylenedioxypyrovalerone (MDPV) and 2-(methylamino)-1-phenylpentan-1-one (pentedrone) intake combined with antipsychotic and antidepressant substances. A 42- year old man with a history of serious psychiatric illness was found unresponsive in his bed. Seized materials were also found close to his body. The forensic autopsy reported myocardial infarction due to multidrug intoxication. Toxicology screening in blood and urine was applied. Biological specimens were analysed by enzyme immunoassay procedure and GC/MS. MDPV, pentedrone and etizolam detected and quantitated in blood and urine. Other drugs quantitated in blood were also olanzapine, mirtazapine, and ephedrine. This was the first fatal case reported in Cyprus associated with new psychoactive substances. Additionally, this was the first case reported to Early Warning System of the European Monitoring Center of Drugs and Drug Abuse (EMCDDA), related to multidrug intoxication, attributed to the consumption of cathinones, designer benzodiazepines, and other drugs.
authors.affiliation: Department of Forensic Chemistry and Toxicology of the State General Laboratory of Ministry of Health, Nicosia 1451, Cyprus. Electronic address: kliveri@sgl.moh.gov.cy.
authors.forename: Katerina
authors.initials: K
authors.lastname: Liveri
authors.affiliation: Department of Forensic Chemistry and Toxicology of the State General Laboratory of Ministry of Health, Nicosia 1451, Cyprus.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Constantinou
authors.affiliation: Department of Forensic Chemistry and Toxicology of the State General Laboratory of Ministry of Health, Nicosia 1451, Cyprus.
authors.forename: Maria
authors.initials: M
authors.lastname: Afxentiou
authors.affiliation: Department of Forensic Chemistry and Toxicology of the State General Laboratory of Ministry of Health, Nicosia 1451, Cyprus.
authors.forename: Popi
authors.initials: P
authors.lastname: Kanari
mesh_terms: D000328:Adult; D000928:Antidepressive Agents / Q000097:blood / Q000506:poisoning; D014150:Antipsychotic Agents / Q000097:blood / Q000506:poisoning; D052117:Benzodioxoles / Q000097:blood / Q000506:poisoning; D003535:Cyprus; D017809:Fatal Outcome; D053593:Forensic Toxicology; D006801:Humans; D008297:Male; D008744:Methylamines / Q000097:blood / Q000506:poisoning; D010422:Pentanones / Q000097:blood / Q000506:poisoning; D011041:Poisoning / Q000097:blood / Q000175:diagnosis*; D011759:Pyrrolidines / Q000097:blood / Q000506:poisoning; D000094982:Synthetic Cathinone
chemical_list: D000928:Antidepressive Agents; D014150:Antipsychotic Agents; D052117:Benzodioxoles; D008744:Methylamines; D010422:Pentanones; D011759:Pyrrolidines; C572410:pentedrone; D000094982:Synthetic Cathinone
keywords: Bath salts; Designer benzodiazepines; Gas chromatography-mass spectrometry; Multidrug intoxication; Postmortem