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Antipsychotics - Postmortem fatal and non-fatal reference concentrations
Karolinska Institute, Sweden; National Board Forens Med, Department Forens Med, Artillerigatan 12, S-58758 Linkoping, Sweden.
National Board Forens Med, Department Forens Med, Artillerigatan 12, S-58758 Linkoping, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. National Board Forens Med, Department Forens Genet and Forens Chemistry, Artillerigatan 12, S-58758 Linkoping, Sweden.
St Olavs University Hospital, Norway; Norwegian University of Science and Technology, Norway.
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2016 (English)In: Forensic Science International, ISSN 0379-0738, E-ISSN 1872-6283, Vol. 266, 91-101 p.Article in journal (Refereed) Published
Abstract [en]

Making the diagnosis fatal intoxication is a challenging task for the forensic pathologist and toxicologist, particularly when the cases involve substances where reference information is scarce or not at all available. This study presents postmortem femoral blood concentrations for 24 antipsychotic substances, based on samples collected and analyzed from 4949 autopsy cases in Sweden during 1992-2010. In addition our study provides information about the prevalence of different antipsychotics in accidental, suicidal, homicidal and uncertain deaths. The data have been selected and evaluated according to strict inclusion and exclusion criteria as well as a manual, multi-reviewer, case-by-case evaluation. The reference information is subdivided into intoxications by one specific substance only (group A, n = 259), multi-substance intoxications (group B, n = 614) and postmortem controls, consisting of deaths not involving incapacitation by substances (group C, n = 507). Moreover, the results are compared with data based on therapeutic drug monitoring, and data collected from driving under the influence cases. Median concentrations in group A were significantly higher than in group C for all substances evaluated. For 17 of 24 substances, the median concentrations in group B were significantly higher than in group C. In general, the therapeutic drug monitoring and driving under the influence concentrations were similar to, or lower than, the concentrations in group C. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

Place, publisher, year, edition, pages
ELSEVIER IRELAND LTD , 2016. Vol. 266, 91-101 p.
Keyword [en]
Antipsychotics; Forensic toxicology; Intoxication; Postmortem; Blood
National Category
Forensic Science
Identifiers
URN: urn:nbn:se:liu:diva-132683DOI: 10.1016/j.forsciint.2016.05.002ISI: 000386334600033PubMedID: 27236367OAI: oai:DiVA.org:liu-132683DiVA: diva2:1048193
Note

Funding Agencies|Centre for Forensic Sciences at Linkoping University

Available from: 2016-11-21 Created: 2016-11-18 Last updated: 2016-11-21

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Tillmar, AndreasKronstrand, RobertReis, Margareta
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