Abstract:
:This paper reviews the complex pharmacology of the new class of antidepressant medications exhibiting selective inhibition of serotonin reuptake. The four selective serotonin reuptake inhibitors (SSRIs) considered--fluoxetine, fluvoxamine, sertraline and paroxetine--can result in toxicity and death through contributing to serotonergic excess resulting in serotonin syndrome, inhibiting the metabolism of other centrally acting drugs, leading to accumulation of toxic concentrations, and exerting complex vasoactive effects on the vascular smooth muscle. This latter feature is of particular concern in patients with preexisting heart disease. An analytical method involving isolation of the drugs by liquid/liquid extraction at alkaline pH into n-butyl chloride, and analysis by gas chromatography/mass spectrometry (GC/MS) is described, together with some of its limitations. Toxicologic and cause and manner of death data were examined in 60 deaths involving fluoxetine, 5 involving fluvoxamine, 75 involving sertraline, and 28 involving paroxetine. Deaths involving drug toxicity were generally a result of ingestion of multiple drugs, and in only a small number of the cases was death attributed principally to the SSRI involved. The potential for drug interactions between members of this class of drugs is discussed as well as their metabolites and a variety of other therapeutic and abused drugs which can contribute to their toxicity. In the absence of other risk factors, the lowest concentrations determined to have resulted in death were 0.63 mg/L for fluoxetine, 0.4 mg/L for paroxetine, and 1.5 mg/L for sertraline. We had insufficient data to make even this crude assessment for fluvoxamine. Drug-induced elevation of serotonin concentrations may be a significant risk factor for patients with atherosclerotic cardiovascular disease (ASCVD). Other factors including preexisting disease and the presence of other drugs and their pharmacology need to be carefully considered before determining the appropriate cause and manner of death in these cases.
journal_name
J Forensic Scijournal_title
Journal of forensic sciencesauthors
Goeringer KE,Raymon L,Christian GD,Logan BKkeywords:
subject
Has Abstractpub_date
2000-05-01 00:00:00pages
633-48issue
3eissn
0022-1198issn
1556-4029journal_volume
45pub_type
杂志文章,评审abstract::The development of less-lethal technologies has provided law enforcement personnel with an alternative to lethal force. Although the less lethal projectile was produced to engender non-penetrating wounds, case studies show that there have been a number of reported penetrating injuries ranging from minor to significant...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:2005-11-01 00:00:00
abstract::In the present study, the effects of amphetamine-class drugs were examined in cases reported to the Victorian coroner from 2001 to 2005 to determine if death can occur from the use of amphetamine-class drugs alone. A total of 169 cases were reviewed where a forensic autopsy detected amphetamine(s) in the blood. Pathol...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/j.1556-4029.2008.00949.x
更新日期:2009-03-01 00:00:00
abstract::Little is known about the effect of edaphic conditions on the decomposition of buried mammalian tissues. To address this, we set up a replicated incubation study with three fresh soils of contrasting pH: a Podsol (acidic), a Cambisol (neutral), and a Rendzina (alkaline), in which skeletal muscle tissue (SMT) of known ...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/j.1556-4029.2009.01070.x
更新日期:2009-07-01 00:00:00
abstract::Positive identification of human remains is often achieved by comparing antemortem and postmortem radiographs. Usually, radiographs contain a number of markers that can serve as reference for comparison, one of these markers is the trabecular bone pattern depicted in the roentgenograms. In the present case, densitomet...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:1994-09-01 00:00:00
abstract::The fingernails of Mary Sullivan, the last victim of the Boston Strangler, were examined to determine if any genetic information about the murderer could be obtained. The nails were extremely friable necessitating the development of new techniques for isolating and purifying DNA. DNA yields from nails were optimized b...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:2003-03-01 00:00:00
abstract::The body of an unidentified elderly woman was found trapped in a floodgate. Prior to autopsy, full-body multislice computed tomography (MSCT) was performed for study of bone lesions and cause of death. Age was estimated by analysis of the sternal end of the fourth rib and of the pubic symphyseal medial articular surfa...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/j.1556-4029.2007.00475.x
更新日期:2007-07-01 00:00:00
abstract::Attenuated total reflection (ATR) is a convenient mode for single fiber analysis by infrared microspectroscopy, particularly when transmission spectra are difficult to obtain or when surface preferenced sampling is desirable. Textile finishes such as spin finishes, anti-static finishes, and permanent press finishes ar...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:2001-11-01 00:00:00
abstract::Skin detail of the hand is used in photographic comparisons, yet its reliability has not been evaluated. This study examines a count-based method for documenting skin features. In Part I, 14 individuals counted skin features on 40 color images of the hand, three of which were repeated. An average correlation value of ...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/1556-4029.12824
更新日期:2015-11-01 00:00:00
abstract::Allele frequencies for six PCR-based loci and three protein-based (i.e., enzyme systems) loci were determined in a Caucasian sample population from New Jersey. The loci are LDLR, GYPA, HBGG, D7S8, Gc, HLA-DQA1, PGM1, ESD, and EAP. All loci meet Hardy-Weinberg expectations. In addition, there is little evidence for ass...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:1997-03-01 00:00:00
abstract::Sodium and potassium cyanide are highly toxic, produced in large amounts by the chemical industry, and linked to numerous high-profile crimes. The U.S. Centers for Disease Control and Prevention has identified cyanide as one of the most probable agents to be used in a chemical terrorism event. We investigated whether ...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/j.1556-4029.2011.01946.x
更新日期:2012-01-01 00:00:00
abstract::Traditionally, the manner of death in most hospital autopsy cases is natural, in which death is due to the natural course of disease or reasonably anticipated outcomes of medical interventions. Some cases fall into a potential gray zone between natural and accident, including rare or unanticipated outcomes of medical ...
journal_title:Journal of forensic sciences
pub_type:
doi:10.1111/1556-4029.13844
更新日期:2019-01-01 00:00:00
abstract::Since forensic facial approximations are used to promote recognition of a deceased person, an accurate forensic facial approximation (FFA) should be easily recognized as the person to whom the skull belonged (target individual). However, the accuracy of FFAs has been previously assessed by the direct comparison of an ...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:2002-03-01 00:00:00
abstract::Human gender identification, based on the amelogenin gene, has important applications in forensic casework, prenatal diagnosis, DNA databasing, and blood sample storage. However, we report on the first known case, in the Israeli population, of an amelogenin sex test failure on a phenotypically normal male. He was type...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:2004-03-01 00:00:00
abstract::Isolated death (ID) (i.e., dying alone without anyone noticing for several days) has been suggested to be related to social isolation, mental disorder, and alcohol and/or drug abuse. A major transfer of patients with a mental disorder and/or alcohol and/or drug abuse from institutionalized care to treatment as outpati...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:2004-03-01 00:00:00
abstract::The delusional misidentification syndromes are characterized by a misidentification delusion of the self and/or others. Delusional misidentification syndromes frequently occur in psychotic disorders such as schizophrenia, psychotic disorder due to general medical condition, or psychotic disorder not otherwise specifie...
journal_title:Journal of forensic sciences
pub_type: 杂志文章,评审
doi:
更新日期:1997-07-01 00:00:00
abstract::Jet-propelled personal watercraft (PWC) or jet-skis have become increasingly popular. The means of propulsion of PWC, which is a jet of water forced out of small nozzle at the rear of the craft, combined with a high risk of falling off of the seat and into close proximity with the water jet stream, raise the potential...
journal_title:Journal of forensic sciences
pub_type: 杂志文章,评审
doi:10.1111/j.1556-4029.2012.02250.x
更新日期:2013-01-01 00:00:00
abstract::While the mitochondrial control region has proven successful for human forensic evaluations by indicating ethnic origin, domestic dogs (Canis lupus familiaris) of seemingly unrelated breeds often form large groups based on identical control region sequences. In an attempt to break up these large haplotype groups, we h...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/j.1556-4029.2008.00952.x
更新日期:2009-03-01 00:00:00
abstract::The same-source problem remains a major challenge in forensic toolmark and firearm examination. Here, we investigate the applicability of the Chumbley method (J Forensic Sci, 2018, 63, 849; J Forensic Sci, 2010, 55, 953) (10,12), developed for screwdriver markings, for same-source identification of striations on bulle...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/1556-4029.13950
更新日期:2019-05-01 00:00:00
abstract::Human erythrocyte peptidase A (Pep A) displays a genetic polymorphism in blacks. Its occurrence in human semen was examined for its possible use as a semen typing system. Studies by starch gel electrophoresis, in which the Pep A was located by an improved method, were carried out on semen, semen stains, and vaginal sw...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:1981-04-01 00:00:00
abstract::A sensitive and reliable method for extraction and quantification of benzoylecgonine (BZE) and cocaine (COC) in urine is presented. Propyl-chloroformate was used as derivatizing agent, and it was directly added to the urine sample: the propyl derivative and COC were then recovered by liquid-liquid extraction procedure...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/1556-4029.12880
更新日期:2015-09-01 00:00:00
abstract::This study evaluated both site dependent differences and time dependent changes in postmortem morphine concentrations in man. In 32 deaths involving morphine, left ventricular blood, femoral blood, and cisternal cerebrospinal fluid, were collected as soon after death as possible (T1), and collected again together with...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:1996-03-01 00:00:00
abstract::A simple, rapid radioimmunoassay employing 125-I-labeled secobarbital derivative has been developed and has been shown to be capable of detecting at the nanogram level a variety of barbiturates in urine as well as in plasma. ...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:1975-01-01 00:00:00
abstract::Continuous monitoring of existing methods of skeletal diagnosis allows improving the reliability of personal identification in forensic and archaeological contexts. This study reports on a blind test re-evaluating the sexing technique proposed by Rogers (8) involving the distal humerus. A total of 351 humeri (184 male...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:2005-11-01 00:00:00
abstract::Moderate to high levels of alcohol decrease brain intracellular free magnesium concentration, a factor known to be critical in brain injury. Phosphorus magnetic resonance spectroscopy was used to examine changes to brain free magnesium concentration after blunt cranial trauma in alcohol-intoxicated rats. Rats exposed ...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/j.1556-4029.2012.02108.x
更新日期:2012-07-01 00:00:00
abstract::The association between perpetration of sexual abuse and the offender's own victimization as a child has been well documented in the literature. Various researchers have examined this relationship by assessing the exclusiveness of the sexual abuser's behavior, the gender of his victims and the gender of his own childh...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:
更新日期:1993-03-01 00:00:00
abstract::A considerable amount of discussion can be found in the forensics literature about the issue of using statistical sampling to obtain for chemical analyses an appropriate subset of units from a police seizure suspected to contain illicit material. Use of the Bayesian paradigm has been suggested as the most suitable sta...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/j.1556-4029.2011.01930.x
更新日期:2012-01-01 00:00:00
abstract::Unclaimed dead are deceased persons with no known next of kin (NoK) or NoK was located but did not claim the deceased. Unclaimed dead in Marion County, Indiana, 2004-2011, are examined. Comparisons are provided of the unclaimed to the claimed dead population and county death patterns. Race, gender, marital status, age...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/1556-4029.12973
更新日期:2016-01-01 00:00:00
abstract::For the past 10 years, medical imaging techniques have been increasingly applied to forensic investigations. To obtain histological and toxicological information, tissue and liquid samples are required. In this article, we describe the development of a low-cost, secure, and reliable approach for a telematic add-on for...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/j.1556-4029.2011.01990.x
更新日期:2012-03-01 00:00:00
abstract::Elevators are mechanical transportation devices used to move vertically between different levels of a building. When first developed, elevators lacked the safety features. When safety mechanisms were developed, elevators became a common feature of multistory buildings. Despite their well-regarded safety record, elevat...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/1556-4029.14235
更新日期:2020-05-01 00:00:00
abstract::The estimation of postmortem interval (PMI) based on successional patterns of adult insects is largely limited, due to the lack of potential PMI markers. Sex and size of adult insects could be easily used for such estimation. In this study, sex- and size-related patterns of carrion attendance by adult insects were ana...
journal_title:Journal of forensic sciences
pub_type: 杂志文章
doi:10.1111/1556-4029.13376
更新日期:2017-09-01 00:00:00