Bupropion and alcohol fatal intoxication: case report

Area of Science:

• Forensic Toxicology
• Analytical Chemistry
• Pharmacology

Background:

• Bupropion is an antidepressant medication.
• Ethanol is a common central nervous system depressant.
• Co-ingestion of substances can lead to complex toxicological outcomes.

Observation:

• A fatality case involving bupropion and ethanol ingestion was investigated.
• Bupropion and its metabolites were identified and quantified in various biological samples.
• Gas chromatography with nitrogen-phosphorus and mass spectrometry detection was employed.

Findings:

• High concentrations of bupropion (4.2 mg/l), hydroxybupropion (5.0 mg/l), and alcohol metabolites (0.6 and 4.6 mg/l) were detected in heart blood.
• Significant blood ethanol concentration (0.27 g/dl) was measured.
• Bupropion distribution was noted in subclavian blood (6.2 mg/l), bile (1.4 mg/l), kidney (2.4 mg/l), liver (1.0 mg/kg), stomach contents (16 mg), and urine (37 mg/l).

Implications:

• This case highlights the potential for severe toxicity and fatality from combined bupropion and ethanol use.
• Accurate toxicological analysis is crucial for determining cause of death in complex poisoning cases.
• Understanding bupropion pharmacokinetics and distribution in fatal overdose scenarios is important for forensic science.