Comparative Study of Postmortem Concentrations of Antidepressants in Several Different Matrices

Area of Science:

• Forensic Toxicology
• Analytical Chemistry
• Postmortem Medicine

Background:

• Peripheral blood is the gold standard for postmortem drug concentration analysis.
• Antidepressants are frequently encountered in forensic toxicology.
• Limited literature exists on antidepressant concentrations in matrices other than peripheral and heart blood.

Purpose of the Study:

• To compare antidepressant concentrations across six different postmortem matrices.
• To evaluate the utility of alternative matrices when peripheral blood is unavailable.
• To compile ratios of drug concentrations between peripheral blood and other matrices.

Main Methods:

• Analysis of 173 postmortem cases, with detailed results from 44 cases involving antidepressants.
• Comparison of antidepressant concentrations in peripheral blood, cardiac blood, pericardial fluid, two muscle samples, and vitreous humor.
• Compilation of concentration ratios from existing literature.

Main Results:

• All investigated antidepressants were detected in all matrices, with generally comparable concentration levels.
• Vitreous humor concentrations were typically lower than other matrices; some antidepressants were undetectable in vitreous humor when blood concentrations were low.
• Ratios between peripheral blood and other matrices generally ranged from 0.5 to 2, with some exceptions.

Conclusions:

• Cardiac blood, pericardial fluid, muscle, and vitreous humor can offer valuable insights into peripheral blood antidepressant concentrations.
• These alternative matrices are crucial for determining cause of death when peripheral blood is inaccessible.
• The findings support the use of alternative matrices in postmortem forensic toxicology.