Carbamazepine Overdose after Psychiatric Conditions: A Case Study for Postmortem Analysis in Human Bone

Area of Science:

• Forensic Toxicology
• Pharmacology
• Analytical Chemistry

Background:

• Carbamazepine is a key preventive medication for bipolar disorder, often used when lithium is ineffective.
• Carbamazepine toxicity is a concern, with specific serum level thresholds indicating potential danger.
• Accurate post-mortem drug quantification is crucial for forensic investigations, particularly when only bone samples are available.

Purpose of the Study:

• To validate a tool for detecting and quantifying carbamazepine concentrations in bone tissue.
• To establish a reliable method for post-mortem carbamazepine analysis in forensic cases.
• To support investigations into suicide or adverse drug reactions (ADR) involving carbamazepine.

Main Methods:

• Validation of a novel analytical tool for drug detection in bone.
• Quantification of carbamazepine levels using mass spectrometry.
• Analysis of bone samples from forensic cases.

Main Results:

• The study successfully validated a tool for detecting and quantifying carbamazepine in bone.
• A distinct carbamazepine peak was observed at minute 12 with a mass fragment of 193 m/z.
• This marks the first documented instance of carbamazepine detection and quantification in bone tissue in forensic science.

Conclusions:

• Carbamazepine can be reliably detected and quantified in bone tissue from forensic cases.
• The developed method is valid, reliable, and trustworthy for post-mortem carbamazepine analysis.
• This technique offers a valuable tool for forensic investigations, aiding in the determination of death causes.