Suicidal intoxication by the ingestion of over-the-counter caffeine pills

We herein describe a suicidal death due to the excessive ingestion of over-the-counter caffeine pills. A female in her 20 s with psychiatric disorders was found dead at her home. A crime scene investigation by police revealed 18 empty sheets, corresponding to ca. 20 g of caffeine, in her room. Forensic autopsy showed that there were neither lethal injuries nor pathological lesions in any organ. In the stomach, there was dark brown-colored food debris weighing 180 g without any tablets. Toxicological analyses revealed that caffeine concentrations in intracardiac and peripheral blood samples reached fatal levels. Therefore, the cause of death was diagnosed as acute caffeine intoxication. To the best of our knowledge, autopsy case reports from caffeine intoxication are rare; however, the risk of caffeine intoxication has increased due to the easy availability of caffeine products. This case report compels governments to restrict the purchase of caffeine at drugstores or through e-markets.