Fatal acute intoxication after snorting cocaine and fluoxetine

IF 1.3 4区医学 Q3 MEDICINE, LEGAL

Legal Medicine Pub Date : 2025-04-01 DOI:10.1016/j.legalmed.2025.102614

Alberto Chighine, Giulio Ferino, Matteo Nioi, Ernesto d’Aloja, Emanuela Locci

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Abstract

A case report of a fatal acute intoxication following cocaine and fluoxetine snorting is described here. A 44-year-old woman with an history of drug abuse was found dead at home. On-site evaluation conducted by police highlighted evidence of recent cocaine consumption whereas no tablets or drug blisters were spotted. In the hypothesis of a drug-related crime the local Prosecutor ordered a judicial autopsy.

Pathological findings were consistent with an acute cardiac failure while toxicological analysis conducted on blood revealed the presence of fluoxetine and cocaine in reportedly fatal concentrations. A blood alcohol concentration of 1.9 g/L was also detected. Nasal swabs were positive for both fluoxetine and cocaine whereas no sign of tablets was spotted in the stomach, which appeared empty.

Death was hence ascribed to an acute cardiac failure secondary to fluoxetine and cocaine intoxication. To the best of the authors knowledge, this is the first post-mortem report of fluoxetine and its active metabolite norfluoxetine in fatal concentrations following intake by snorting.

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来源期刊

Legal Medicine Nursing-Issues, Ethics and Legal Aspects

CiteScore

2.80

自引率

6.70%

发文量

119

审稿时长

7.9 weeks

期刊介绍： Legal Medicine provides an international forum for the publication of original articles, reviews and correspondence on subjects that cover practical and theoretical areas of interest relating to the wide range of legal medicine. Subjects covered include forensic pathology, toxicology, odontology, anthropology, criminalistics, immunochemistry, hemogenetics and forensic aspects of biological science with emphasis on DNA analysis and molecular biology. Submissions dealing with medicolegal problems such as malpractice, insurance, child abuse or ethics in medical practice are also acceptable.