Seltene Todesursache bei Schizophrenie und Alkoholkrankheit

Postmortem findings of pipamperone after fatal intoxications and its distribution in body fluids and tissues

“…The concentrations of all additionally proven drugs were lower than the toxic range listed by Schulz et al, even considering that blood concentrations differ from plasma concentrations and therefore the additionally proven drugs had probably no significant impact on the fatal intoxication except clozapine in Case 3 . Apart from this, there will be a higher risk for intoxication by pipamperone if there is a “concurrent use of one or more drugs known to cause prolongation of the QT interval.” According to the package inserts of the additionally proven drugs, QT interval prolongation is not cited as a side effect.…”

“…12,23 Apart from this, there will be a higher risk for intoxication by pipamperone if there is a "concurrent use of one or more drugs known to cause prolongation of the QT interval." 10,11 According to the package inserts of the additionally proven drugs, QT interval prolongation is not cited as a side effect.…”

“…In clinical and forensic‐toxicological investigations, pipamperone was proven successfully in plasma, cerebrospinal fluid, several postmortem and exhumed material, especially by liquid chromatography−tandem mass spectrometry (LC–MS/MS) . Furthermore, an LC–MS/MS method for several postmortem materials was successfully validated .…”

“…[5][6][7] Non-fatal as well as fatal intoxications, which are related to therapeutic up to toxic concentrations of pipamperone, may be triggered by drug-drug interactions. [8][9][10][11] Furthermore, Bont et al reported a non-fatal pipamperone intoxication in which the determined serum concentration of 3.2 μg/mL was highly above the known toxic concentration range of 0.5-0.6 μg/mL. 6,12 Another non-fatal intoxication was caused by the intake of 2000 mg pipamperone.…”

“…In clinical and forensic-toxicological investigations, pipamperone was proven successfully in plasma, cerebrospinal fluid, several postmortem and exhumed material, especially by liquid chromatography −tandem mass spectrometry (LC-MS/MS). 8,11,13,14 Furthermore, an LC-MS/MS method for several postmortem materials was successfully validated. 15 In this context, the results obtained for postmortem and exhumed material need to be questioned because postmortem redistribution may lead to concentration alterations after death.…”