Abstract
Most cases of ecstasy overdose turn out to be accidental, whereas suicide attempts with designer drugs occur only sporadically. We report an announced suicide by means of a combination of 3,4-methylenedioxymethamphetamine (MDMA) and 3,4-methylenedioxyethylamphetamine (MDEA). During autopsy, sampling for toxicological investigation (peripheral blood, urine, cerebrospinal fluid, bile and gastric contents) occurred. Serum concentrations as high as 13.33 mg/l for MDMA, 7.32 mg/l for MDEA and 0.43 mg/l for 3,4-methylenedioxyamphetamine were found. Ecstasy tablets, which were confiscated by the police a few days earlier, showed also a combination of MDMA and MDEA. This fact suggests that the ingested tablets probably came from the same source as the seized pills.
References
Kalant H (2001) The pharmacology and toxicology of “ecstasy” (MDMA) and related drugs. CMAJ 165:917–928
De Letter EA, Espeel MF, Craeymeersch ME et al (2003) Immunohistochemical demonstration of the amphetamine derivatives 3,4-methylenedioxymethamphetamine (MDMA) and 3,4-methylenedioxyamphetamine (MDA) in human post-mortem brain tissues and the pituitary gland. Int J Legal Med 117:2–9
Arimany J, Medallo J, Pujol A, Vingut A, Borondo JC, Valverde JL (1998) Intentional overdose and death with 3,4-methylenedioxyethamphetamine (MDEA; “Eve”): case report. Am J Forensic Med Pathol 19:148–151
Hinkelbein J, Gabel A, Volz M, Ellinger K (2003) Suicide attempt with high-dose ecstasy. Anaesthesist 52:51–54
Karlovsek MZ, Alibegovic A, Balazic J (2005) Our experiences with fatal ecstasy abuse (two case reports). Forensic Sci Int 147(Suppl):S77–S80
Kunitz O, Ince A, Kuhlen R, Rossaint R (2003) Hyperpyrexia and rhabdomyolysis after ecstasy (MDMA) intoxication. Anaesthesist 52:511–515
Roberts L, Wright H (1994) Survival following intentional massive overdose of ‘Ecstasy’. J Accid Emerg Med 11:53–54
Walubo A, Seger D (1999) Fatal multi-organ failure after suicidal overdose with MDMA, ‘ecstasy’: case report and review of the literature. Human Exp Toxicol 18:119–125
Byard RW, Gilbert J, James R, Lokan RJ (1998) Amphetamine derivative fatalities in South Australia—is “Ecstasy” the culprit? Am J Forensic Med Pathol 19:261–265
Fineschi V, Centini F, Mazzeo E, Turillazzi E (1999) Adam (MDMA) and Eve (MDEA) misuse: an immunohistochemical study on three fatal cases. Forensic Sci Int 104:65–74
Garcia-Repetto R, Moreno E, Soriano T, Jurado C, Gimenez MP, Menendez M (2003) Tissue concentrations of MDMA and its metabolite MDA in three fatal cases of overdose. Forensic Sci Int 135:110–114
Gill JR, Hayes JA, deSouza IS, Marker E, Stajic M (2002) Ecstasy (MDMA) deaths in New York City: a case series and review of the literature. J Forensic Sci 47:121–126
Lora-Tamayo C, Tena T, Rodriguez A (1997) Amphetamine derivative related deaths. Forensic Sci Int 85:149–157
Parrott AC (2004) Is ecstasy MDMA? A review of the proportion of ecstasy tablets containing MDMA, their dosage levels, and the changing perceptions of purity. Psychopharmacology 173:234–241
Ramsey JD, Butcher MA, Murphy MF, Lee T, Johnston A, Holt DW (2001) A new method to monitor drugs at dance venues. BMJ 323:603
Dowling GP (1990) Human death and toxic reactions attributed to MDMA and MDEA. In: Peroutka SJ (ed) Ecstasy: the clinical pharmacology and neurotoxicological effects of the drug MDMA. Kluwer, New York, pp 63–75
Cole JC, Bailey M, Sumnall HR, Wagstaff GF, King LA (2002) The content of ecstasy tablets: implications for the study of their long-term effects. Addiction 97:1531–1536
Schifano F (2000) Potential human neurotoxicity of MDMA (‘Ecstasy’): subjective self-reports, evidence from an Italian drug addiction centre and clinical case studies. Neuropsychobiology 42:25–33
ChEck IT Jahresbericht (2003) Verein Wiener Sozialprojekte: http://www.vws.or.at
Libiseller K, Pavlic M, Grubwieser P, Rabl W (2005) Ecstasy-deadly risk even outside rave parties. Forensic Sci Int 153(2–3):227–230
De Letter EA, Bouche MP, Van Bocxlaer JF, Lambert WE, Piette MH (2004) Interpretation of a 3,4-methylenedioxymethamphetamine (MDMA) blood level: discussion by means of a distribution study in two fatalities. Forensic Sci Int 141:85–90
Lo DST, Goh EWS, Yoa YJ, Wee KP (2001) The first fatal overdose with MDMA in Singapore. TIAFT Bull 31:13–14
De Letter EA, Clauwaert KM, Lambert WE, Van Bocxlaer JF, De Leenheer AP, Piette MH (2002) Distribution study of 3,4-methylenedioxymethamphetamine and 3,4-methylenedioxyamphetamine in a fatal overdose. J Anal Toxicol 26:113–118
Weinmann W, Bohnert M (1998) Lethal monointoxication by overdosage of MDEA. Forensic Sci Int 91:91–101
Dams R, De Letter EA, Mortier KA et al (2003) Fatality due to combined use of the designer drugs MDMA and PMA: a distribution study. J Anal Toxicol 27:318–322
De Letter EA, Clauwaert KM, Belpaire FM, Lambert WE, Van Bocxlaer JF, Piette MHA (2002) Post-mortem redistribution of 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) in the rabbit. Part I: experimental approach after in vivo intravenous infusion. Int J Legal Med 116:216–224
De Letter EA, Belpaire FM, Clauwaert KM, Lambert WE, Van Bocxlaer JF, Piette MHA (2002) Post-mortem redistribution of 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) in the rabbit. Part II: post-mortem infusion in trachea or stomach. Int J Legal Med 116:225–232
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Libiseller, K., Pavlic, M., Grubwieser, P. et al. An announced suicide with ecstasy. Int J Legal Med 121, 40–43 (2007). https://doi.org/10.1007/s00414-005-0039-9
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DOI: https://doi.org/10.1007/s00414-005-0039-9