Medical Psychotropics in Forensic Autopsies in European Countries: Results from a Three-Year Retrospective Study in Spain

Ethanol and Medical Psychotropics Co-Consumption in European Countries: Results from a Three-Year Retrospective Study of Forensic Samples in Spain

Ethanol and medical psychotropics (MPs) are legal psychoactive substances widely consumed in Western countries that are routinely detected in standard toxicological analyses at compulsory autopsies, and toxicokinetic interactions between these drugs have been described. However, studies assessing the consequences of this co-consumption are scarce in Europe. We performed a retrospective study on toxicological results from compulsory autopsies in Spain. Thirty-five legal psychotropics, including ethanol, were measured in blood samples from 380 decedents to assess the determinants of such co-consumption. MPs were detected in 42.4% of the subjects. Polypharmacy was frequent in our series (25%), being more frequent in men than in women. More than one-third of the decedents had detectable levels of ethanol, and a significant positive association between ethanol levels and age was evident. About one-third of MPs consumers were also co-consumers of ethanol. The simultaneous consumption of ethanol and MPs was higher in men than in women. Blood alcohol concentrations (BAC) were lower in men who consumed MPs. In polypharmacy deaths, there was a significant negative association between the number of MPs consumed and BAC in men (r = -0.097; p = 0.029). Our results showed a high prevalence of co-consumption of MPs and ethanol in the European population involved in medico-legal issues and suggest that toxicokinetic interactions may be lowering BAC in men. This is a very worrying result, as it could indicate that the legal blood ethanol limits set by legislation would not be appropriate for men on MPs treatment.

Influence of Chromatographic Conditions on LOD and LOQ of Fluoxetine and Sertraline Analyzed by TLC-Densitometric Method

This research introduces the analysis of fluoxetine and sertraline by means of the TLC-densitometric method. They provide information on LOD and LOQ under various chromatographic conditions. The study used adsorption (NPTLC) and partition (RPTLC) thin-layer chromatography in combination with a densitometric analysis. Four types of chromatographic plates precoated with: silica gel 60 F254, silica gel 60, silanized silica gel 60 F254 (RP-2), and a mixture of silica gel 60 and kieselguhr F254, as well as three mobile phases: chloroform + methanol + ammonia (9:1:0.4, v/v/v), chloroform + methanol + glacial acetic acid (5:4:1, v/v/v), and acetone + toluene + ammonia (10:9:1, v/v/v), were used in NPTLC. RP-18F254 and silanized silica gel 60 F254 (RP-2) plates and four mobile phases: methanol + water (10:0 and 9:1, v/v), acetone + water (10:0 and 9:1, v/v), were used in RPTLC. The lowest LOD and LOQ values for fluoxetine were obtained using a silanized silica gel 60 F254 (RP-2) with acetone + toluene + ammonia (10:9:1, v/v/v) in NPTLC, and with a silanized silica gel 60 F254 (RP-2) in combination with methanol + water (10:0, v/v) in RPTLC. The lowest LOD and LOQ values of sertraline were obtained using a silica gel 60 with acetone + toluene + ammonia (10:9:1; v/v/v) in NPTLC. The smallest amount of sertraline was detected on the silanized silica gel 60 F254 plate in combination with methanol + water (9:1, v/v) in RPTLC. The obtained results provide important information that can give a good basis and set the direction for further, more detailed research; the results can also benefit other researchers who analyze fluoxetine and sertraline with the TLC technique in model systems (testing standards) as well as in drug and biological samples.