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1000 Titel
  • A case of fatal multidrug intoxication involving flualprazolam: distribution in body fluids and solid tissues
1000 Autor/in
  1. Giorgetti, Arianna |
  2. Sommer, Michaela J. |
  3. Wilde, Maurice |
  4. Perdekamp, Markus Große |
  5. Auwärter, Volker |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-08-11
1000 Erschienen in
1000 Quellenangabe
  • 40(1):180-188
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s11419-021-00591-w |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9715448/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Purpose!#!Designer benzodiazepines (DBZDs) increasingly emerged on the novel psychoactive substance (NPS) market in the last few years. They are usually sold as readily available alternatives to prescription benzodiazepines (BZDs) or added to counterfeit medicines. BZDs are generally considered relatively safe drugs due to the low risk of serious acute adverse effects in mono-intoxication, though e.g., alprazolam seems to display an elevated risk of respiratory depression. Here we report on a fatal intoxication involving the novel DBZD flualprazolam.!##!Methods!#!A complete postmortem examination was performed. General unknown screenings and analysis of drugs of abuse were performed on postmortem samples by immunoassay, gas chromatography-mass spectrometry and liquid chromatography-mass spectrometry. The standard addition method was employed to quantify flualprazolam in postmortem blood and tissues. Finally, a toxicological significance score (TSS) was assigned.!##!Results!#!Flualprazolam was detected in heart serum (25.4 ng/mL) and peripheral blood (21.9 ng/mL) as well as in urine, stomach contents, brain, liver and kidney (65.2-323 ng/g). The cause of death was deemed as central nervous system (CNS) and respiratory depression with agonal aspiration of stomach contents, in the setting of a multiple drug intake. Given the concentration levels of the co-consumed CNS depressants, the contribution of flualprazolam to the death was considered likely (TSS of 3).!##!Conclusions!#!Our results support that highly potent DBZDs like flualprazolam carry an elevated risk for unintended toxicity, especially in association with other CNS depressants. A multidisciplinary evaluation of fatalities remains mandatory, especially when pharmacological/toxicological data on intoxicating compounds are lacking. To our knowledge this is the first report of flualprazolam concentrations in solid tissues in human.
1000 Sacherschließung
lokal Alprazolam [MeSH]
lokal Body Fluids [MeSH]
lokal LC–MS/MS
lokal Novel psychoactive substance (NPS)
lokal Standard addition method
lokal Drug-Related Side Effects and Adverse Reactions [MeSH]
lokal Humans [MeSH]
lokal Triazolobenzodiazepine
lokal Benzodiazepines [MeSH]
lokal Flualprazolam
lokal Designer benzodiazepine
lokal Case Report
1000 Liste der Beteiligten
  1. https://frl.publisso.de/adhoc/uri/R2lvcmdldHRpLCBBcmlhbm5h|https://frl.publisso.de/adhoc/uri/U29tbWVyLCBNaWNoYWVsYSBKLg==|https://frl.publisso.de/adhoc/uri/V2lsZGUsIE1hdXJpY2U=|https://frl.publisso.de/adhoc/uri/UGVyZGVrYW1wLCBNYXJrdXMgR3Jvw59l|https://orcid.org/0000-0002-1883-2804
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1000 Erstellt am 2023-04-27T13:42:01.360+0200
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1000 Zuletzt bearbeitet Fri Oct 20 13:13:54 CEST 2023
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