An Intentional Poisoning by Lormetazepam in a Patient Treated with Nordiazepam

Phak-Rop Pos Pok, Emilie Berland, Michel Mauras, Magali Valès, Erika Kuhlmann

Laboratoire de Police Scientifique de Marseille, Section Toxicologie, Institut National de Police Scientifique, France.

DOI: 10.4236/fmar.2014.24018                

Abstract

A case of suspected poisoning by benzodiazepines is presented in this paper. Toxicological analyses were applied on the blood collected 48 hours after the facts. GC-MS and HPLC-DAD have detected only nordiazepam which was prescribed in the treatment. Therefore, LC-MS/MS has detected lormetazepam and lorazepam (major metabolite of lormetazepam) in addition of nordiazepam. The concentrations of lormetazepam, lorazepam and nordiazepam measured in blood were 6.8, 6.3, and 16.2 ng/mL, respectively. The initial concentration of each drug at the relevant time, has been calculated from these residual concentrations, using an extrapolation approach. According to estimates, only lormetazepam (189 ng/mL) and lorazepam (68 ng/mL), were active at the target moment. A poisoning by lormetazepam was then considered. The more technology we have, the greater chance we have to get an outcome that is favorable to justice.

Keywords

Benzodiazepines, Discrimination between Poison and Medication, LC-MS/MS

Conflicts of Interest

The authors declare no conflicts of interest.

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