A 30-year-old woman died after consuming a powder she bought online that was labeled as iboga (Tabernanthe iboga). Analysis of the powder found no ibogaine but instead contained toxic alkaloids—ajmaline, yohimbine, and reserpine—which are characteristic of Rauvolfia plant species. Blood concentrations were 109.1 ng/mL ajmaline, 98.2 ng/mL yohimbine, and 30.8 ng/mL reserpine; bile concentrations were much higher. The death was attributed to ingesting a substantial quantity of crushed Rauvolfia roots combined with concomitant drug withdrawal.
A 26-year-old man with no psychiatric history and no suicidal symptoms was found dead in a locked house with large neck wounds. A dropper bottle containing LSD was near the body, and toxicology confirmed acute LSD exposure: LSD at 1460 pg/mL and O-H-LSD at 182 pg/mL in blood, with LSD, nor-LSD, and O-H-LSD in urine at 3670, 201, and 4890 ng/L. This is the first reported case of fatal self-inflicted neck wounds during acute LSD intoxication in a person without prior mental illness. The case is notable given renewed interest in LSD therapy, though the literature has not shown a link between LSD exposure and suicide risk.