A Fatality Related to Two Novel Hallucinogenic Compounds: 4-Methoxyphencyclidine and 4-Hydroxy-N-methyl-N-ethyltryptamine

A man with a history of strange behavior was found dead in his locked room. Toxicology testing detected the hallucinogen 4-methoxyphencyclidine (4-MeO-PCP) at a peripheral blood concentration of 8.2 mg/L and a central blood concentration of 14 mg/L. The liver contained 120 mg/kg, vitreous fluid 5.1 mg/L, urine 140 mg/L, and gastric contents 280 mg. Another hallucinogen, 4-hydroxy-N-methyl-N-ethyltryptamine, was also present but not quantified. Therapeutic levels of venlafaxine, olanzapine, lorazepam, and hydroxyzine were confirmed, but phencyclidine was not detected. The death was certified as an accident due to acute mixed drug intoxication.

Study at a glance

Abstract

In this case report, we present an evaluation of postmortem concentration distribution of the hallucinogenic compound 4-methoxyphencyclidine (4-MeO-PCP) in a fatality principally attributed to this drug. Another hallucinogen, 4-hydroxy-N-methyl-N-ethyltryptamine was also detected, but was not quantitated. A man--who had a history of recent 'strange' behavior--was found deceased, on his bed, in his locked room. Toxicology testing, which initially screened positive for phencyclidine (PCP) by ELISA, subsequently detected and confirmed the two hallucinogens by gas chromatography-mass spectrometry. 4-MeO-PCP concentrations were then quantified by a specific secondary testing technique. The peripheral blood concentration was 8.2 mg/L compared with the central blood concentration of 14 mg/L. The liver concentration was 120 mg/kg, the vitreous was 5.1 mg/L, the urine was 140 mg/L and the gastric contents contained 280 mg. PCP was not detected, but therapeutic concentrations of venlafaxine, olanzapine, lorazepam and hydroxyzine were confirmed. The cause of death was certified due to acute mixed drug intoxication, and the manner of death was certified as accident.