TITLE:
An Intentional Poisoning by Lormetazepam in a Patient Treated with Nordiazepam
AUTHORS:
Phak-Rop Pos Pok, Emilie Berland, Michel Mauras, Magali Valès, Erika Kuhlmann
KEYWORDS:
Benzodiazepines, Discrimination between Poison and Medication, LC-MS/MS
JOURNAL NAME:
Forensic Medicine and Anatomy Research,
Vol.2 No.4,
October
30,
2014
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.