Methling Maximilian, Krumbiegel Franziska, Hartwig Sven
Institute of Legal Medicine and Forensic Sciences, Charité-University Medicine Berlin, Berlin, Germany.
Institute of Pharmacy, Pharmaceutical Chemistry, Freie Universität Berlin, Berlin, Germany.
Drug Test Anal. 2020 Jun;12(6):659-676. doi: 10.1002/dta.2784. Epub 2020 Mar 17.
Antidepressant and antipsychotic drugs are regularly encountered in different aspects of forensic toxicology, and some cases require the examination of hair samples. In this study, common antidepressant and antipsychotic drugs regarding hair concentrations over the past decades were reviewed. Although numerous publications around method validations, case reports, or controlled dose studies were found, apparently there is a lack of comprehensive data for many substances. Information on the hair length and dosage across the publications varied largely, and case numbers were generally low except for several retrospective controlled dose studies. Many substances were described only in method validations or case reports, and data were obtained from small case numbers. On the contrary, clozapine, haloperidol, amitriptyline, nortriptyline, risperidone and its metabolite, methylphenidate, citalopram, chlorpromazine, chlorprothixene, and quetiapine had a well-founded database as these substances were investigated in controlled dose studies with higher case numbers. Given the advancements made in analytical techniques over the past years, gas chromatography-mass spectrometry and liquid chromatography with tandem mass spectrometry techniques were the methods of choice and allowed the detection of chemical compounds at low concentrations. The controversy around a potential use of hair analysis to estimate the dosage remains as dose-concentration studies provided divergent results. A harmonization on the investigated hair length as well as on the extraction protocol would be of favor to achieve better comparability. Although hair analysis research focused mainly on drug abuse, availability of more data on antidepressants and antipsychotics would help to gain better knowledge and assist other forensic investigators.
在法医毒理学的不同领域中,经常会遇到抗抑郁药和抗精神病药,有些案例需要对毛发样本进行检测。在本研究中,我们回顾了过去几十年中有关毛发浓度的常见抗抑郁药和抗精神病药。尽管我们发现了大量关于方法验证、病例报告或对照剂量研究的出版物,但显然许多物质缺乏全面的数据。各出版物中关于毛发长度和剂量的信息差异很大,除了几项回顾性对照剂量研究外,病例数普遍较少。许多物质仅在方法验证或病例报告中有所描述,且数据来自少量病例。相反,氯氮平、氟哌啶醇、阿米替林、去甲替林、利培酮及其代谢物、哌甲酯、西酞普兰、氯丙嗪、氯普噻吨和喹硫平有可靠的数据库,因为这些物质在病例数较多的对照剂量研究中得到了调查。鉴于过去几年分析技术的进步,气相色谱 - 质谱联用和液相色谱 - 串联质谱技术是首选方法,能够检测低浓度的化合物。围绕使用毛发分析来估计剂量的争议仍然存在,因为剂量 - 浓度研究提供了不同的结果。在研究的毛发长度以及提取方案方面进行统一将有助于实现更好的可比性。尽管毛发分析研究主要集中在药物滥用方面,但获得更多关于抗抑郁药和抗精神病药的数据将有助于更好地了解情况,并协助其他法医调查人员。