Institute of Legal Medicine, University Medical Center, St.-Georg-Strasse 108, 18055, Rostock, Germany.
Int J Legal Med. 2020 Sep;134(5):1727-1731. doi: 10.1007/s00414-020-02352-7. Epub 2020 Jun 30.
A 49-year old man was found dead at home next to a glass containing a dried, white, crystalline substance and near a bag containing pills with the imprint XANAX, the trade name of alprazolam. A comprehensive screening of material collected during the autopsy revealed the presence of etizolam and caffeine in lethal concentrations (0.77 μg/mL and 190 μg/mL) but no trace of alprazolam. Benzodiazepine analogue etizolam is rarely prescribed in Germany, and as a result there are not many reports about fatal cases. It has anxiolytic, hypnotic, sedative and muscle-relaxant properties and is used for the short-term treatment of anxiety and panic attacks. The purine alkaloid caffeine, conversely, is the most widely used central nervous system stimulant. The following report outlines potentially the first reported case of a lethal combination of the downer etizolam and the upper caffeine in medical literature.
一位 49 岁男子被发现在家中死亡，身旁有一个装有白色干燥结晶物质的玻璃杯，旁边还有一个装有印有“XANAX”（阿普唑仑的商品名）的药丸的袋子。尸检过程中采集的综合材料检测显示，存在致死浓度的艾司唑仑和咖啡因（0.77μg/mL 和 190μg/mL），但没有阿普唑仑的痕迹。苯二氮䓬类类似物艾司唑仑在德国很少开处方，因此关于致命病例的报道并不多。它具有抗焦虑、催眠、镇静和肌肉松弛作用，用于短期治疗焦虑和惊恐发作。相反，嘌呤生物碱咖啡因是使用最广泛的中枢神经系统兴奋剂。本报告概述了在医学文献中可能首次报道的艾司唑仑镇静剂和咖啡因兴奋剂致命组合的案例。
