Le Daré Brendan, Gicquel Thomas, Baert Alain, Morel Isabelle, Bouvet Renaud
Institut national de la santé et de la recherche médicale, Institut national de recherche agronomique, University Hospital Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer).
Forensic Toxicology Laboratory.
Medicine (Baltimore). 2020 Jul 2;99(27):e20868. doi: 10.1097/MD.0000000000020868.
Lysergic acid diethylamide (LSD) is a highly potent psychedelic drug derived from ergot alkaloids. The available literature data derived from controlled studies or usage in a medical setting seem reassuring; however the literature contains very rare cases of fatal self-inflicted injuries associated with LSD exposure. The behavioral disorder that created the conditions conducive to death is a maladaptive or irrational response to the psychiatric manifestations induced by the substance.
Here, we report the case of a 26-year-old man found dead with large neck wounds in a locked house. No medical history other than recreational use of alcohol and narcotics was reported as well as any history of psychotic disease. The entirety of the other investigations carried out did not demonstrate the presence of a third party at the place of death and a dropper bottle containing LSD was found near the body.
We report the first case of fatal self-inflicted neck wounds with a cutting instrument in the context of acute exposure to LSD in a patient with no psychiatric history and without suicidal symptoms at the time of the self-aggressive act.
In the present work, we used a validated method using liquid chromatography coupled with mass spectrometry for simultaneous quantification of LSD and its metabolites (O-H-LSD and Nor-LSD) in whole blood and urine samples. LSD and O-H-LSD were respectively found at 1460 and 182 pg/mL in blood. In the urine, the concentrations of LSD, nor-LSD, O-H-LSD were, respectively, 3670, 201, and 4890 ng/L.
This observation is particularly relevant in view of the resurgence of interest in the therapeutic use of LSD, notwithstanding the fact that the literature has not demonstrated a link between suicidal risk and acute or chronic exposure to LSD.
麦角酸二乙酰胺（LSD）是一种从麦角生物碱中提取的高效致幻药物。来自对照研究或医疗环境中使用的数据似乎令人安心；然而，文献中包含极罕见的与LSD暴露相关的致命自残伤害案例。导致死亡的行为障碍是对该物质引起的精神症状的适应不良或非理性反应。
在此，我们报告一例26岁男性的案例，该男子被发现死在一间锁着的房子里，颈部有多处大伤口。除了有饮酒和使用麻醉品的娱乐史外，未报告其他病史以及任何精神疾病史。进行的所有其他调查均未表明死亡地点有第三方存在，且在尸体附近发现了一个装有LSD的滴管瓶。
我们报告了首例在无精神病史且在自我攻击行为发生时无自杀症状的患者急性暴露于LSD情况下，使用切割工具造成致命颈部自残伤口的案例。
在本研究中，我们使用了一种经过验证的方法，即液相色谱-质谱联用，用于同时定量全血和尿液样本中的LSD及其代谢物（O-H-LSD和去甲LSD）。血液中LSD和O-H-LSD的含量分别为1460和182 pg/mL。尿液中LSD、去甲LSD、O-H-LSD的浓度分别为3670、201和4890 ng/L。
鉴于对LSD治疗用途的兴趣再度兴起，这一观察结果尤为重要，尽管文献尚未证明自杀风险与急性或慢性暴露于LSD之间存在关联。
