Institut de Médecine Légale, Strasbourg, France.
X-Pertise Consulting, Mittelhausbergen, France.
J Forensic Sci. 2021 May;66(3):1165-1170. doi: 10.1111/1556-4029.14684. Epub 2021 Feb 9.
Mirtazapine is an antidepressant drug, used to treat depression, but also, in some specific conditions, to treat obsessive-compulsive disorder and anxiety. Although mirtazapine is not a hypnotic, it can make the subject feel drowsy. Children under the age of 18 should not take mirtazapine, but for some very special diseases, a physician can prescribe it for a limited period of time. The authors report a case involving 2 children (7- and 9-year-old) who were administered mirtazapine without consent by the mother, who was under daily therapy with this antidepressant. Hair specimens, collected from the children were tested by liquid chromatography coupled to tandem mass spectrometry for mirtazapine and its metabolite, N-desmethylmirtazapine, on 3 × 1 cm segments. The hair test results (3 × 1 cm segments) have demonstrated that both children have been repetitively exposed to mirtazapine for approximately the last 3 months before hair collection, with concentrations in the range 1.32-3.79 and 0.64-2.54 ng/mg for mirtazapine and N-desmethylmirtazapine, respectively. Environmental contamination was ruled out as the measured concentrations are highly variable according to the pattern of drug distribution and the washes were negative. Hair testing for drugs appears as an excellent diagnostic tool for child protection toward drug exposure.
米氮平是一种抗抑郁药，用于治疗抑郁症，但在某些特定情况下，也用于治疗强迫症和焦虑症。尽管米氮平不是催眠药，但它会使服用者感到昏昏欲睡。18 岁以下的儿童不应服用米氮平，但对于某些非常特殊的疾病，医生可以在有限的时间内开处方。作者报告了 2 例儿童（7 岁和 9 岁）的案例，他们未经母亲同意就服用了米氮平，而母亲正在接受这种抗抑郁药的日常治疗。从儿童身上采集的头发样本，通过液相色谱-串联质谱法对米氮平和其代谢物 N-去甲米氮平进行了检测，在 3×1cm 段上进行了检测。头发测试结果（3×1cm 段）表明，在采集头发前的大约 3 个月内，这两个孩子都曾反复接触米氮平，米氮平和 N-去甲米氮平的浓度范围分别为 1.32-3.79 和 0.64-2.54ng/mg。已排除环境污染的可能性，因为根据药物分布模式，测量的浓度差异很大，且清洗物为阴性。药物头发检测似乎是一种针对儿童药物暴露的极好的诊断工具。
