Fatal intoxication because of trihexyphenidyl

Trihexyphenidyl (THP) is an anticholinergic agent with forensic toxicological interest. We present a case of a 59-year-old woman with a history of paranoid disorder, who was found dead in the house where she lived alone. The autopsy findings revealed no marked pathological changes. Toxicological analysis based on gas chromatography-mass spectrometry (GC-MS) analysis revealed THP and its major metabolite (hydroxy-THP) in blood and urine, with THP concentrations of 0.053 and 0.560 mg/L, respectively. The blood and urine ethanol concentrations were low 0.096 and 0.100 g/L, respectively. Based on these results, we determined the cause of death to be THP poisoning. It is suggested that rare case of death associated with THP overdosage should be taken in conjunction with central nervous system depressants (benzodiazepines, ethanol) and/or with other pathological disorders. Thus, our case could not be supportive for this allegation.     

GC—MS同时测定血液中苯海索、氯丙嗪和氯氮平

目的建立GC—MS同时测定血液中苯海索、氯丙嗪和氯氮平的方法。方法血液中加入内标SKFszs。．在pH〉10条件下用V（苯）：v（乙酸乙酯）=1：l提取,用GC—MS全扫描法进行定性检测：以地西泮一d;为内标,样品在pH〉10条件下用V（苯）：v（乙酸乙酯）=l：1提取,用GC—MS选择离子监测方法进行定量检测．结果苯海索、氯丙嗪和氯氮平在20～10000ng／mL范围内呈线性关系,最小检测限分别为0．3、0．3和0．7n幽L（信噪比≥3）,方法回收率为79．9％～85．5％,日内、日间精密度均小于5．1％。结论本方法可同时分析血液中苯海索、氯丙嗪和氯氮平,方法灵敏度高、快速、操作简便,适用于苯海索、氯丙嗪和氯氮平的血药浓度监测和急性中喜案件竹枪测