Case report of a fatal intoxication by citalopram

Citalopram is an antidepressant drug within the group of the selective serotonin reuptake inhibitors (SSRI). It is widely prescribed both in Europe and in United States, and it has always been considered a "safe" drug as pure intoxication with lethal outcome is rare, and most cases of overdose, even with high doses of citalopram ingested, are reported to have an uneventful course.We report the case of a young woman found dead at home. She had been prescribed citalopram by her family doctor 3 weeks before her death for a depressive syndrome. Police found in her house 3 empty blister packages of 28 citalopram tablets (20 mg) and 2 bottles of citalopram oral solution (4%, 15 mL each). The autopsy findings were unremarkable. Nasal swabs, blood from femoral vein, urine, bile and tissue samples were collected for toxicologic investigation. Citalopram separation was performed by solid/liquid method, using Bond-Elute columns. The extracts were analyzed by GLC and GC/MS methods. The toxicologic analysis showed high levels of citalopram in all the examined fluids and tissue samples (blood concentration: 11.60 mg/L). No other drugs and alcohol were detected. Our data confirm that if no other drug is involved, fatal complications occur only after ingestion of very high doses. However, there is no predefined "toxic dose," and the conditions under which the overdose occurs can be very important. We report the exact concentrations of the citalopram in the organs, and wethink that this can be useful in the cases where the blood samples were not available (ie, carbonized or decomposed body).     

Elections,repression and authoritarian survival in post-transition Indonesia and the Philippines

Abstract

This paper compares post-transition Philippines and Indonesia, examining the ways in which authoritarian practices survive and are shaped by regime transition. It examines the transition process in each case, to identify the problems of management and control that regime elites set for themselves in the post-dictatorship period. It is argued that Philippine elites set out to disaggregate and domesticate an already mobilized opposition movement, while the Indonesian authorities strove to keep similar popular politics from mobilizing. The paper then considers how these political objectives find expression in the structuring of two important institutional fields – the electoral and policy making processes – concluding with an examination of how these considerations influence patterns of repression. In particular, the paper also investigates whether repression targets primarily proscribed modes of activity, or sets out to threaten and intimidate proscribed organizations and people. Differences in electoral and policy processes, as well as in patterns of repression, demonstrate the ways in which authoritarianism can survive regime transitions and can undermine the promise of democracy in the post-dictatorship period.