Postmortem Tissue Distribution of Citalopram in a Case of Carbon Monoxide Poisoning
Abstract Citalopram abuse may impair judgment and increase the risk of suicidal thoughts. This case report aims to study the postmortem tissue distribution of citalopram in a case of carbon monoxide poisoning. Initial analysis was done by both immunoassay and non-targeted GC-MS screening methods. Carbon monoxide was identified and quantified by measuring the carboxyhemoglobin levels in spleen secretion (black bile) and spleen blood using a UV-visible spectrophotometer, while citalopram was identified and quantified by using an LC-MS-MS system. Initial analysis showed that citalopram was present in all samples determined by immunoassay. The results of carboxyhemoglobin analysis were 85% in the spleen secretion and spleen blood, which are generally fatal levels. The results of LC-MS-MS showed that citalopram concentrations were 0.58 mg/L, 0.37 mg/L, 0.29 mg/L, 0.13 mg/L, 0.10 mg/L, and 0.01 mg/L, in the spleen blood, brain, spleen, kidney, liver and stomach, respectively. The highest concentrations of citalopram, 0.58 mg/L and 0.37 mg/L, were detected in spleen blood and brain tissue, respectively, which could be used as an alternative specimen to blood.