A Fatal Case Involving N-Ethyldeschloroketamine (2-Oxo-PCE) and Venlafaxine.

A 52-year-old man died after abusing N-ethyldeschloroketamine and venlafaxine. The highest concentration of N-ethyldeschloroketamine was found in the liver (6,137 ng/g), followed by urine, bile fluid, gastric contents, heart blood, and liquor, with the lowest in femoral blood (375 μg/L). Venlafaxine tablets were found in the duodenum during autopsy. Other substances detected in urine included deschloroketamine, bisoprolol, and ramiprilate. The femoral blood concentration provides a reference point for evaluating future N-ethyldeschloroketamine intoxications, and the other values help assess post-mortem distribution of this research chemical.

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Abstract

Methoxetamine, 3-methoxyphencyclidine or 3-methoxyeticyclidine are arylcyclohexylamines which have been abused in the past. However, the market for new psychoactive substances, in particular for research chemicals, is rapidly growing and new compounds are being regularly explored by users. Abuse can lead to clinical case and in the worst-case scenario to fatalities. We present the fatal case of a 52-year-old man, who was found dead in the bedroom by his fiancé. He had abused N-ethyldeschloroketamine and venlafaxine prior to his death. These compounds were retrieved from a non-targeted gas chromatography/mass spectrometry-based screening approach of a purified urine sample. In addition, deschloroketamine, bisoprolol and ramiprilate were found in the urine sample, but were either absent or only present at low level in femoral blood. During autopsy a number of tablets were found in the duodenum and identified as venlafaxine. Furthermore, N-ethyldeschloroketamine was quantified in various specimens taken during autopsy and the highest concentration was observed in liver (6,137 ng/g) followed by urine (3,468 μg/L), bile fluid (3,290 μg/L), gastric contents (3,086 μg/L), heart blood (2,159 μg/L) and liquor (1,564 μg/L). The smallest amount was found in femoral blood (375 μg/L). N-ethyldeschloroketamine was also found in the disposable syringes, in a beaker and on the spatula along with deschloroketamine, morphine, metamizole, oxycodone, flupirtin or ibuprofen. The concentrations presented-in particular for femoral blood-are a good starting point for evaluating N-ethyldeschloroketamine intoxications in the future. The other values are helpful for evaluating the post-mortem concentration distribution of this research chemical.