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.