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Twice a young man was admitted to hospital upon having taken baclofen overdoses by intention. The ingested dose was 1,850 mg at the first episode and up to 2,500 mg at the second. In both cases the patient had severe overdose symptoms and scored 4-5 on the Glascow Coma Scale and was admitted to intensive care. Continuous venovenous hemodiafiltration (CVVHDF) was initiated. The elimination pharmacokinetics and toxicokinetics for baclofen is not fully known. During the second submission a shorter elimination half-life time was observed and it might be due to either compartmental distribution of baclofen, or more likely caused by an advantageous effect of the CVVHDF.

We report the case of a 20-year-old man with MDMA (3,4-methylenedioxymethamphetamine) intoxication after a single ingestion of ecstasy. As in most severe cases, this patient exhibited hyperthermia, convulsions, disseminated intravascular coagulation, rhabdomyolysis and renal failure. The patient survived, but with severe brain damage. Toxicological findings taken 12 hours after the incident revealed a toxic/fatal amount of MDMA. The clinical and biochemical findings are discussed.

Introduction: The goal of this investigation was to determine the pattern of fatal poisonings in eastern Denmark from 1998 to 2002 and compare it with similar investigations from 1979 to 1996., Materials and Methods: The material included 2,996 autopsies from eastern Denmark in which extensive forensic chemical investigations were performed., Results: Of the 2,996 autopsies, 694 cases were drug addicts, in whom 497 fatal overdoses were detected, while in the remaining 2,302 cases of nonaddicts, 443 fatal poisonings were determined. Morphine (heroine) and methadone were the main causes of death among the fatal poisonings of the drug addicts, accounting for 90% of the cases. The fatal poisonings among the nonaddicts were due mainly to medicine (73% of the cases); 13% were due to carbon monoxide and/or cyanide poisoning, and 12% were due to acute ethanol poisoning. The medicine was a wide range of strong and weak analgesics, antidepressants and antipsychotic drugs of older and newer origins. Comparison with earlier investigations from 1979 to 1996 showed that the poisoning pattern had changed, but similarities were also seen. The most frequently occurring drugs involved in fatal poisonings in eastern Denmark from 1979 to 2002 were morphine, methadone, ethanol and carbon monoxide/cyanide, of which methadone increased in occurrence over the 23-year period., Conclusion: The investigation of fatal poisonings is an important element in monitoring changes in drug abuse and poisoning patterns and levels.