Differentiation of selegiline metabolites and illicit methamphetamine and amphetamine use in elderly postmortem cases: Insights from LC-MS/MS and immunoassay techniques

Costa, Suzel; Rosendo, Luana M.; Barroso, Mário; Franco, João Miguel

http://hdl.handle.net/10400.26/54093

Use this identifier to reference this record.

Name:	Description:	Size:	Format:
Differentiation of Selegiline Metabolites and Illicit Methamphetamine and Amphetamine Use in Elderly Postmortem Cases.pdf		1.33 MB	Adobe PDF	Download

Send Feedback

Authors

Abstract(s)

Abstract: Introduction: In forensic toxicology, distinguishing between pharmaceutical metabolites and illicit substances is crucial for accurate case interpretation. This study explores two post-mortem cases involving elderly individuals where methamphetamine and amphetamine were detected, raising initial concerns about illicit drug use. Aims: To demonstrate the application of liquid chromatography-tandem mass spectrometry (LC-MS/MS) and immunoassay techniques in differentiating between selegiline metabolites and illicit methamphetamine and amphetamine. Methods: Blood samples from three deceased elderly individuals (ages 91 and 89) were analyzed using LC-MS/MS for the quantitative detection of selegiline and metabolites. Initial screening revealed methamphetamine and amphetamine levels suggestive of potential illicit use. Immunoassay testing for dextro isomers (those associated with drug abuse) was subsequently performed to differentiate between isomers. Results and Discussion: LC-MS/MS analysis confirmed selegiline in both cases, with methamphetamine and amphetamine detected. Immunoassay results were negative for dextro isomers, indicating that the detected substances were L-isomers, which is consistent with selegiline metabolism rather than illicit use. Conclusion: This study highlights the critical role of combining LC-MS/MS and immunoassay techniques in forensic toxicology. The negative immunoassay results for dextro isomers clarified that the methamphetamine and amphetamine present were metabolic byproducts of selegiline therapy. Accurate differentiation between therapeutic and illicit substances is essential to avoid misinterpretation, particularly in elderly individuals, where illicit drug use is infrequent. These findings emphasize the need for comprehensive analytical approaches in forensic investigations to ensure accurate and reliable results.