Overdose of carbamazepine before hanging by a child: a case report of a complex suicide

Abstract

BackgroundCompared to death by hanging, fatal cases due to carbamazapine intake is hardly seen. We are reporting a rare case where the victim had used this combination to terminate life as a complex suicide.Case presentationThe deceased was a 16-year-old school girl, who had been on carbamazepine for 10 years for epilepsy. Following a heated argument with her family members, who had disapproved of her love affair, the victim was found hanging from a rafter in her bedroom, with a plume of froth coming from both nostrils and mouth. A complete death investigation, including scene investigation and complete autopsy examination, was carried out. Her stomach contained pieces of tablets which were later confirmed to be carbamazepine, which was also seen in fatal levels in the blood. The cause of death was confirmed as hanging, in a patient who had ingested a massive dose of carbamazepine. The manner of death was suicide and more towards planned complex type.ConclusionThe value of toxicological analysis should not be underestimated even in cases of hanging. This case further highlights the responsibility cast upon the guardians of children diagnosed with chronic diseases like epilepsy, where stressful situations need to be handled in a tactful manner, to avoid catastrophic consequences.