Identification of taxine derivatives in biological fluids from a patient after attempted suicide by ingestion of yew (Taxus baccata) leaves

The yew tree (Taxus baccata) is an evergreen conifer that is widespread over central and southern Europe. The toxic effects of this conifer and its leaves have been known since ancient times. The seeds are generally responsible for accidental intoxications in childhood, whereas the bark and the leaves are mainly used for homicidal or suicidal attempts. We investigated the metabolic pattern of taxines in a healthy 44-year-old male farmer who was admitted to Bergamo Emergency Department after attempting suicide. High-performance liquid chromatography was used to separate and identify taxine metabolites. Data reported in this paper confirmed that the patient attempted suicide by ingesting Taxus baccata leaves, which had been suggested by clinical examination. The most abundant free and conjugated taxine metabolites were characterized. The high concentration of conjugated metabolites found in urine underscores the critical role that conjugation in the liver plays in eliminating taxines and increasing the probability of the patient's survival.