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A comprehensive screening of material collected during the autopsy revealed the presence of etizolam and caffeine in lethal concentrations (0.77\u00a0\u03bcg\/mL and 190\u00a0\u03bcg\/mL) but no trace of alprazolam. Benzodiazepine analogue etizolam is rarely prescribed in Germany, and as a result there are not many reports about fatal cases. It has anxiolytic, hypnotic, sedative and muscle-relaxant properties and is used for the short-term treatment of anxiety and panic attacks. The purine alkaloid caffeine, conversely, is the most widely used central nervous system stimulant. The following report outlines potentially the first reported case of a lethal combination of the downer etizolam and the upper caffeine in medical literature.<\/jats:p>","DOI":"10.1007\/s00414-020-02352-7","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T05:13:22Z","timestamp":1593494002000},"page":"1727-1731","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["The adulterated XANAX pill: a fatal intoxication with etizolam and caffeine"],"prefix":"10.1007","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0718-2332","authenticated-orcid":false,"given":"V.","family":"Kolbe","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Rentsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Boy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Kegler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"B\u00fcttner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,6,30]]},"reference":[{"issue":"9","key":"2352_CR1","doi-asserted-by":"publisher","first-page":"543","DOI":"10.1185\/03007998909112670","volume":"11","author":"F Pariante","year":"1989","unstructured":"Pariante F, Caddeo S, Ecari U (1989) Etizolam in the treatment of generalized anxiety disorder associated with depressive symptoms. 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