4,4′‐Dimethylaminorex (“4,4′‐DMAR”; “Serotoni”) misuse: A Web‐based study

Abstract

Background 4,4′‐DMAR (4,4′‐dimethylaminorex; “Serotoni”) is a potent stimulant drug that has recently been associated with a number of fatalities in Europe. Over the last few years, online communities have emerged as important resources for disseminating levels of technical knowledge on novel psychoactive substances. Objective Analysing the information provided by the fora communities on 4,4′‐DMAR use, additionally critical reviewing the available evidence‐based literature on this topic. Methods Different website drug fora were identified. A critical review of the existing evidence‐based literature was undertaken. Individuation and analysis of qualitative data from the identified website fora were performed. Results The combined search results identified six website fora from which a range of qualitative data on recurring themes was collected. These themes included routes of administration and doses; desired effects; adverse effects; comparison with other drugs; association with other drugs; medications self‐administered to reverse 4,4′‐DMAR action; overall impression; and provision of harm‐reduction advice. Conclusions Although being characterized by a number of methodological limitations, the social networks' Web monitoring approach (netnography) may be helpful to better understand some of the clinical and psychopharmacological issues pertaining to a range of novel psychoactive substances, including 4,4′‐DMAR, for which only extremely little, if any, scientific knowledge is available.

Designer drugs: mechanism of action and adverse effects

“…Aminorex was first marketed as an over-the-counter appetite suppressant in parts of Europe in the 1960s, but it was withdrawn a few years later because of an epidemic of chronic pulmonary hypertension that was associated with many fatalities (Maier et al 2018a). Aminorex analogs that have found their way onto the designer drug market include 4-methylaminorex (4-MAR) and 4,4 0 -dimethylaminorex (4,4 0 -DMAR), the reported effects of which include euphoria, mental and physical stimulation, sociability, empathy, arousal, and changes in visual perception (European Monitoring Centre for Drugs and Drug Addiction 2015; Glanville et al 2015;Loi et al 2017). A comprehensive review of the history of aminorex use and the emergence of its designer drug analogs was recently published (Maier et al 2018a).…”

“…Adverse effects of aminorex designer drugs that have been reported by users on various Internet discussion platforms include agitation, dysphoria, insomnia, amnesia, panic attacks, psychosis, hallucinations, facial spasms, dilated pupils, foaming at the mouth, dry mouth, jaw clenching, elevations of body temperature, sweating, elevations of heart rate, nausea, and restless legs (Glanville et al 2015;Loi et al 2017;Maier et al 2018a). Pulmonary hypertension (i.e., the adverse effect that led to the removal of aminorex from the market) has been associated with the recreational use of 4-MAR (Gaine et al 2000).…”

Novel Opioids: Systematic Web Crawling Within the e-Psychonauts’ Scenario

“…Future studies by our group will be focused on expanding drug searches on less accessible areas of the web such as the deep web and the darknet . A qualitative/netnographic approach (Loi et al, 2017;Wang, 2019) will be needed as well to better assess the levels of online information relating to the possible psychonauts' preference between analogs and their motivation for use, that is, recreational or selfmedication purposes. As previous studies have highlighted their importance in NPS-based studies , next NPS.Finder R -based projects will need to focus as well on further languages, for example, Chinese, Japanese, and Arabic.…”

DARK Classics in Chemical Neuroscience: Aminorex Analogues

“…The fact that aminorex also acts as a substrate and releaser at SERT has been linked to pulmonary arterial hypertension43,185. Drug users have mentioned hand, muscle twitches, numbness, hallucinations, panic attacks, nausea, tachycardia and hyperthermia as unwanted side-effects of the consumption of 4-MAR and 4,4'-DMAR144,221. The clinical and autopsy reports of 4,4'-DMAR patients have described short-term complications such as hyperthermia, seizures, hallucinations, agitation, internal bleeding, edema and heart and lung failure133.…”