Acute toxicity associated with the recreational use of the ketamine derivative methoxetamine

Wood, David M.; Davies, Susannah; Puchnarewicz, Malgorzata; Johnston, Atholl; Dargan, Paul I.

doi:10.1007/s00228-011-1199-9

Cited by 108 publications

(86 citation statements)

References 14 publications

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“…6,3 Actually, signs and symptoms observed in our patient such as hypertension, tachycardia, confusion, sedation, shifts in perception of reality, agitation, nystagmus, opisthotonus, amnesia, and urinary retention are compatible with the effects induced by MXE, ketamine, and PCP. 7,8,9 Moreover, speech disorders such as pressured speech, verbigerations, and echolalia have been regularly reported by users of PCP and ketamine. 8,9 Hypertension and nystagmus, which were observed in our patient, are hallmarks of PCP intoxication, and both have been reported to occur in about 57% of the cases and to resolve within 4 h of PCP consumption.…”

Section: Discussionmentioning

confidence: 99%

Acute toxicity associated with the recreational use of the novel dissociative psychoactive substance methoxphenidine

Hofer

Degrandi

Müller

et al. 2014

Clinical Toxicology

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INTRODUCTION:Methoxphenidine is a novel dissociative designer drug of the diarylethylamine class which shares structural features with phencyclidine (PCP), and is not at present subject to restrictive regulations. There is very limited information about the acute toxicity profile of methoxphenidine and the only sources are anonymous internet sites and a 1989 patent of the Searle Company. We report a case of analytically confirmed oral methoxphenidine toxicity. CASE DETAILS: A 53-year-old man was found on the street in a somnolent and confusional state. Observed signs and symptoms such as tachycardia (112 bpm), hypertension (220/125 mmHg), echolalia, confusion, agitation, opisthotonus, nystagmus and amnesia were consistent with phencyclidine-induced adverse effects. Temperature (99.1°F (37.3°C)) and peripheral oxygen saturation while breathing room air (99%) were normal. Laboratory analysis revealed an increase of creatine kinase (max 865 U/L), alanine aminotransferase (72 U/L) and gamma-glutamyl transpeptidase (123 U/L). Methoxphenidine was identified by a liquid chromatography tandem mass spectrometry toxicological screening method using turbulent flow online extraction in plasma and urine samples collected on admission. The clinical course was favourable and signs and symptoms resolved with symptomatic treatment. CONCLUSION: Based on this case report and users' web reports, and compatible with the chemical structure, methoxphenidine produces effects similar to those of the arylcyclohexylamines, as PCP. Running headAcute toxicity associated with the recreational use of methoxphenidine.The paper is written in UK English. Word count (excluding references, figures, and abstract): 1536References: 15 diarylethylamine, drug of abuse, NMDA receptor, designer drug, phencyclidine, ketamine, psychedelic, 2-MeO-diphenidine Declarations of interestNone of the authors has conflicts of interest concerning commercial or financial involvements. No author is affiliated with an organization whose financial interests may be affected by material in the manuscript.2 AbstractIntroduction: Methoxphenidine is a novel dissociative designer drug of the

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Section: Discussionmentioning

confidence: 99%

Acute toxicity associated with the recreational use of the novel dissociative psychoactive substance methoxphenidine

Hofer

Degrandi

Müller

et al. 2014

Clinical Toxicology

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“…The most common physical effect is tachycardia (8). Additional studies have shown that, apart from tachycardia, tachypnea, hypertension, mydriasis, agitation, and cerebellar symptoms are also among common symptoms (9)(10)(11). Having observed that 30% of the physicians who participated in our study did not have any idea about this matter, physicians working in emergency services should be more knowledgeable about the common physical effects of these substances.…”

Section: Acil Servis Hekimlerinin Sentetik Kannabinoidler Hakkındaki mentioning

confidence: 75%

Emergency Department Physicians’ Knowledge of Synthetic Cannabinoids

2015

J Turgut Ozal Med Cent

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Aim: Substances containing synthetic cannabinoid are known with different names in various countries and abuse of these substances increase day by day. Different combinations of these substances make difficult to predict clinical effects. In this study, the aim is to evaluate the awareness of emergency department physicians on the clinical presentation of people using these substances. Materials and Methods: A questionnaire was applied to 100 physicians in emergency departments; the survey did not involve any scales but only contained the following three options: "Yes," "No," and "No idea." Results: The average age of physicians was 34,5±6,8 and the average work experience in the emergency department was 6,4±5,2 years. The proportion of research assistants was 42%; 29% of the physicians were experts while the other 29% were practitioners. The rate of the physicians with true knowledge abouth varied clinical appearances of drug abuse was 68%. The percentage of physicians who had no idea about the variable contents of this substances was 44%. 80% of the physicians knew that it is necessary to report these cases as "Criminal cases." Conclusion: Due to the rapid increase in the use of substances containing synthetic cannabinoid, physicians should consider welcoming new information and improve their knowledge on these substances and their properties.

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“…a dissociative state with detachment of body and mind, leading some users to experiment with imminent death experiences. [66,67] The effects sought also include euphoria, empathy, and a pleasant intensification of sensory experiences, in particular music. [68] Nevertheless, these effects are often accompanied by negative effects like visual hallucinations, trembling, confusion, agitation or somnolence and memory loss.…”

Section: Methoxetaminementioning

confidence: 99%

“…Users also regularly present signs of sympathomimetic toxicity, generally with elevated blood pressure and tachycardia. [59,67] Cerebellar toxicity with dysarthria can occur, accompanied by unsteady gait, nystagmus etc. [69] Medical care of acute MXE intoxication is based on symptomatic treatment with benzodiazepines in case of agitation and hypertonia, and with beta-blockers in case of sympathomimetic toxicity.…”

Section: Methoxetaminementioning

confidence: 99%

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New Synthetic Drugs in Addictovigilance

et al. 2015

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-New substances, also known as "designer drugs" or "legal highs" are increasingly available to drug users. Two hundred and fifteen hitherto unlisted substances have been notified by European Union member states since 2005. These synthetic drugs, which have been developed to side-step the legislation on drugs, are analogues or derivatives of existing drugs and medications. The availability of these "legal highs", sold on Internet under various denominations such as bath salt, plant fertilizer, chemical not intended for human use, or spice, is unlimited. The effects felt by users vary, and the substances may be stimulant, entactogenic, hallucinogenic, psychedelic or dissociative. The pharmacological targets also vary, and may be either the increase of extracellular levels of neurotransmitters via different mechanisms (reuptake inhibition, stimulation of intracellular release) or else fixation on specific receptors. Several chemical classes, themselves divided into sub-classes, are involved: phenethylamines, tryptamines, piperazines, cathinones, cannabinoids etc. The toxicity of the main members of these categories is increasingly well known, the most deleterious being behavioural effects, physical manifestations, and cardiovascular consequences. However, small variations in their chemical structure can generate effects that are quantitatively different, thus enhancing their toxicity or addictive potential, and much remains to be achieved in terms of knowledge about these new drugs. These substances are indeed present on the French territory, as shown by data provided by the Observatoire Français des Drogues et Toxicomanies, and notifications by the French Addictovigilance network. Screening in clinical toxicology laboratories is not widespread, since these molecules are not detected by the standard screening tests, so that there is probably an under-estimation of the use of these new drugs. The legislation on these substances changes regularly, with more and more countries classifying them as "narcotics" or illegal psychotropic drugs so as to restrict their use, applying a generic classification when possible.

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Acute toxicity associated with the recreational use of the ketamine derivative methoxetamine

Cited by 108 publications

References 14 publications

Acute toxicity associated with the recreational use of the novel dissociative psychoactive substance methoxphenidine

Acute toxicity associated with the recreational use of the novel dissociative psychoactive substance methoxphenidine

Emergency Department Physicians’ Knowledge of Synthetic Cannabinoids

New Synthetic Drugs in Addictovigilance

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