Analytically Confirmed Intoxication by 4-Fluoromethylphenidate, an Analog of Methylphenidate

Papa, P.; Valli, A.; Tuccio, Marcello Di; Frison, Giampietro; Zancanaro, Flavio; Buscaglia, Eleonora; Locatelli, Carlo

doi:10.1093/jat/bkz001

Cited by 8 publications

(8 citation statements)

References 23 publications

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“…Table III provides a summary of the toxicity profiles related to synthetic stimulants. Additional information related to adverse effects associated with NPS stimulant use can be found in Table IV ( 84–94 ).…”

Section: Nps Stimulantsmentioning

confidence: 99%

“…His femoral blood contained 47 ng/mL of 4-methyl-α-pyrrolidinohexiophenone (MPHP) and 1.6 ng/mL of 4-methyl-α-ethylaminopentiophenone (4-MEAP). In a nonfatal 4F-MPH case, a disoriented and confused individual with severe psychomotor agitation was admitted to the ED and had mild tachycardia lasting 2 days ( 84 ). 4F-MPH blood and urine concentrations were 32 and 827 ng/mL, respectively.…”

Section: Nps Stimulantsmentioning

confidence: 99%

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Reports of Adverse Events Associated with Use of Novel Psychoactive Substances, 2017–2020: A Review

Mohr

Logan

Fogarty

et al. 2022

Journal of Analytical Toxicology

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An important role of modern forensic and clinical toxicologists is to monitor the adverse events of novel psychoactive substances (NPS). Following a prior review from 2013-2016, this critical literature review analyzes and evaluates published case reports for NPS from January 2017 through December 2020. The primary objective of this study is to assist in the assessment and interpretation of these cases as well as provide references for confirmation methods. Chemistry, pharmacology, adverse events, and user profiles (e.g., polypharmacy) for NPS are provided including case history, clinical symptoms, autopsy findings, and analytical results. Literature reviews were performed in PubMed and Google Scholar for publications using search terms such as NPS specific names, general terms (e.g., “designer drugs,” “novel psychoactive substances”), drug classes (e.g., “designer stimulants,”), and outcome-based terms (e.g., “overdose,” “death”). Government and website drug surveillance databases and abstracts published by professional forensic science organizations were also searched. Toxicological data and detailed case information were extracted, tabulated, analyzed, and organized by drug category. Case reports included overdose fatalities (378 cases), clinical treatment and hospitalization (771 cases), and driving under the influence of drugs (170 cases) for a total of 1,319 cases providing details of adverse events associated with NPS. Confirmed adverse events with associated toxidromes of more than 60 NPS were reported to include synthetic cannabinoid, NPS stimulant, NPS hallucinogen, NPS benzodiazepine, and NPS opioid cases. Fifty of these NPS were reported for the first time in January 2017 through December 2020 as compared to the previous four years surveyed. This study provides insight and context of case findings described in the literature and in digital government surveillance databases and websites during a recent four-year period. This review will increase awareness of adverse events associated with NPS use to better characterize international emerging drug threats.

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Section: Nps Stimulantsmentioning

confidence: 99%

Section: Nps Stimulantsmentioning

confidence: 99%

Reports of Adverse Events Associated with Use of Novel Psychoactive Substances, 2017–2020: A Review

Mohr

Logan

Fogarty

et al. 2022

Journal of Analytical Toxicology

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“…LC-HRAM-Orbitrap-MS analyses of both non-biological and biological specimens were carried out employing the analytical conditions previously published for the characterization of several NPS ( Frison et al, 2015 ; Frison et al, 2016a ; Frison et al, 2016b ; Papa et al, 2019 ). Briefly, powder solutions and biosample extracts were analyzed using a Thermo Scientific Accela 1250 UHPLC system equipped with a Hypersil Gold PFP analytical column (2.1 mm × 100 mm, 1.9 µm particle size), coupled to a Thermo Scientific single-stage Exactive HCD MS system, interfaced with an HESI-II source.…”

Section: Methodsmentioning

confidence: 99%

Analytical Characterization of 3-MeO-PCP and 3-MMC in Seized Products and Biosamples: The Role of LC-HRAM-Orbitrap-MS and Solid Deposition GC-FTIR

Frison¹,

Zancanaro²,

Frasson³

et al. 2021

Front. Chem.

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Among the phencyclidine (PCP) and synthetic cathinone analogs present on the street market, 3-methoxyphencyclidine (3-MeO-PCP) is one of the most popular dissociative hallucinogen drugs, while 3-methylmethcathinone (3-MMC) is a commonly encountered psychostimulant. Numerous 3-MeO-PCP- and 3-MMC-related intoxication cases have been reported worldwide. Identification of the positional isomers of MeO-PCP and MMC families are particularly challenging for clinical and forensic laboratories; this is mostly due to their difficult chromatographic separation (particularly when using liquid chromatography–LC) and similar mass spectrometric behaviors. 3-MeO-PCP and 3-MMC were identified in two powders, detained by two subjects and seized by the police, by different analytical techniques, including liquid chromatography-high-resolution accurate-mass Orbitrap mass spectrometry (LC-HRAM-Orbitrap-MS), and solid deposition gas chromatography-Fourier transform infrared spectroscopy (sd-GC-FTIR). LC-HRAM-Orbitrap-MS allowed us to assign the elemental formulae C18H27NO (MeO-PCP) and C11H15NO (MMC) through accurate mass measurement of the two MH+ ions, and the comparison of experimental and calculated MH+ isotopic patterns. However, MH+ collision-induced product ions spectra were not conclusive in discriminating between the positional isomers [(3-MeO-PCP vs. 4-MeO-PCP) and (3-MMC vs. 4-MMC and 2-MMC)]. Likewise, sd-GC-FTIR easily allowed us to differentiate between the MeO-PCP and MMC positional isomers unambiguously, confirming the presence of 3-MeO-PCP and 3-MMC, due to the high-quality match factor of the experimental FTIR spectra against the target FTIR spectra of MeO-PCP and MMC isomers in a dedicated library. 3-MeO-PCP (in contrast to 3-MMC) was also detected in blood and urine samples of both subjects and analyzed in the context of routine forensic casework by LC-HRAM-Orbitrap-MS following a simple deproteinization step. In addition, this untargeted approach allowed us to detect dozens of phase I and phase II 3-MeO-PCP metabolites in all biological specimens. Analysis of the extracted samples by sd-GC-FTIR revealed the presence of 3-MeO-PCP, thus confirming the intake of such specific methoxy-PCP isomer in both cases. These results highlight the effectiveness of LC-HRAM-Orbitrap-MS and sd-GC-FTIR data in attaining full structural characterization of the psychoactive drugs, even in absence of reference standards, in both non-biological and biological specimens.

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“…TOXBASE suggests that due its structural similarity with ethylphenidate and 4-fluoromethylphenidate, clinical features for 4F-EPH are likely to be consistent with those of amphetamines and similar stimulants (4). However, there is a nonfatal case report concerning 4-fluoromethylphenidate (4F-MPH) a closely related analog (25). There are also case reports of deaths involving 4F-MPH and ethylphenidate (26,27).…”

Section: Hospital and Emergency Room Presentationsmentioning

confidence: 99%

First Death Involving 4-Fluoroethylphenidate (4F-EPH): Case Report, User Experiences, and Review of the Related Literature

Corkery¹,

Schifano²

2022

Academic Forensic Pathology

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Background: 4-Fluoroethylphenidate (4F-EPH) is a psychoactive substance, sold primarily over the Internet as a `research chemical'. Recreational and `functional' use of this drug has been reported by online user fora. Scientifically-based data on the pharmacological, physiological, psychopharmacological, toxicological, and epidemiological characteristics of this molecule is non-existent. The aim of this paper is to remedy this situation. Methods: Recent literature (including ’grey‘) was searched to update what is known about 4F-EPH, especially its toxicity. This was supplemented by netnographic examinations of internet sites. Results: The resultant information is presented, including details of the first reported death involving 4F-EPH use in 2016. There are no international controls imposed on 4F-EPH. However, it has been made a controlled drug in several European countries, including the United Kingdom since 31 May 2017, as well as Canada. Conclusions: It is vital that any other cases, including non-fatal overdoses, are documented so that a firmer scientific evidence-base can be established for this molecule. This will then help inform clinical practice.

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Analytically Confirmed Intoxication by 4-Fluoromethylphenidate, an Analog of Methylphenidate

Cited by 8 publications

References 23 publications

Reports of Adverse Events Associated with Use of Novel Psychoactive Substances, 2017–2020: A Review

Reports of Adverse Events Associated with Use of Novel Psychoactive Substances, 2017–2020: A Review

Analytical Characterization of 3-MeO-PCP and 3-MMC in Seized Products and Biosamples: The Role of LC-HRAM-Orbitrap-MS and Solid Deposition GC-FTIR

First Death Involving 4-Fluoroethylphenidate (4F-EPH): Case Report, User Experiences, and Review of the Related Literature

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