Ethylphenidate: availability, patterns of use, and acute effects of this novel psychoactive substance

Ho, James H; Bailey, George P.; Archer, John R. H.; Dargan, Paul I.; Wood, David M.

doi:10.1007/s00228-015-1906-z

Cited by 23 publications

(27 citation statements)

References 50 publications

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“…Parks et al, also indicate that in 9 of the 17 reported cases ethylphenidate was being injected. Previous studies have utilised internet forum case reports to investigate the routes of administration of ethylphenidate [8,9]. In the case reports ethylphenidate is most commonly insufflated (52.5%) followed by multiple routes (16.7%), oral ingestion (11.6%) and intravenous injection (9.6%).…”

Section: Resultsmentioning

confidence: 99%

“…In the case reports ethylphenidate is most commonly insufflated (52.5%) followed by multiple routes (16.7%), oral ingestion (11.6%) and intravenous injection (9.6%). Minor routes include rectal insertion, sublingual insertion, smoking and intramuscular injection [8].…”

Section: Resultsmentioning

confidence: 99%

“…The effects of ethylphenidate that have been reported by users (stimulation, euphoria, an increase in focus, improved concentration, increased sociableness, empathy [8,9]) are similar to those observed with other stimulants [10]. These "positive" effects are counteracted with the side-effects (anxiety; paranoia; hallucinations; increased heart rate blood pressure and body temperature; peripheral vasoconstriction; insomnia; sweating and nasal pain on insufflation [7][8][9]11]) that are again commonly seen with other abuse stimulants [10].…”

Section: Introductionmentioning

confidence: 99%

“…To date ethylphenidate has been sold in head shops and online under various names including "Nopaine", "Gogaine", "Ching" and "Burst (duck)" [6,7], in various forms (powder, crystals and "pellets" (25 mg or 50 mg)) [7,8], with a "recommended" oral dose of between 25 -50 mg [8]. For insufflation users have reportedly used between 10 and 100 mg [9].…”

Section: Introductionmentioning

confidence: 99%

“…The pharmacokinetics of ethylphenidate are unclear but information from user reports suggest that the mean onset time for ethylphendiate is ~ 13 min (range 0 -35 min; n = 32) for nasal insufflation, and ~ 23 min (range 5 -31 min; n = 8) for oral administration [8]. The mean duration of the effects were 117 min for all routes of administration (range 15 -300 min; n = 29) however this is complicated by redosing.…”

Section: Introductionmentioning

confidence: 99%

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Seven fatalities associated with ethylphenidate

Maskell

Smith

Cole

et al. 2016

Forensic Science International

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Ethylphenidate is a stimulant novel psychoactive substance that is an analogue of the prescription drug methylphenidate (Ritalin ®. Methylphenidate is used commonly for the treatment of attention deficit hyperactivity disorder. Due to its stimulant effects ethylphenidate is being abused. There is a single case report of a death associated with ethylphenidate in Germany, and a case series of 19 deaths in the East of Scotland, but otherwise, the contribution of ethylphenidate to death is poorly documented. We report the analytical results of 7 cases (between February 2013 and January 2015) in which ethylphenidate was detected and quantitated with a validated liquid chromatography tandem mass spectrometry method (LC-MS/MS). The individuals (all male) ranged in age from 23 to 49 years (median 25 years). The concentration of ethylphenidate in the cases ranged from 0.026 mg/L to 2.18 mg/L in unpreserved post-mortem femoral blood. Only one case had ethylphenidate present as a sole drug. All other cases had at least 2 other drug classes present (benzodiazepines, heroin, methadone antipsychotics, other new psychoactive compounds). Ethylphenidate toxicity was the sole contribution to the cause of death in one case. Hanging was the cause of death in 2 cases, with the other 4 cases being reported as having occurred due to mixed drug toxicity. These data will further help with the interpretation of post-mortem ethylphenidate levels.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Seven fatalities associated with ethylphenidate

Maskell

Smith

Cole

et al. 2016

Forensic Science International

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Drug Regimen Individualization for Attention‐Deficit/Hyperactivity Disorder: Guidance for Methylphenidate and Dexmethylphenidate Formulations

et al. 2018

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In 2000, the first biphasic modified-release (MR) formulation of methylphenidate (MPH) was approved for the treatment of attention-deficit/hyperactivity disorder (ADHD). An immediate-release (IR) MPH pulse (22% of the dose) facilitates rapid onset of stimulant action, while the remaining MR portion of the dose provides for day-long duration of efficacy. A wide array of oral MR-MPH products has subsequently been approved that also allows for once-daily dosing, though each product is characterized by distinctive exposure time courses. This review compares each member of the current MPH armamentarium to assist in the rational selection of a specific MPH regimen for the individualized treatment of patients with ADHD. The IR portion of biphasic MPH formulations now ranges from 15%, 20%, 22%, 25%, 30%, and 37% IR-MPH, as well as a 50% IR-MPH product whose distinctly pulsatile time course closely resembles that of the pre-century "gold standard" twice-daily IR-MPH regimen. Further, transdermal, suspension, and orally disintegrating tablet products are now available to overcome any solid dosage form swallowing difficulties. Most of these formulations are racemic, though in 2001, a chiral switch drug IR-dexmethylphenidate (dexMPH) was approved, followed by biphasic MR-dexMPH (50% IR) in 2005. New U.S. Food and Drug Administration (FDA) partial area under the curve (pAUC) bioavailability metrics have improved discrimination between specific generic MR-MPH products. This has resulted in two Orange Book MR-MPH products being recoded from "AB" (i.e., meets necessary bioequivalence requirements) to "BX" (i.e., insufficient data to confirm bioequivalence). The metabolic drug interaction between MPH and alcohol, which increases MPH bioavailability, potentiates euphoric effects, and heightens abuse liability, is discussed. This review concludes with brief considerations of pharmacogenomic predictors of ADHD first-line drug selection, carboxylesterase allelic variants influencing interindividual MPH metabolism, and novel MPH formulations in the regulatory pipeline. KEY WORDS methylphenidate, dexmethylphenidate, attention-deficit/hyperactivity disorder, pharmacokinetics, partial area under the curve, early exposure, relative bioavailability, carboxylesterase 1, bioequivalence.Estimates of attention-deficit/hyperactivity disorder (ADHD) global prevalence generally range from 5% to 7% in the pediatric population. 1,2 Recognition that ADHD often persists into adulthood has become well established, a

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New psychoactive substances: an overview on recent publications on their toxicodynamics and toxicokinetics

Meyer

2016

Arch Toxicol

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This review article covers English-written and PubMed-listed review articles and original studies published between January 2015 and April 2016 dealing with the toxicodynamics and toxicokinetics of new psychoactive substances. Compounds covered include stimulants and entactogens, synthetic cannabinoids, tryptamines, NBOMes, phencyclidine-like drugs, benzodiazepines, and opioids. First, an overview and discussion is provided on timely review articles followed by an overview and discussion on recent original studies. Both sections are then concluded by an opinion on these latest developments. This review shows that the NPS market is still highly dynamic and that the data published on their toxicodynamics and toxicokinetics can hardly keep pace with the appearance of new entities. However, data available are very helpful to understand and predict how NPS may behave in severe intoxication. The currently best-documented parameter is the in vitro metabolism of NPS, a prerequisite to allow detection of NPS in biological matrices in cases of acute intoxications or chronic consumption. However, additional data such as their chronic toxicity are still lacking.

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Ethylphenidate: availability, patterns of use, and acute effects of this novel psychoactive substance

Abstract: This review of the scientific and grey literature has demonstrated that the acute harms associated with its use are stimulant in nature and that ethylphenidate is widely available to users over the Internet, with significant discounts for bulk purchases.

Cited by 23 publications

References 50 publications

Seven fatalities associated with ethylphenidate

Seven fatalities associated with ethylphenidate

Drug Regimen Individualization for Attention‐Deficit/Hyperactivity Disorder: Guidance for Methylphenidate and Dexmethylphenidate Formulations

New psychoactive substances: an overview on recent publications on their toxicodynamics and toxicokinetics

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