Synthetic cathninoes

Much of the current knowledge on health related effects comes from user reports and clinical observations. Further research is needed to provide evidence of short and long-term health risks and the addiction potential associated with the use of these substances.

Whereas cardiac, psychiatric, and neurological signs are some of the adverse effects generic viagra pharmacy order amoxicillin medication phentermine 37.5mg reported by synthetic cathinone users, agitation, ranging from mild agitation to severe psychosis, is the most common symptom identified from medical observations [1]. Studies of patients under the apparent influence of mephedrone have also shown that synthetic cathinones present similar sympathomimetic effects (including tachycardia and hypertension as well as psychoactive effects) to similar amphetamine derivatives [2]. In a student survey, more than half of those who had taken mephedrone reported adverse effects associated with the central nervous system, nasal/respiratory system and cardiovascular system [3]. The first fatality related to the sole use of mephedrone, confirmed by toxicological analysis, was reported in Sweden in 2008 [4]. Most fatalities associated with the use of mephedrone involved the use of other substances [5]. Deaths associated with the use of other synthetic cathinones include two deaths related to methedrone [6] and two other deaths related to butylone [7].

The Finnish Poisons Information Centre reported 33 calls regarding exposures to MDPV during the period of January 2008 to October 2009. Post mortem toxicological analysis confirmed 6 deaths related to MDPV between 2009 and 2010, although in most of the cases the presence of other drugs was also detected [8]. A report from the United States provided details on the case of 35 patients who visited an Emergency Department over a 3-month-period after ingesting, inhaling or injecting substances sold as ‘bath salts’ and asserted that these products could contain stimulant compounds such as MDPV or mephedrone. One person was dead upon arrival at the emergency department. The toxicological analysis revealed a high level of MDPV, along with cannabis and prescription drugs, but the autopsy results revealed MDPV toxicity to be the primary factor contributing to death [9].

 

References
[1] J.M. Prosser and L.S. Nelson, “The toxicology of bath salts: a review of synthetic cathinones”, The Journal of Medical Toxicology 2012, 8(1): 33-42.

[2] The term sympathomimetic refers to a pharmacologic agent that mimics the effects of stimulation of organs and structures by the sympathetic nervous system. It functions by occupying adrenergic receptor sites and acting as an agonist or by increasing the release of the neurotransmitter norepinephrine at postganglionic nerve endings; European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), “Synthetic cathinones”, Drug Profiles accessed at www.emcdda.europa.eu.

[3] Dargan, P.I., Albert, S. and Wood, D.M., “Mephedrone use and associated adverse effects in school and college/university students before the UK legislation change”, Oxford Journal of Medicine 103.10 (2010): 875-9.

[4] Gustavsson, D. and Escher, C., “Mephedrone – internet drug which seems to have come and stay. Fatal cases in Sweden have drawn attention to previously unknown substance”, Lakartidningen 1.6.43 (2009): 2769-71.

[5] The death of a 46-year old man in the UK was caused by a combination of mephedrone and heroin. Other cases reported from Scotland revealed the presence of other substances along with mephedrone. See also Dickson, A.J., Vorce, S.P., Levine, B. and Past M.R., “Multiple-drug toxicity caused by the coadministration of 4-methylmethcathinone (mephedrone) and heroin”, Journal of Analytical Toxicology 34.3 (2010): 162-8; Torrance, H. and Cooper, G., “The detection of mephedrone (4-methylmethcathinone) in 4 fatalities in Scotland”, Forensic Science International 202 (2010): 62-3.

[6] Wikström, M., Thelander, G., Nyström, I. and Kronstrand, R, ‘Two fatal Intoxications with the New Designer Drug Methedrone (4-Methoxymethcathinone)’, Journal of Analytical Toxicology, 2010, 34, 594-98.

[7] N. Carter, et.al., “Deaths associated with MBDB misuse”, Journal of Legal Medicine 2000, 113: 168–70.

[8] National Institute for Health and Welfare (THL), “MDPV in Finland”, Finland, 2010 accessed at https://ewsd.wiv-isp.be/Publications%20on%20new%20psychoactive%20substances/MDPV/MDPV%20facts%20from%20Finland.pdf

[9] Centers for Disease Control and Prevention (CDC), “Emergency Department visits after use of a drug sold as “bath salts”, Morbidity and Mortality Weekly Report (MMWR) May 20, 2011, vol. 60(19): 624-627.


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