Adverse effects after the use of JWH‐210 – a case series from the EU Spice II plus project

Abstract

Since 2009, more than 140 different synthetic cannabinoids (SC) have been identified in herbal mixtures consumed as recreational drugs. Knowledge of the acute toxicity of each individual compound remains sparse. Here we present a retrospective observational case series of patients presenting to emergency departments with analytically confirmed intake of JWH-210 as the only SC detected in serum samples. Cases were selected from a poison centre database from March 2011 to June 2014. In total, 22 patients were included (aged 12-25 years, median 17.5; 18 males 4 female). JWH-210 was identified in the serum samples in concentrations ranging from 0.18 to 90 ng/mL. Tachycardia, nausea, somnolence, hypokalemia, hypertension, restlessness, and/or agitation were most frequently reported. Diplopia, seizures, syncope, and ECG changes such as T-wave inversion and bradycardia were also noted. Acute adverse effects of JWH-210 typically include central nervous system depression or cerebral seizures, but also signs of sympathomimetic toxicity. Nausea was reported in 80% and typically shows a sudden onset shortly after inhalation, suggesting a central nervous effect possibly mediated by CB receptors. Cardiovascular effects are reported in up to 80% of the patients and might not only include alterations in blood pressure and heart rate, but also changes in the electrocardiogram (ECG). JWH-210 as a representative of a strong CB receptor agonist confirms previous reports about adverse effects of SC, but shows a distinct quantitative pattern of symptoms, compared to several other SC. Copyright © 2016 John Wiley & Sons, Ltd.

Underestimated impact of novel psychoactive substances: laboratory confirmation of recreational drug toxicity in Oslo, Norway

“…We found seven different NPS: 4 Methylone, a synthetic cathinone also sharing many properties with MDMA [24]. JWH-210 and AM-2201, both synthetic cannabinoid receptor agonists, the latter previously reported in Norway in suspected impaired drivers [25][26][27]. Finally, dimethyltryptamine (DMT), a hallucinogenic indole alkaloid and one of the constituents of ayahuasca, a botanical preparation used for ritual and therapeutic purposes in the Amazon [28,29].…”

Four cases of death involving the novel synthetic cannabinoid 5F-Cumyl-PEGACLONE

“…Despite its widespread consumption, pharmacokinetic and pharmacodynamic data are still limited. The compound can presumably cause typical adverse effects, such as nausea, vomiting, somnolence, dizziness, anxiety, panic attacks, psychosis, tachycardia, seizures, and comatose states [18,19], similarly to other potent CB 1 receptor agonists. Seizures and collapse were reported in a case of SGT-151 administration [20], while in a recent study by Kevin RC et al, 2019, it was found that SCs, including those bearing a cumyl-substituent, such as 1-pentyl-N-(2-phenylpropan-2-yl)-1H-indole-3-carboxamide (CUMYL-PICA) and 1-(5-fluoropentyl)-N-(2-phenylpropan-2-yl)-1H-indole-3-carboxamide (5F-CUMYL-PICA), undergo thermal degradation with release of potentially toxic substances [21].…”

Functional evaluation of carboxy metabolites of synthetic cannabinoid receptor agonists featuring scaffolds based on L‐valine or L‐tert‐leucine

“…The intake of these highly potent drugs of abuse has caused considerable morbidity and mortality in the United States, Europe, and Japan, as well as in many other countries . Observed adverse effects include agitation, hypertension, acute kidney injury and tachycardia and may even result in fatalities …”

“…[6][7][8] Observed adverse effects include agitation, hypertension, acute kidney injury and tachycardia and may even result in fatalities. [9][10][11][12][13][14][15][16] As xenobiotics, SCRAs undergo extensive metabolism and clearance, mainly by the liver, to remove these substances from the human body. The goal of drug metabolism is to detoxify potentially harmful compounds and excrete them from the body.…”