Mephedrone toxicity in a Scottish emergency department

Regan, Luke; Mitchelson, Mark; Macdonald, Catriona M. M.

doi:10.1136/emj.2010.103093

Cited by 69 publications

(61 citation statements)

References 9 publications

(10 reference statements)

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“…These results are consistent with previous studies in animal models, reporting that, it induces substantial increases in blood pressure, heart rate, and cardiac contractility (Meng et al, 2012), in addition to acute cardiovascular toxicity characterized by hypertension and tachycardia (Sivagnanam et al, 2013;Nicholson et al, 2010;Regan et al, 2011;Maskell et al, 2011;Wood et al, 2010). Moreover, mephedrone consistently results in mydriasis, a specific and acute effect also observed after MDMA and amphetamine administration de la Torre et al, 2000de la Torre et al, , 2004Mas et al, 1999), although slighter in comparison with MDMA.…”

Section: Discussionsupporting

confidence: 93%

Human Pharmacology of Mephedrone in Comparison with MDMA

Papaseit

Pérez‐Mañá

Mateus

et al. 2016

Neuropsychopharmacol

129

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Mephedrone (4-methylmethcathinone) is a novel psychoactive substance popular among drug users because it displays similar effects to MDMA (3,4-methylenedioxymethamphetamine, ecstasy). Mephedrone consumption has been associated with undesirable effects and fatal intoxications. At present, there is no research available on its pharmacological effects in humans under controlled and experimental administration. This study aims to evaluate the clinical pharmacology of mephedrone and its relative abuse liability compared with MDMA. Twelve male volunteers participated in a randomized, double-blind, crossover, and placebo-controlled trial. The single oral dose conditions were: mephedrone 200 mg, MDMA 100 mg, and placebo. Outcome variables included physiological, subjective, and psychomotor effects, and pharmacokinetic parameters. The protocol was registered in ClinicalTrials.gov (NCT02232789). Mephedrone produced a significant increase in systolic and diastolic blood pressure, heart rate, and pupillary diameter. It elicited stimulant-like effects, euphoria, and well-being, and induced mild changes in perceptions with similar ratings to those observed after MDMA administration although effects peaked earlier and were shorter in duration. Maximal plasma concentration values for mephedrone and MDMA peaked at 1.25 h and 2.00 h, respectively. The elimination half-life for mephedrone was 2.15 h and 7.89 h for MDMA. In a similar manner to MDMA, mephedrone exhibits high abuse liability. Its earlier onset and shorter duration of effects, probably related to its short elimination half-life, could explain a more compulsive pattern of use as described by the users.

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Section: Discussionsupporting

confidence: 93%

Human Pharmacology of Mephedrone in Comparison with MDMA

Papaseit

Pérez‐Mañá

Mateus

et al. 2016

Neuropsychopharmacol

129

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“…Although mephedrone was here identified on its own in the cause of death in only one-third of cases (n = 18, 30%), this finding confirms some of the concerns recently expressed regarding the acute toxicity potential of the drug itself (James et al, 2011;Maskell et al, 2011;Schifano et al, 2011;Torrance & Cooper, 2010;Regan et al, 2010). It could be argued that the fact there are such a relatively large number of deaths in a comparatively short period (two years) underlines the need to inform consumers of its potential to cause death on its own.…”

Section: Mephedrone Use With Other Substancessupporting

confidence: 80%

Mephedrone-Related Fatalities in the United Kingdom: Contextual, Clinical and Practical Issues

Corkery¹,

Schifano²,

Ghodse³

2012

Pharmacology

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“…Nine of the patients in this series had laboratory confirmation of mephedrone ingestion [30]. In a retrospective review of self-reported exposures in a Scottish emergency department agitation was the most common symptom [35]. Similarly, in a prospective US series 66% were agitated [13].…”

Section: Subjective User Effectsmentioning

confidence: 99%

The Toxicology of Bath Salts: A Review of Synthetic Cathinones

2011

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Synthetic cathinones have recently emerged and grown to be popular drugs of abuse. Their dramatic increase has resulted in part from sensationalized media attention as well as widespread availability on the Internet. They are often considered "legal highs" and sold as "bath salts" or "plant food" and labeled "not for human consumption" to circumvent drug abuse legislation. Cathinone is a naturally occurring beta-ketone amphetamine analogue found in the leaves of the Catha edulis plant. Synthetic cathinones are derivatives of this compound. Those that are being used as drugs of abuse include butylone, dimethylcathinone, ethcathinone, ethylone, 3-and 4-fluoromethcathinone, mephedrone, methedrone, methylenedioxypyrovalerone (MDPV), methylone, and pyrovalerone. Synthetic cathinones are phenylalkylamines derivatives, and are often termed "bk-amphetamines" for the beta-ketone moiety. They may possess both amphetaminelike properties and the ability to modulate serotonin, causing distinct psychoactive effects. Desired effects reported by users of synthetic cathinones include increased energy, empathy, openness, and increased libido. Cardiac, psychiatric, and neurological signs and symptoms are the most common adverse effects reported in synthetic cathinone users who require medical care. Deaths associated with use of these compounds have been reported. Exposure to and use of synthetic cathinones are becoming increasingly popular despite a lack of scientific research and understanding of the potential harms of these substances. The clinical similarities to amphetamines and MDMA specifically are predictable based on the chemical structure of this class of agents. More work is necessary to understand the mechanisms of action, toxicokinetics, toxicodynamics, metabolism, clinical and psychological effects as well as the potential for addiction and withdrawal of these agents.

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Mephedrone toxicity in a Scottish emergency department

Abstract: A profile of largely psychoactive and cardiovascular toxicity is described with drug naivety perhaps explaining the high rates of bingeing and addiction reported.

Cited by 69 publications

References 9 publications

Human Pharmacology of Mephedrone in Comparison with MDMA

Human Pharmacology of Mephedrone in Comparison with MDMA

Mephedrone-Related Fatalities in the United Kingdom: Contextual, Clinical and Practical Issues

The Toxicology of Bath Salts: A Review of Synthetic Cathinones

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