Severe clinical toxicity associated with analytically confirmed recreational use of 25I–NBOMe: case series

Abstract

Severe clinical toxicity may occur following recreational use of 25I-NBOMe, with stimulant and serotoninergic features predominating. Clinicians should be alert to this substance, in view of its emergence in Europe as well as in the United States.

Receptor interaction profiles of novel N-2-methoxybenzyl (NBOMe) derivatives of 2,5-dimethoxy-substituted phenethylamines (2C drugs)

“…Thus, such substance characteristics as the higher lipophilicity of NBOMe drugs may further accentuate the clinical drug response. As a result, there is likely a high risk of overdose with NBOMe drugs, and several fatalities have been reported (Hill et al, 2013;Srisuma et al, 2015;Walterscheid et al, 2014;Wood et al, 2015).…”

“…Of particular interest are N-2-methoxybenzyl-phenethylamines (NBOMe drugs), which are novel and reportedly very potent hallucinogens that have been increasingly used recreationally (Forrester, 2014;Hill et al, 2013;Ninnemann and Stuart, 2013;Rose et al, 2013;Walterscheid et al, 2014;Wood et al, 2015;Zuba, 2012), with additional potential use as radiotracers (Ettrup et al, 2011;Ettrup et al, 2010). Recreationally used NBOMe drugs include 25I-NBOMe, 25C-NBOMe, 25B-NBOMe, and 25D-MBOMe (Armenian and Gerona, 2014;Poklis et al, 2014;Rose et al, 2013), which are derivatives of 2,5-dimethoxy-4-substituted phenethylamines (2C drugs; Dean et al, 2013;Hill and Thomas, 2011;Shulgin and Shulgin, 1991).…”

“…Importantly, NBOMe drugs have been reported to produce psycho-and cardiovascular stimulant effects, in addition to hallucinations. Specifically, sympathomimetic toxicity, including tachycardia, hypertension, mydriasis, agitation, and hyperthermia, is commonly reported in cases of acute NBOMe drug intoxication (Hill et al, 2013;Rose et al, 2013;Srisuma et al, 2015;Stellpflug et al, 2014;Wood et al, 2015). Pharmacologically, compounds of the 2C series, including 2C-C, 2C-E, and 2C-I, inhibit the norepinephrine (NE) and serotonin transporters (NET and SERT, respectively), similar to amphetamines, although with only very low potency (Eshleman et al, 2014;Nagai et al, 2007).…”

Rapid Screening Method for New Psychoactive Substances of Forensic Interest: Electrochemistry and Analytical Determination of Phenethylamines Derivatives (NBOMe) via Cyclic and Differential Pulse Voltammetry

“…Only a few pharmacologic studies on humans have been conducted on these drugs. Reports of adverse effects after ingestion began to appear in the scientific literature in 2013, describing prominent neuropsychiatric effects and instability 6,[10][11][12][13][14][15][16] . In severe cases death can occur even after ingesting a single dose 14 .…”

New Synthetic Drugs in Addictovigilance

“…In the absence of a specific antidote, the care provision for 2C-X or 25X-NBOMe intoxication is merely symptomatic, involving in particular sedation using benzodiazepines as the first line treatment. [22,27,28,[32][33][34][35] Intoxications can be severe, and deaths have been related to 2C-T-7 [23,36] and 2C-E. [37] Concerning 25X-NBOMe, several deaths have also been reported, particularly involving 25I-NBOMe, this being so despite the recent appearance of these drugs on the market. World Health Organization (WHO) has reported over twenty deaths as a result of using 25X-NBOMe, the majority being attributed to acute overdose.…”