Symptoms, toxicities, and analytical results for a patient after smoking herbs containing the novel synthetic cannabinoid MAM-2201

Abstract

We report a case of intoxication by the synthetic cannabinoid MAM-2201 ([1-(5-fluoropentyl)-1H-indol-3-yl] (4-methyl-1-naphthalenyl)-methanone). A 31-year-old man smoked about 300 mg of a herbal blend. He experienced an acute transient psychotic state with agitation, aggression, anxiety, and vomiting associated with a sympathomimetic syndrome. MAM-2201 was detected and quantified in a plasma sample using liquid chromatography-tandem mass spectrometry (LC-MS-MS). The level was 49 ng/ml 1 h after smoking. The use of other drugs was analytically excluded. The presence of MAM-2201 was confirmed in the herbal blend using gas chromatography-mass spectrometry (GC-MS) and LC-high resolution MS. This is the first description of an analytically confirmed intoxication and of the determination of MAM-2201 in human blood plasma.

Increases in synthetic cannabinoids-related harms: Results from a longitudinal web-based content analysis

“…Our analysis shows that the proportion of drug-related posts mentioning at least one SCRA and no other drug has consistently decreased since 2008 without completely disappearing. The most frequent categories of effects mentioned in SCRA-only posts are “High,” “Hallucinations,” “Anxiety,” “Euphoria,” “Nausea,” “Overdose,” and “Seizure.” These types of SCRA-related effects are consistent with the effects described by ER patients in the literature (Derungs, et al, 2013; Tait, et al, 2016): for example, gastrointestinal symptoms such as nausea and vomiting (Banerji, Deutsch, & Bronstein, 2010; Bozkurt, Umut, Evren, & Karabulut, 2014; Fattore & Fratta, 2011; Forrester, Kleinschmidt, Schwarz, & Young, 2011; Freeman, et al, 2013; Gugelmann, et al, 2014; Heath, Burroughs, Thompson, & Tecklenburg, 2012; Heltsley, et al, 2012; Hermanns-Clausen, Kneisel, Hutter, Szabo, & Auwärter, 2013; Hermanns-Clausen, Kneisel, Szabo, & Auwärter, 2013; Hopkins & Gilchrist, 2013; McQuade, Hudson, Dargan, & Wood, 2013; Schneir, et al, 2011; Simmons, et al, 2011; Tofighi & Lee, 2012; Vearrier & Osterhoudt, 2010), anxiety (Benford & Caplan, 2011; Castellanos, et al, 2011; J. Cohen, et al, 2012; Control & Prevention, 2013; Every-Palmer, 2011; Glue, et al, 2013; Harris & Brown, 2013), hallucinations (Auwärter, et al, 2009; Castellanos, et al, 2011; J.…”

Motor vehicle collisions caused by the ‘super-strength’ synthetic cannabinoids, MAM-2201, 5F-PB-22, 5F-AB-PINACA, 5F-AMB and 5F-ADB in Japan experienced from 2012 to 2014

“…However, as seen in the typical cases 1 and 2 (Table 4), naphthoyl indole SCs elicited excitation behaviors by itself, as reported in an intoxicated patient with MAM-2201 [5]. …”

Acute intoxication by synthetic cannabinoids – Four case reports

“…[24] In analogy to these findings, it is predictable that in case of MAM-2201 or other 5-fluoropentyl derivatives, a defluorination takes place leading to typical metabolites of the non-fluorinated compounds. The relatively low cannabinoid concentrations in Case 2 [32] (as no published data on serum levels for UR-144 are available in the literature, we referred to own unpublished data for comparison) indicate that the patient was not a chronic user of these drugs, because in chronic, heavy users much higher serum levels are seen for several days after cessation of use (own unpublished data). A further metabolic particularity is the decarboxylation of the JWH-018 carboxy metabolite, leading to metabolites typical for JWH-073.…”