Three Fatal Cases of PMA and PMMA Poisoning in Denmark

Abstract

Paramethoxyamphetamine (PMA) and paramethoxymetamphetamine (PMMA) are methoxylated phenylethylamine derivatives with effects similar to methylenedioxymetamphetamine (MDMA) and sold as such. However, PMA and PMMA are more potent than MDMA, but have a slower onset of action, which encourages users to take more. Three fatal cases involving PMA and PMMA in Denmark in year 2000 are investigated including history, pathological, and toxicological findings. The methods used for extraction, identification, and quantitation of PMA and PMMA are described. In two of the cases, lethal postmortem blood concentrations of PMA and PMMA were determined at 3.4 and 3.3 mg/kg (case 1) and 0.78 and 0.68 mg/kg (case 3), respectively. In addition, other drugs such as MDMA, tetrahydrocannabinol, cocaine, and alcohol were involved in these cases. In the third case, death occurred four days after the ingestion of tablets containing PMA and PMMA, and therefore only low postmortem concentrations of PMA and amphetamine were detected. However, in a serum sample taken at admission to the hospital, PMA and PMMA were found, but not quantitated. It is believed that the cause of death in case 2, multiple-organ failure, was caused by overdoses of PMA and PMMA.

Linking the pharmacological content of ecstasy tablets to the subjective experiences of drug users

“…However, most studies on subjective effects of BZP were done in healthy, drug-naive volunteers and doses were not determined in the present study, important factors which might contribute to the differences in effects found and make comparisons difficult. The adverse subjective effects reported in this study after ingestion of tablets containing MDMA with PMMA largely support the existing toxicological findings by others of casualties and fatalities after consumption of PMMA or its metabolite PMA (Caldicott et al 2003;Johansen et al 2003;Becker et al 2003;Lin et al 2007). Extreme hyperthermia was described as one of the symptoms of PMMA intoxication, especially in crowded environments (Rohanova and Balikova 2009;Páleníček et al 2011).…”

Comparative <i>in Vitro</i> Studies of the Metabolism of Six 4-Substituted Methamphetamines and Their Inhibition of Cytochrome P450 2D6 by GC-MS with Trifluoroacetyl Derivatization

“…Designer drugs are a serious problem worldwide, especially among young people, and in some cases they have resulted in fatal poisoning [1][2][3][4][5][6][7]. New designer drugs are created by changing the molecular structure of an existing drug.…”

“…This creates a compound with similar pharmacological effects, and is performed to circumvent existing drug laws. For example, 4-methoxymethamphetamine (4-MMA) and 4-fluoromethamphetamine (4-FMA), which are 4-substituted psychoactive analogs of methamphetamine (MA), have emerged on the illicit drug market [1,2,[8][9][10][11]. Designer drugs such as illicit amphetamine-type stimulants are often co-administered with other drugs in tablet, capsule, or powder form [12][13][14][15][16][17].…”

Direct Analysis of Conjugate Metabolites of Methamphetamine, 3,4-Methylenedioxymethamphetamine, and Their Designer Drugs in Biological Fluids

“…[1][2][3][4][5] Recently, the abuse of their designer drugs including p-methoxyamphetamine (PMA) analogues and 2-methylamino-1-(3,4methy-lenedioxyphenyl)-propan-1-one (methylone) analogues, as shown in Fig. 1, have also been on the rise in Japan as well as in Europe and the U.S.A. [6][7][8][9][10][11][12] More recently, the Japanese authorities, therefore, have begun to prevent not only the recreational uses of the designer drugs under Narcotics and Psychotropics Control Law, but also the importation and distribution under Pharmaceutical Affairs Law.…”