Two Cases of Non-fatal Intoxication with a Novel Street Hallucinogen: 3-Methoxy-Phencyclidine

Židková, Monika; Hložek, Tomáš; Borggrefe, Martin; Kopecky, Ondrej; Těšínský, P; Švanda, Jan; Balı́ková, Marie

doi:10.1093/jat/bkx009

Cited by 25 publications

(7 citation statements)

References 14 publications

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“…Adverse effects of dissociative arylcyclohexylamine and diarylethylamine designer drugs resemble adverse effects of traditional dissociatives, including agitation, confusion, disorientation, dissociation, hallucinations, amnesia, nystagmus, slurred speech, diaphoresis, hypertension, tachycardia, renal deficiency, nausea, ataxia, and muscle rigidity (Bäckberg et al 2015a;Dunlop et al 2019;Gerace et al 2017;Helander et al 2015;Hofer et al 2012Hofer et al , 2014 Arylcyclohexylamine and diarylethylamine designer drugs Johansson et al 2017;Shields et al 2012;Thornton et al 2017;Ward et al 2011;Wood et al 2012;Zawilska 2014;Zidkova et al 2017). In severe cases, dissociative designer drugs may potentially cause neurological impairment, manifested as cerebellar toxicity (Shields et al 2012) or rhabdomyolysis (Bäckberg et al 2015a;Lam et al 2016).…”

Section: Adverse Effects Of Arylcyclohexylamine and Diarylethylamine mentioning

confidence: 99%

Designer drugs: mechanism of action and adverse effects

2020

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Psychoactive substances with chemical structures or pharmacological profiles that are similar to traditional drugs of abuse continue to emerge on the recreational drug market. Internet vendors may at least temporarily sell these so-called designer drugs without adhering to legal statutes or facing legal consequences. Overall, the mechanism of action and adverse effects of designer drugs are similar to traditional drugs of abuse. Stimulants, such as amphetamines and cathinones, primarily interact with monoamine transporters and mostly induce sympathomimetic adverse effects. Agonism at l-opioid receptors and c-aminobutyric acid-A (GABA A) or GABA B receptors mediates the pharmacological effects of sedatives, which may induce cardiorespiratory depression. Dissociative designer drugs primarily act as N-methyl-D-aspartate receptor antagonists and pose similar health risks as the medically approved dissociative anesthetic ketamine. The cannabinoid type 1 (CB 1) receptor is thought to drive the psychoactive effects of synthetic cannabinoids, which are associated with a less desirable effect profile and more severe adverse effects compared with cannabis. Serotonergic 5-hydroxytryptamine-2A (5-HT 2A) receptors mediate alterations of perception and cognition that are induced by serotonergic psychedelics. Because of their novelty, designer drugs may remain undetected by routine drug screening, thus hampering evaluations of adverse effects. Intoxication reports suggest that several designer drugs are used concurrently, posing a high risk for severe adverse effects and even death.

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Section: Adverse Effects Of Arylcyclohexylamine and Diarylethylamine mentioning

confidence: 99%

Designer drugs: mechanism of action and adverse effects

2020

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“…The distinction between concentrations from non-fatal (49-350 ng/mL) [10][11][12] and fatal intoxications (50-3 200 ng/mL) is not very obvious. Often, when concomitant use of other psychoactive substances occurs, the fatal concentrations of 3-MeO-PCP appear to be lower than the ones measured in single intoxications.…”

Section: Resultsmentioning

confidence: 99%

Determination of 3-MeO-PCP in human blood and urine in a fatal intoxication case, with a specific focus on metabolites identification

Arbouche

Kintz

Zagdoun

et al. 2021

Forensic Sciences Research

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3-Methoxyphencyclidine (3-MeO-PCP) is a new psychoactive substance that belongs to the phencyclidines family, first identified in Europe in 2012. This drug presents a stronger binding to N-methyl-D-aspartate (NMDA) receptors when compared to phencyclidine, which results in more potent effects, even at low concentrations. Very few articles have been published regarding 3-MeO-PCP in forensic toxicology. In this paper, the authors present a fatal 3-MeO-PCP intoxication case. In addition to the detection of the parent drug, metabolites were investigated in urine and, for the first time in the scientific literature, in blood. 3-MeO-PCP and its metabolites were quantitated by liquid chromatography-tandem mass spectrometry system (LC-MS/MS). Identification was confirmed by liquid chromatography-high resolution mass spectrometry (LC-HRMS). 3-MeO-PCP tested positive in femoral blood (3 525 ng/mL) and urine (7 384 ng/mL). The femoral blood concentration was higher than the fatal concentrations range already reported in the literature (from 50 to 3 200 ng/mL). 3-MeO-PCP metabolites, including O-demethyl-3-MeO-PCP, piperidine-OH-3-MeO-PCP, O-demethyl-piperidine-di-OH-3 -MeO-PCP and piperidine-di-OH-3-MeO-PCP, were detected in blood. In addition, two new metabolites, O-demethyl-piperidine-OH-3-MeO-PCP and O-demethyl-cyclohexyl-OH, were identified in both blood and urine. Unfortunately, due to the lack of reference material on the market, it was not possible to measure the concentration of these metabolites. However, the ratios between the metabolites and the parent drug were useful to estimate their analytical response and prevalence. At this time, considering the low ratios (<1) between metabolites and parent drug, metabolites testing does not seem useful to increase the detection window of the drug.

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“…3-MeO-PCP is an isomer of 4-MeO-PCP. Few metabolic and kinetic data are available, although several cases of intoxication have been published [ 20 , 63 , 107 ]. 3-MeO-PCP was first noted by the EMCDDA in 2012 [ 123 ].…”

Section: Arylcyclohexylamines: Clinical Toxicity and Forensic Casesmentioning

confidence: 99%

Arylcyclohexylamine Derivatives: Pharmacokinetic, Pharmacodynamic, Clinical and Forensic Aspects

Pelletier

Daré

Bouëdec

et al. 2022

IJMS

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Since the 2000s, an increasing number of new psychoactive substances (NPS) have appeared on the drug market. Arylcyclohexylamine (ACH) compounds such as ketamine, phencyclidine and eticyclidine derivatives are of particular concern, given their rapidly increasing use and the absence of detailed toxicity data. First used mainly for their pharmacological properties in anesthesia, their recreational use is increasing. ACH derivatives have an antagonistic activity against the N-methyl-D-aspartate receptor, which leads to dissociative effects (dissociation of body and mind). Synthetic ketamine derivatives produced in Asia are now arriving in Europe, where most are not listed as narcotics and are, thus, legal. These structural derivatives have pharmacokinetic and pharmacodynamic properties that are sometimes very different from ketamine. Here, we describe the pharmacology, epidemiology, chemistry and metabolism of ACH derivatives, and we review the case reports on intoxication.

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Two Cases of Non-fatal Intoxication with a Novel Street Hallucinogen: 3-Methoxy-Phencyclidine

Cited by 25 publications

References 14 publications

Designer drugs: mechanism of action and adverse effects

Designer drugs: mechanism of action and adverse effects

Determination of 3-MeO-PCP in human blood and urine in a fatal intoxication case, with a specific focus on metabolites identification

Arylcyclohexylamine Derivatives: Pharmacokinetic, Pharmacodynamic, Clinical and Forensic Aspects

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