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Synthetic Cathinones and Related Fatalities in the United Kingdom
Published in Ornella Corazza, Andres Roman-Urrestarazu, Handbook of Novel Psychoactive Substances, 2018
John M. Corkery, Christine Goodair, Hugh Claridge
Four categories of synthetic cathinones are typically described in terms of behavioural effects (Guirguis et al., 2017): Cocaine-MDMA-mixed—Molecules such as mephedrone, 4-methylethcathinone (4-MEC), methylone, ethylone, butylone, and naphyrone are substrates for the dopamine transporter (DAT), norepinephrine transporter (NET), and serotonin transporter (SERT). Consumed orally, these substances give an entactogenic, MDMA-like effect, but taken intranasally, they produce psychostimulant, cocaine-like effects (Liechti, 2015).MDMA-like—Molecules such as methedrone and 4-trifluoromethylmethcathinone exhibit a higher inhibitory potency at SERT compared to their prevention of DAT but at the same time promote release of both NE and 5-HT-like amphetamine analogues, such as MDMA, paramethoxymethamphetamine (PMMA), paramethoxyamphetamine (PMA), and 4-ethylthioamphetamine (4-MTA) (Simmler, Rickli, Hoener, & Liechti, 2014).Methamphetamine-like—Molecules such as cathinone, methcathinone, flephedrone, ethcathinone, and 3-fluoromethcathinone are monoamine transporter substrates with DAT selective profiles, show high inhibitory potencies at DAT, and exhibit lower inhibitory potencies at SERT (Simmler et al., 2013, 2014). They promote the release of NE and DA in a similar way to methylamphetamine (Liechti, 2015).Pyrovalerone—Molecules such as pyrovalerone, MDPV, and alpha- pyrrolidinovalerophenone (α-PVP) are non-substrate transporter inhibitors, showing inhibitory potencies at NET and DAT ≥ methylamphetamine (Aarde, Huang, Creehan, Dickerson, & Taffe, 2013) or cocaine (Baumann et al., 2013). MDPV and α-PVP are both considered to be cocaine-like (Smith, Blough, & Banks, 2017). Recent research on the pyrovalerone analogue alpha-pyrrolidinopentiothiophenone (α-PVT suggests it has reinforcing and rewarding effects similar to both methylamphetamine and cocaine (Cheong et al., 2017).In addition to these observations are reports that some users find that a cathinone-induced stimulant effect at low doses is comparable to methylphenidate or at high doses to a combined effect of both cocaine and amphetamine (Coppola & Mondola, 2012). The EMCDDA (2012) note that some synthetic cathinone consumers perceive such molecules to be pharmacologically similar to and as potent as amphetamine, cocaine, and ecstasy/MDMA.
Fatal intoxication with N-ethylpentylone: a case report
Published in Journal of Community Hospital Internal Medicine Perspectives, 2018
Chisom Ikeji, Charmian D. Sittambalam, Lyn M. Camire, David S. Weisman
In 2011, cathinones such as mephedrone, 3,4-methylenedioxypyrovalerone, methedrone, and methylone were named under Schedule I of the Controlled Substances Act. However, N-ethylpentylone currently is not listed as a Schedule I substance in the USA, Canada, or Europe [4,5]. Makers of new designer drugs continue to avoid legal risk by slight alterations of chemical structure, and these drugs have become more readily available. The number of reported emergency room visits and fatal outcomes involving these drugs has increased in recent years [2,6]. This case report illustrates the behavior effects, clinical presentation, and potential fatal outcome of N-ethylpentylone drug intoxication.
Novel psychoactive substances-related presentations to the emergency departments of the European drug emergencies network plus (Euro-DEN plus) over the six-year period 2014–2019
Published in Clinical Toxicology, 2022
Benjamin Crulli, Alison M. Dines, Georgina Blanco, Isabelle Giraudon, Florian Eyer, Matthias E. Liechti, Òscar Miró, Knut E. Hovda, Fridtjof Heyerdahl, Christopher Yates, Odd Martin Vallersnes, David M. Wood, Paul I. Dargan
There were 15 deaths following presentations to ED reporting an NPS and before discharge from hospital (0.5% of all NPS presentations). Of those, 11 patients presented to ED in cardiac arrest. Six patients died in ED, one patient died within 72 h of presentation, and 8 died 72 h or more after hospital presentation. Mephedrone or methedrone was reported in 7 (46.7%) of these deaths while SCs were involved in 4 (26.7%). Notably, non-NPS agents were co-used in 11 (73.3%) deaths. Most of the deaths (13, 86.7%) were in males, and the median age at death was 34 (24.5–42.5) years.