2-(4-chloro-2-5-dimethoxyphenyl)-n-((2-methoxyphenyl)methyl)ethanamine and Drug-Overdose

NBOMe is a class of emerging new psychoactive substances that has recently gained prominence in the drug abuse market. NBOMes are N-2-methoxy-benzyl substituted 2C class of hallucinogens, currently being marked online as "research chemicals" under various names: N-bomb, Smiles, Solaris, and Cimbi. This article reviews available literature on the pharmacology; the analytical methods currently used for the detection and quantification of NBOMe in biological matrices and blotters, together with intoxication cases and NBOMe-related fatalities.. Relevant scientific articles were identified from Medline, Cochrane Central, Scopus, Web of Science, Science Direct, EMBASE and Google Scholar, through June 2015 using the following keywords: "NBOMe", "Nbomb", "Smiles", "intoxication", "toxicity" "fatalities", "death", "pharmacology", "5-HT2A receptor", "analysis" and "analytical methods". The main key word "NBOMe" was individually searched in association to each of the others.. The review of the literature allowed us to identify 43 citations on pharmacology, analytical methods and NBOMe-related toxicities and fatalities.. The high potency of NBOMes (potent agonists of 5-HT2A receptor) has led to several severe intoxications, overdose and traumatic fatalities; thus, their increase raises significant public health concerns. Moreover, due to the high potency and ease of synthesis, it is likely that their recreational use will become more widespread in the future. The publication of new data, case reports and evaluation of the NBOMes metabolites is necessary in order to improve knowledge and awareness within the forensic community.

Topics: Benzylamines; Drug Overdose; Hallucinogens; Humans; Phenethylamines; Substance-Related Disorders

This paper reports on a fatal overdose case involving the potent hallucinogenic drug 25C-NBOMe (2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine). In the present case, a young male was hospitalized after the recreational use of this potent drug. He died at the hospital at approximately 12h after ingestion, with preceding signs of serotonin toxicity. Medico-legal autopsy was performed on the deceased, during which time peripheral whole blood, urine, vitreous humor, liver and gastric content samples were submitted for toxicological examination. Further, whole blood collected at the hospital at 2-4h following ingestion of the drug was analyzed. 25C-NBOMe and a demethylated and glucuronidated metabolite of 25C-NBOMe were identified in the urine and blood samples using ultra-performance liquid chromatography with high-resolution time-of-flight mass spectrometry (UPLC-HRTOF-MS). Subsequently, 25C-NBOMe was quantified in the peripheral whole blood (0.60μg/kg), urine (2.93μg/kg), vitreous humor (0.33μg/kg), liver (0.82μg/kg) and gastric content (0.32μg total) samples collected during autopsy and in the ante-mortem whole blood (0.81μg/kg) by ultra-performance liquid chromatography with tandem mass spectrometry (UPLC-MS/MS). The autopsy findings were consistent with acute poisoning. Based on the toxicological findings, the cause of death was determined to be a fatal overdose of 25C-NBOMe in combination with amphetamine intake. To our knowledge, the present paper reports the first quantification of 25C-NBOMe in biological specimens from a fatal intoxication case.

Topics: Benzylamines; Chromatography, Liquid; Drug Overdose; Forensic Toxicology; Gastrointestinal Contents; Hallucinogens; Humans; Inhalant Abuse; Male; Mass Spectrometry; Phenethylamines; Vitreous Body; Young Adult

Effects of overdosing 2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine (25C-NBOMe) have not been previously described. Currently the drug is legal in most parts of the world.. The case of a 19-year-old man who had nasally administered 2 mg of 25C-NBOMe, a novel psychoactive drug, within 1 h is described. Two hours later, he experienced a generalized seizure. Due to loss of consciousness and low oxygen saturation, he required mechanical ventilation. On day 2, he could be extubated without need for supplemental oxygen and appeared to recover quickly. On day 3, he developed acute kidney failure requiring hemofiltration. His condition continued to deteriorate with development of acute lung failure on day 4. He again required non-invasive and subsequently invasive ventilation with high demands for oxygen and high supporting pressure. On days 7 and 8 his condition became life threatening due to difficulties to achieve sufficient oxygenation even with a FIO2 of 80 %. After 13 days in the intensive care unit, he finally recovered without sequelae.. In summary, 2 mg of 25C-NBOMe placed a young healthy man in a critical situation both acutely a few hours after ingestion due to a generalized seizure and during the subsequent days due to multiple organ failure.

Topics: Administration, Intranasal; Benzylamines; Critical Care; Drug Overdose; Hallucinogens; Humans; Male; Multiple Organ Failure; Phenethylamines; Psychotropic Drugs; Young Adult