4-iodo-2-5-dimethoxy-beta-phenethylamine and Substance-Related-Disorders

Designer drugs are constantly evolving, with the NBOMe derivatives of the 2C class of phenethylamines recently emerging in the US market. Cases of 2C-I-NBOMe toxicity have recently been reported in the literature. No reports to date describe the clinical effects 2C-C-NBOMe toxicity.

Topics: Chromatography, Liquid; Designer Drugs; Dimethoxyphenylethylamine; Emergency Treatment; Female; Humans; Mass Spectrometry; Nevada; Substance-Related Disorders; Young Adult

The phenethylamines, including 2, 5 dimethoxy-4-iodophenethylamine, commonly referred to as 2C-I, have recently emerged as a new class of designer drugs. Cases of toxicity from these drugs are not well described in the literature. This case report describes a 19 year-old male who insufflated 2C-I. Following the ingestion, the patient developed recurrent seizures, and was taken to the emergency department, where he was noted to be hyperadrenergic and had recurrent seizures. The patient was diagnosed with serotonin syndrome and experienced prolonged respiratory failure, although he ultimately made a full recovery. Comprehensive drug testing revealed the presence of 2C-I. The pharmacologic properties of 2C-I are also discussed.

Topics: Adult; Designer Drugs; Dimethoxyphenylethylamine; Emergency Service, Hospital; Humans; Insufflation; Male; Phenethylamines; Respiratory Insufficiency; Seizures; Serotonin Syndrome; Substance-Related Disorders; Treatment Outcome; Young Adult

A case is presented of a 39-year-old woman who suffered severe debilitation because of a hemorrhagic stroke in the context of substance abuse. The patient presented to the emergency room with rapidly diminishing mental status, hypertension, and vasoconstriction; her friends provided a history of ingestion of cocaine, 3,4-methylenedioxymethamphetamine (MDMA), and 2C-I, a novel designer amine. A multi-targeted LC-MS/MS method for sympathomimetic amines and related drugs in urine detected and quantified 2C-I and MDA, while ruling out MDMA. The cause of the stroke was determined to be an underlying cerebrovascular abnormality called Moyamoya, secondary to substance abuse. In clinical laboratories, gas chromatography-mass spectrometry or liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmation of a positive amphetamine immunoassay is usually directed only towards amphetamine, methamphetamine, MDMA and MDA. This report demonstrates the utility of testing for a wider menu of compounds using LC-MS/MS in order to better characterize the prevalence and toxicities of novel amines such as 2C-I.

Topics: 3,4-Methylenedioxyamphetamine; Adult; Chromatography, Gas; Designer Drugs; Dimethoxyphenylethylamine; Female; Forensic Toxicology; Gas Chromatography-Mass Spectrometry; Hallucinogens; Humans; Intracranial Hemorrhages; Moyamoya Disease; Quadriplegia; Stroke; Substance Abuse Detection; Substance-Related Disorders