5-(2-aminopropyl)indole and Substance-Related-Disorders

5-(2-aminopropyl)indole (5-IT) is a new psychoactive substance, a 'legal high', that recently invaded the drug arena in Europe and has already led to numerous intoxications and fatalities. Knowledge upon its pharmacology and toxicity is non-existent or restricted; the only available information involves very few published scientific articles, official reports from the European Monitoring Centre for Drugs and Drug Addiction and drug abusers' experiences expressed in online drug forums.. A review of the existing knowledge on 5-IT is reported, concerning its chemistry and synthesis, its pharmacological and toxicological aspects, as well as information concerning the fatal and toxic consequences of its use. The existing methodologies for the determination of 5-IT in biological and seized samples as well as its legal status are also presented. All the relative data were gathered through a detailed search of PubMed and the Internet.. No original studies have investigated and/or confirmed its pharmacological properties, acute and chronic toxicity, physiological and behavioural effects or the dependence potential of the drug. Thus, it is difficult to specify the physical effects of 5-IT in humans. This drug is a phenomenon with global significance for public health as its use can lead to intoxication and fatalities.. Significant information on 5-IT is provided for pharmacologists, toxicologists, forensic pathologists and regulatory authorities.. 5-IT is a current public health challenge. Better international collaboration, effective legislation and continuous community alertness are needed to tackle this current growing phenomenon.

Topics: Animals; Humans; Illicit Drugs; Indoles; Psychotropic Drugs; Public Health; Substance-Related Disorders

5-(2-aminopropyl)indole (5-IT) is a new psychoactive substance (NPS; "legal high" or "research chemical") structurally related to indoleamines and substituted phenethylamines and implicated in several fatalities. We describe the clinical characteristics and results of laboratory investigations of 14 analytically confirmed nonfatal cases of 5-IT intoxication within the Swedish STRIDA project.. Observational case series of consecutive patients with admitted or suspected intake of NPS presenting to hospitals in Sweden in 2012.. Blood and/or urine samples were collected from intoxicated patients presenting to emergency departments and intensive care units over the country. Analysis of NPS was performed using an LC-MS/MS multi-component method. Clinical data were collected when caregivers consulted the Poisons Information Centre and also retrieved from medical records. The severity of poisoning was graded retrospectively using the Poisoning Severity Score (PSS).. Eleven male and three female patients (age: 21-53 years, median: 27) tested positive for 5-IT in 2012, all cases appearing in April-July. The 5-IT concentration in serum ranged between 0.015 and 0.59 μg/mL (median: 0.22; n = 8) and in urine between 0.005 and 24.7 μg/mL (median: 5.95; n = 12). Five intoxications were indicated to be caused by 5-IT alone, whereas additional psychoactive substances were detected in the other nine cases. Six (43%) of fourteen cases were graded as severe (PSS 3), five (36%) as moderate (PSS 2), and three (21%) as minor (PSS 1) poisonings. In the severe cases, agitation, hallucinations, dilated pupils without light reaction, tachycardia, hypertension, hyperthermia, myoclonus, muscle rigidity, arrhythmias, seizures, rhabdomyolysis, and/or renal failure were noted.. The results demonstrated that severe clinical toxicity was commonly present in patients with analytically confirmed 5-IT exposure. The clinical features are consistent with a sympathomimetic toxidrome, and some patients also displayed symptoms associated with serotonin toxicity.

Topics: Adult; Designer Drugs; Female; Humans; Indoles; Male; Middle Aged; Severity of Illness Index; Substance-Related Disorders; Sweden; Young Adult

During 2012, the designer drug 5-(2-aminopropyl)indole emerged in Sweden, and became available at different web sites under the name 5-IT or 5-API. This compound is an indole derivative and a positional isomer of alpha-methyltryptamine. In this paper, we report the pathology and toxicology from 15 deaths involving 5-IT. Routine postmortem toxicology was performed in femoral blood, using a targeted screening for pharmaceuticals and drugs of abuse with liquid chromatography time-of-flight technology, and positive results were quantified using chromatographic techniques. For 5-IT, a new method was developed using ultra-high-performance liquid chromatography and tandem mass spectrometry. In 11 cases, intoxication was the cause of death. Two cases were signed out as causa ignota, and they were considered to be natural deaths. All determinations of 5-IT were performed in femoral blood and the concentrations ranged from 0.7 to 18.6 µg/g. Two cases had 5-IT as the only drug identified, while the others presented with other psychotropic drugs or medications in the blood as well. Shortly after this series of deaths, 5-IT was scheduled as a hazardous substance according to the regulation Certain Goods Dangerous to Health on 18 September 2012 prohibiting the handling and selling of the drug. Since then, no positive cases have been found.

Topics: Adult; Chromatography, High Pressure Liquid; Designer Drugs; Forensic Toxicology; Government Regulation; Humans; Indoles; Male; Middle Aged; Reproducibility of Results; Substance Abuse Detection; Substance-Related Disorders; Sweden; Tandem Mass Spectrometry; Young Adult