Severe clinical toxicity associated with analytically confirmed recreational use of 25I-NBOMe: case series

Abstract Context. 4-Iodo-2,5-dimethoxy-N-(2-methoxybenzyl)phenethylamine (25I-NBOMe) is a N-methoxybenzyl-substituted phenethylamine with potent serotoninergic effects. We describe seven cases of analytically confirmed toxicity due to the recreational use of 25I-NBOMe in the United Kingdom. Case ser...

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Bibliographic Details
Published in:Clinical toxicology (Philadelphia, Pa.) Pa.), 2013-07, Vol.51 (6), p.487-492
Main Authors: Hill, Simon L., Doris, Tom, Gurung, Shiv, Katebe, Stephen, Lomas, Alexander, Dunn, Mick, Blain, Peter, Thomas, Simon H. L.
Format: Article
Language:English
Subjects:
25I-NBOMe
2C-I
5HT2a
Adult
Akathisia, Drug-Induced - etiology
Benzylamines - blood
Benzylamines - toxicity
Complications of poisoning
Dimethoxyphenylethylamine - analogs & derivatives
England - epidemiology
Gas Chromatography-Mass Spectrometry
Hallucinations - chemically induced
Hallucinogens
Humans
Hypertension - chemically induced
Male
Phenethylamines - blood
Phenethylamines - toxicity
Recreational drug use
Serotonin
Street Drugs - blood
Street Drugs - toxicity
Substance-Related Disorders - epidemiology
Tachycardia - chemically induced
Young Adult
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Summary:Abstract Context. 4-Iodo-2,5-dimethoxy-N-(2-methoxybenzyl)phenethylamine (25I-NBOMe) is a N-methoxybenzyl-substituted phenethylamine with potent serotoninergic effects. We describe seven cases of analytically confirmed toxicity due to the recreational use of 25I-NBOMe in the United Kingdom. Case series. Seven patients, all young adult males, presented to hospitals in the northeast of England with clinical toxicity after recreational drug use in January 2013. Clinical features included tachycardia (n = 7), hypertension (4), agitation (6), aggression, visual and auditory hallucinations (6), seizures (3), hyperpyrexia (3), clonus (2), elevated white cell count (2), elevated creatine kinase (7), metabolic acidosis (3), and acute kidney injury (1). LC-MS/MS analysis identified 25I-NBOMe as the main active substance in the plasma of all seven cases. Conclusions. Severe clinical toxicity may occur following recreational use of 25I-NBOMe, with stimulant and serotoninergic features predominating. Clinicians should be alert to this substance, in view of its emergence in Europe as well as in the United States.
ISSN:1556-3650
1556-9519
DOI:10.3109/15563650.2013.802795