Severe poisoning after self-reported use of 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine, a novel substituted amphetamine: a case series

摘要: Significant toxicity from amphetamine and cathinone derivatives is being increasingly reported. We describe a series of self-reported exposures to 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine (25-I-NBOME or 25-I), novel derivative. Ten patients with an average age 17 years presented local emergency departments (EDs) in our community after ingestion and/or insufflation drug referred as "25-I." Of 10 patients, 6 reported taking 25-I alone; other substances included ethanol; 2,5-dimethoxy-4-ethylphenethylamine; marijuana; ketamine. Most common effects tachycardia (90%), hypertension (70%), agitation (60%), hallucinations (50%). The heart rate was 123 beats per minute. Two were found status epilepticus, another unresponsive. One patient who had seizure multiple, discrete intraparenchymal hemorrhages acute kidney injury. Six admitted the intensive care unit, two treated ED released, 1 each psychiatry managed clinical decision unit subsequently discharged. Three required emergent intubation, all (7/10) given intravenous benzodiazepines for sedation. Urine blood specimens obtained patient, which showed analytic confirmation 25-I. In addition sympathomimetic effects, methoxy substituent groups impart serotonergic resulting hallucinogenic properties. appears be extremely potent "dose" 500 μg increased potential inadvertent overdose. This case describes significant morbidity cluster young use 25-I, newly identified abuse.