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Xiang J, Wen D, Zhai W, Zhao J, Xiang P, Ma C, Shi Y. Metabolic characterization of 25X-NBOH and 25X-NBOMe phenethylamines based on UHPLC-Q-Exactive Orbitrap MS in human liver microsomes. J Pharm Biomed Anal 2024; 242:116020. [PMID: 38359493 DOI: 10.1016/j.jpba.2024.116020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 01/31/2024] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
The types and quantities of new psychoactive substances synthesized based on structural modifications have increased rapidly in recent years and pose a great challenge to clinical and forensic laboratories. N-benzyl derivatives of phenethylamines, 25B-NBOH, 25E-NBOH, 25H-NBOH, and 25iP-NBOMe have begun to flow into the black market and have caused several poisoning cases and even fatal cases. The aim of this study was to avoid false negative results by detecting the parent drug and its metabolites to extend the detection window in biological matrices and provide basic data for the simultaneous determination of illegal drugs and metabolites in forensic and emergency cases. To facilitate the comparison of metabolic characteristics, we divided the four compounds into two groups of types, 25X-NBOH and 25X-NBOMe. The in vitro phase I and phase II metabolism of these four compounds was investigated by incubating 10 mg mL-1 pooled human liver microsomes with co-substrates for 180 min at 37 ℃, and then analyzing the reaction mixture using ultrahigh-performance liquid chromatography-quadrupole/electrostatic field orbitrap mass spectrometry. In total, 70 metabolites were obtained for the four compounds. The major biotransformations were O-demethylation, hydroxylation, dehydrogenation, N-dehydroxybenzyl, N-demethoxybenzyl, oxidate transformation to ketone and carboxylate, glucuronidation, and their combination reactions. We recommended the major metabolites with high peak area ratio as biomarkers, B2-1 (56.61%), B2-2 (17.43%) and B6 (17.78%) for 25B-NBOH, E2-1 (42.81%), E2-2 (34.90%) and E8-2 (10.18%) for 25E-NBOH, H5 (49.28%), H2-1 (21.54%), and H1 (18.37%) for 25H-NBOH, P3-1 (10.94%), P3-2 (33.18%), P3-3 (14.85%) and P12-2 (23.00%) for 25iP-NBOMe. This is a study to evaluate their metabolic characteristics in detail. Comparative analysis of the N-benzyl derivatives of phenethylamines provided basic data for elucidating their pharmacology and toxicity. Timely analysis of the metabolic profiles of compounds with abuse potential will facilitate the early development of regulatory measures.
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Affiliation(s)
- Jiahong Xiang
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Key Laboratory of Forensic Sciences, Ministry of Justice, Shanghai 200063, PR China; College of Forensic Medicine, Hebei Medical University, Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, Research Unit of Digestive Tract Microecosystem Pharmacology and Toxicology, Chinese Academy of Medical Sciences, Shijiazhuang 050017, Hebei Province, PR China
| | - Di Wen
- College of Forensic Medicine, Hebei Medical University, Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, Research Unit of Digestive Tract Microecosystem Pharmacology and Toxicology, Chinese Academy of Medical Sciences, Shijiazhuang 050017, Hebei Province, PR China
| | - Wenya Zhai
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Key Laboratory of Forensic Sciences, Ministry of Justice, Shanghai 200063, PR China
| | - Junbo Zhao
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Key Laboratory of Forensic Sciences, Ministry of Justice, Shanghai 200063, PR China
| | - Ping Xiang
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Key Laboratory of Forensic Sciences, Ministry of Justice, Shanghai 200063, PR China
| | - Chunling Ma
- College of Forensic Medicine, Hebei Medical University, Hebei Key Laboratory of Forensic Medicine, Collaborative Innovation Center of Forensic Medical Molecular Identification, Research Unit of Digestive Tract Microecosystem Pharmacology and Toxicology, Chinese Academy of Medical Sciences, Shijiazhuang 050017, Hebei Province, PR China
| | - Yan Shi
- Department of Forensic Toxicology, Academy of Forensic Science, Shanghai Key Laboratory of Forensic Medicine, Shanghai Forensic Science Platform, Key Laboratory of Forensic Sciences, Ministry of Justice, Shanghai 200063, PR China.
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Di Gaudio F, Giaccone V, Cucina A, Indelicato S, Raso M, Brunacci G, Lundari A, Rotolo MC, Busardò F, La Rocca M. Technical and health governance aspects of the external quality assessment system for classical and new psychoactive substances analysis testing in blood. J Pharm Biomed Anal 2024; 245:116175. [PMID: 38728951 DOI: 10.1016/j.jpba.2024.116175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 03/15/2024] [Accepted: 04/22/2024] [Indexed: 05/12/2024]
Abstract
New psychoactive substances (NPS) are uncontrolled analogues of existing drugs or newly synthesized chemicals that exhibit psychopharmacological effects. Due to their diverse nature, composition, and increasing prevalence, they present significant challenges to the healthcare system and drug control policies. In response, healthcare system laboratories have developed analytical methods to detect NPS in biological samples. As a Regional Reference Centre, the Sicilian CRQ Laboratory (Regional Laboratory for Quality Control) developed and conducted an External Quality Assessment (EQA) study to assess, in collaboration with the Istituto Superiore di Sanità (ISS), the ability of different Italian laboratories to identify NPS and traditional drugs of abuse (DOA) in biological matrices. Two blood samples were spiked with substances from various drug classes, including synthetic cannabinoids, cathinones, synthetic opiates, and benzodiazepines, at concentrations ranging from 2 to 10 ng/mL. The blood samples were freeze-dried to ensure the stability of DOA and NPS. Twenty-two laboratories from the Italian healthcare system participated in this assessment. The information provided by the laboratories during the registration in an in-house platform included a general description of the laboratory, analytical technique, and the chosen panels of analytes. The same platform was employed to collect and statistically analyze the data and record laboratory feedback and comments. The evaluation of the results revealed that the participating laboratories employed three different techniques for analyzing the samples: GC-MS, LC-MS, and immunoenzymatic methods. Approximately 90 % of the laboratories utilized LC-MS techniques. Around 40 % of false negative results were obtained, with the worst results in the identification of 5-chloro AB PINACA. The results showed that laboratories that used LC-MS methods obtained better specificity and sensitivity compared to the laboratories using other techniques. The results obtained from this first assessment underscore the importance of external quality control schemes in identifying the most effective analytical techniques for detecting trace molecules in biological matrices. Since the judicial authorities have not yet established cut-off values for NPS, this EQA will enable participating laboratories to share their analytical methods and expertise, aiming to establish common criteria for NPS identification.
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Affiliation(s)
- Francesca Di Gaudio
- PROMISE, University of Palermo, Piazza delle Cliniche, 2, Palermo 90127, Italy; Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Chromatography and Mass Spectrometry Section, Quality Control and Chemical Risk (CQRC), Via del Vespro, 133, Palermo 90127, Italy.
| | - Vita Giaccone
- Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Chromatography and Mass Spectrometry Section, Quality Control and Chemical Risk (CQRC), Via del Vespro, 133, Palermo 90127, Italy
| | - Annamaria Cucina
- Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Chromatography and Mass Spectrometry Section, Quality Control and Chemical Risk (CQRC), Via del Vespro, 133, Palermo 90127, Italy.
| | - Sergio Indelicato
- Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Chromatography and Mass Spectrometry Section, Quality Control and Chemical Risk (CQRC), Via del Vespro, 133, Palermo 90127, Italy
| | - Maria Raso
- Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Chromatography and Mass Spectrometry Section, Quality Control and Chemical Risk (CQRC), Via del Vespro, 133, Palermo 90127, Italy
| | - Giuseppina Brunacci
- Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Chromatography and Mass Spectrometry Section, Quality Control and Chemical Risk (CQRC), Via del Vespro, 133, Palermo 90127, Italy
| | - Anna Lundari
- Azienda Ospedaliera Ospedali Riuniti Villa Sofia Cervello, Chromatography and Mass Spectrometry Section, Quality Control and Chemical Risk (CQRC), Via del Vespro, 133, Palermo 90127, Italy
| | | | - Francesco Busardò
- Department of Anatomical, Histological, Forensic and Orthopaedic Sciences, Sapienza University, Rome, Italy
| | - Mario La Rocca
- Assessorato regionale della salute, Dipartimento per la pianificazione strategica, piazza Ottavio Ziino, 24, Palermo 90145, Italy
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Cassiano LMG, Oliveira MDS, de Barros WA, de Fátima Â, Coimbra RS. Neurotoxic effects of hallucinogenic drugs 25H-NBOMe and 25H-NBOH in organotypic hippocampal cultures. Heliyon 2023; 9:e17720. [PMID: 37449113 PMCID: PMC10336585 DOI: 10.1016/j.heliyon.2023.e17720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/26/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction NBOMes and NBOHs are psychoactive drugs derived from phenethylamines and have hallucinogenic effects due to their strong agonism to serotonin 5-HT2A receptors. Although cases of toxicity associated with the recreational use of substituted phenethylamines are frequently reported, there is a lack of information on the possible neurotoxic effects of NBOMe and NBOH in the brain hippocampus, a major neurogenesis region. Objectives This study aimed at assessing the phenotypic and molecular effects of prolonged exposure of the hippocampus to the drugs 25H-NBOMe and 25H-NBOH. Methods The ex vivo organotypic culture model of hippocampal slices (OHC) was used to investigate, by immunofluorescence and confocal microscopy, and transcriptome analyses, the mechanisms associated with the neurotoxicity of 25H-NBOMe and 25H-NBOH. Results Reduction in the density of mature neurons in the OHCs occurred after two and seven days of exposure to 25H-NBOMe and 25H-NBOH, respectively. After the withdrawal of 25H-NBOMe, the density of mature neurons in the OHCs stabilized. In contrast, up to seven days after 25H-NBOH removal from the culture medium, progressive neuron loss was still observed in the OHCs. Interestingly, the exposure to 25H-NBOH induced progenitor cell differentiation, increasing the density of post-mitotic neurons in the OHCs. Corroborating these findings, the functional enrichment analysis of differentially expressed genes in the OHCs exposed to 25H-NBOH revealed the activation of WNT/Beta-catenin pathway components associated with neurogenesis. During and after the exposure to 25H-NBOMe or 25H-NBOH, gene expression patterns related to the activation of synaptic transmission and excitability of neurons were identified. Furthermore, activation of signaling pathways and biological processes related to addiction and oxidative stress and inhibition of the inflammatory response were observed after the period of drug exposure. Conclusion 25H-NBOMe and 25H-NBOH disrupt the balance between neurogenesis and neuronal death in the hippocampus and, although chemically similar, have distinct neurotoxicity mechanisms.
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Affiliation(s)
- Larissa Marcely Gomes Cassiano
- Neurogenômica, Imunopatologia, Instituto René Rachou, Fiocruz, Belo Horizonte, MG, 30190-002, Brazil
- Programa de Pós-Graduação em Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Marina da Silva Oliveira
- Neurogenômica, Imunopatologia, Instituto René Rachou, Fiocruz, Belo Horizonte, MG, 30190-002, Brazil
| | - Wellington Alves de Barros
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Ângelo de Fátima
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Roney Santos Coimbra
- Neurogenômica, Imunopatologia, Instituto René Rachou, Fiocruz, Belo Horizonte, MG, 30190-002, Brazil
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Syrová K, Šíchová K, Danda H, Lhotková E, Jorratt P, Pinterová-Leca N, Vejmola Č, Olejníková-Ladislavová L, Hájková K, Kuchař M, Horáček J, Páleníček T. Acute pharmacological profile of 2C-B-Fly-NBOMe in male Wistar rats—pharmacokinetics, effects on behaviour and thermoregulation. Front Pharmacol 2023; 14:1120419. [PMID: 36969854 PMCID: PMC10033663 DOI: 10.3389/fphar.2023.1120419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 02/27/2023] [Indexed: 03/11/2023] Open
Abstract
Introduction:N-2-methoxy-benzylated (“NBOMe”) analogues of phenethylamine are a group of new psychoactive substances (NPS) with reported strong psychedelic effects in sub-milligram doses linked to a number of severe intoxications, including fatal ones. In our present work, we provide a detailed investigation of pharmacokinetics and acute behavioural effects of 2C-B-Fly-NBOMe (2-(8-bromo-2,3,6,7-tetrahydrobenzo [1,2-b:4,5-b′]difuran-4-yl)-N-[(2-methoxybenzyl]ethan-1-amine), an analogue of popular psychedelic entactogen 2C-B (4-Bromo-2,5-dimethoxyphenethylamine).Methods: All experiments were conducted on adult male Wistar rats. Pharmacokinetic parameters of 2C-B-Fly-NBOMe (1 mg/kg subcutaneously; s. c.) in blood serum and brain tissue were analysed over 24 h using liquid chromatography-mass spectrometry (LC/MS). For examination of behavioural parameters in open field test (OFT) and prepulse inhibition (PPI) of acoustic startle reaction (ASR), 2C-B-Fly-NBOMe (0.2, 1 and 5 mg/kg s. c.) was administered in two temporal onsets: 15 and 60 min after administration. Thermoregulatory changes were evaluated in individually and group-housed animals over 8 h following the highest dose used in behavioural experiments (5 mg/kg s. c.).Results: Peak drug concentrations were detected 30 and 60 min after the drug application in serum (28 ng/ml) and brain tissue (171 ng/g), respectively. The parental compound was still present in the brain 8 h after administration. Locomotor activity was dose-dependently reduced by the drug in both temporal testing onsets. ASR was also strongly disrupted in both temporal onsets, drug’s effect on PPI was weaker. 2C-B-Fly-NBOMe did not cause any significant thermoregulatory changes.Discussion: Our results suggest that 2C-B-Fly-NBOMe penetrates animal brain tissue in a relatively slow manner, induces significant inhibitory effects on motor performance, and attenuates sensorimotor gating. Its overall profile is similar to closely related analogue 2C-B and other NBOMe substances.
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Affiliation(s)
- Kateřina Syrová
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Klára Šíchová
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
| | - Hynek Danda
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Eva Lhotková
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
| | - Pascal Jorratt
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Nikola Pinterová-Leca
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Čestmír Vejmola
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Lucie Olejníková-Ladislavová
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Kateřina Hájková
- Forensic Laboratory of Biologically Active Compounds, Department of Chemistry of Natural Compounds, University of Chemistry and Technology, Prague, Czechia
| | - Martin Kuchař
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
- Forensic Laboratory of Biologically Active Compounds, Department of Chemistry of Natural Compounds, University of Chemistry and Technology, Prague, Czechia
- *Correspondence: Tomáš Páleníček, ; Martin Kuchař,
| | - Jiří Horáček
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
| | - Tomáš Páleníček
- Psychedelics Research Centre, National Institute of Mental Health, Prague, Czechia
- Third Faculty of Medicine, Charles University, Prague, Czechia
- *Correspondence: Tomáš Páleníček, ; Martin Kuchař,
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Simão AY, Antunes M, Cabral E, Oliveira P, Rosendo LM, Brinca AT, Alves E, Marques H, Rosado T, Passarinha LA, Andraus M, Barroso M, Gallardo E. An Update on the Implications of New Psychoactive Substances in Public Health. Int J Environ Res Public Health 2022; 19:ijerph19084869. [PMID: 35457736 PMCID: PMC9028227 DOI: 10.3390/ijerph19084869] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 02/04/2023]
Abstract
The emergence of new psychoactive substances has earned a great deal of attention, and several reports of acute poisoning and deaths have been issued involving, for instance, synthetic opiates. In recent years, there have been profound alterations in the legislation concerning consumption, marketing, and synthesis of these compounds; rapid alert systems have also been subject to changes, and new substances and new markets, mainly through the internet, have appeared. Their effects and how they originate in consumers are still mostly unknown, primarily in what concerns chronic toxicity. This review intends to provide a detailed description of these substances from the point of view of consumption, toxicokinetics, and health consequences, including case reports on intoxications in order to help researchers and public health agents working daily in this area.
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Affiliation(s)
- Ana Y. Simão
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, 6200-284 Covilha, Portugal
| | - Mónica Antunes
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
- Serviço de Química e Toxicologia Forenses, Instituto Nacional de Medicina Legal e Ciências Forenses, Delegação do Sul, 1150-219 Lisboa, Portugal
| | - Emanuel Cabral
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
| | - Patrik Oliveira
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
| | - Luana M. Rosendo
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
| | - Ana Teresa Brinca
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
| | - Estefânia Alves
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
| | - Hernâni Marques
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, 6200-284 Covilha, Portugal
| | - Tiago Rosado
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, 6200-284 Covilha, Portugal
| | - Luís A. Passarinha
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
- UCIBIO—Applied Molecular Biosciences Unit, Departamento de Química, NOVA School of Science and Technology, Universidade NOVA, 2829-516 Caparica, Portugal
- Associate Laboratory i4HB-Institute for Health and Bioeconomy, NOVA School of Science and Technology, Universidade NOVA, 2819-516 Caparica, Portugal
- Correspondence: (L.A.P.); (M.A.); (M.B.); (E.G.); Tel.: +351-275-329-001 (L.A.P. & E.G.); +55-800-042-0384 (M.A.); +351-21-881-1800 (M.B.)
| | - Maristela Andraus
- Chromatox/Dasa Laboratory Ltda. Sumaré, São Paulo 01259-000, Brazil
- Correspondence: (L.A.P.); (M.A.); (M.B.); (E.G.); Tel.: +351-275-329-001 (L.A.P. & E.G.); +55-800-042-0384 (M.A.); +351-21-881-1800 (M.B.)
| | - Mário Barroso
- Serviço de Química e Toxicologia Forenses, Instituto Nacional de Medicina Legal e Ciências Forenses, Delegação do Sul, 1150-219 Lisboa, Portugal
- Correspondence: (L.A.P.); (M.A.); (M.B.); (E.G.); Tel.: +351-275-329-001 (L.A.P. & E.G.); +55-800-042-0384 (M.A.); +351-21-881-1800 (M.B.)
| | - Eugenia Gallardo
- Centro de Investigação em Ciências da Saúde (CICS-UBI), Universidade da Beira Interior, 6200-506 Covilha, Portugal; (A.Y.S.); (M.A.); (E.C.); (P.O.); (L.M.R.); (A.T.B.); (E.A.); (H.M.); (T.R.)
- Laboratório de Fármaco-Toxicologia, UBIMedical, Universidade da Beira Interior, 6200-284 Covilha, Portugal
- Correspondence: (L.A.P.); (M.A.); (M.B.); (E.G.); Tel.: +351-275-329-001 (L.A.P. & E.G.); +55-800-042-0384 (M.A.); +351-21-881-1800 (M.B.)
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Rudin D, Liechti ME, Luethi D. Molecular and clinical aspects of potential neurotoxicity induced by new psychoactive stimulants and psychedelics. Exp Neurol 2021; 343:113778. [PMID: 34090893 DOI: 10.1016/j.expneurol.2021.113778] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 05/25/2021] [Accepted: 05/29/2021] [Indexed: 12/20/2022]
Abstract
New psychoactive stimulants and psychedelics continue to play an important role on the illicit new psychoactive substance (NPS) market. Designer stimulants and psychedelics both affect monoaminergic systems, although by different mechanisms. Stimulant NPS primarily interact with monoamine transporters, either as inhibitors or as substrates. Psychedelic NPS most potently interact with serotonergic receptors and mediate their mind-altering effects mainly through agonism at serotonin 5-hydroxytryptamine-2A (5-HT2A) receptors. Rarely, designer stimulants and psychedelics are associated with potentially severe adverse effects. However, due to the high number of emerging NPS, it is not possible to investigate the toxicity of each individual substance in detail. The brain is an organ particularly sensitive to substance-induced toxicity due to its high metabolic activity. In fact, stimulant and psychedelic NPS have been linked to neurological and cognitive impairments. Furthermore, studies using in vitro cell models or rodents indicate a variety of mechanisms that could potentially lead to neurotoxic damage in NPS users. Cytotoxicity, mitochondrial dysfunction, and oxidative stress may potentially contribute to neurotoxicity of stimulant NPS in addition to altered neurochemistry. Serotonin 5-HT2A receptor-mediated toxicity, oxidative stress, and activation of mitochondrial apoptosis pathways could contribute to neurotoxicity of some psychedelic NPS. However, it remains unclear how well the current preclinical data of NPS-induced neurotoxicity translate to humans.
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Affiliation(s)
- Deborah Rudin
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland; Institute of Pharmacology, Medical University of Vienna, Vienna, Austria
| | - Matthias E Liechti
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Dino Luethi
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland; Institute of Pharmacology, Medical University of Vienna, Vienna, Austria; Institute of Applied Physics, TU Wien, Vienna, Austria.
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Kamińska K, Świt P, Malek K. 2-(4-Iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine (25I-NBOME): A Harmful Hallucinogen Review. J Anal Toxicol 2021; 44:947-956. [PMID: 32128596 DOI: 10.1093/jat/bkaa022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
NBOMes are N-benzylmethoxy derivatives of the 2C family compounds with N-2-methoxybenzyl moiety substituted by the methoxy group at the 2- and 5-position and the halogen group at the 4-position of the phenyl ring. These substances are a new class of potent serotonin 5-HT2A receptor agonist hallucinogens with potential harmful effects. The substitution with halogen of the already psychoactive phenethylamine produces a derivative (2C-I) with increased hallucinogenic effects. This class of hallucinogens has chemical structures very similar to natural hallucinogenic alkaloid mescaline and these are sold mainly via internet as a 'legal' alternative to other hallucinogenic drug-lysergic acid diethylamide (LSD). 25I-NBOMe is the first synthesized and one of the most common compound from NBOMes. Knowledge of pharmacological properties of 25I-NBOMe is very limited so far. There are only a few in vivo and in vitro so far published studies. The behavioral experiments are mainly related with the hallucinogenic effect of 25I-NBOMe while the in vitro studies concerning mainly the affinity for 5-HT2A receptors. The 25I-NBOMe Critical Review 2016 reported 51 non-fatal intoxications and 21 deaths associated with 25I-NBOMe across Europe. Case reports describe various toxic effects of 25I-NBOMe usage including tachycardia, hypertension, hallucinations, rhabdomyolysis, acute kidney injury and death. The growing number of fatal and non-fatal intoxication cases indicates that 25I-NBOMe should be considered as a serious danger to public health. This review aims to present the current state of knowledge on pharmacological effects and chemical properties of 25I-NBOMe and to describe reported clinical cases and analytical methods available for identification of this agent in biological material.
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Affiliation(s)
- Katarzyna Kamińska
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University in Krakow, Bobrzynskiego 14, Krakow 30-348, Poland
| | - Paweł Świt
- Jagiellonian Centre for Experimental Therapeutics, Jagiellonian University in Krakow, Bobrzynskiego 14, Krakow 30-348, Poland
| | - Kamilla Malek
- Faculty of Chemistry, Jagiellonian University in Krakow, Gronostajowa 2, Krakow 30-387, Poland
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8
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Lodygin AN, Rakhmanova EA, Popova EA, Batotsyrenov BV, Popov AA, Bolshakova MA, Rakhmanov RM. [Optimization of treatment of acute poisoning with severe psychodisleptics]. Zh Nevrol Psikhiatr Im S S Korsakova 2020; 120:60-65. [PMID: 33081448 DOI: 10.17116/jnevro202012009160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To increase the efficacy of acute poisoning with severe psychodisleptics. MATERIAL AND METHODS Fifty-two patients with acute psychoactive substance poisoning were studied. Patients of the main group (n=27) received cytoflavin infusion in combination with inhaled sedation with sevoflurane in addition to conventional therapy. The comparison group consisted of 25 patients who received conventional therapy. RESULTS AND CONCLUSION Augmentation of conventional therapy with cytoflavin in combination with inhaled sedation with sevoflurane, affecting various links in the pathogenesis of acute severe poisoning with psychodisleptics, made it possible to cope in a shorter time.
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Affiliation(s)
- A N Lodygin
- Dzhanelidze St. Petersburg research Institute of emergency medicine, St-Petersburg, Russia
| | - E A Rakhmanova
- Karpovich Krasnoyarsk Interdistrict clinical hospital of emergency medical care, Krasnoyarsk, Russia.,Voino-Yasenetsky Krasnoyarsk state medical University, Krasnoyarsk, Russia
| | - E A Popova
- Karpovich Krasnoyarsk Interdistrict clinical hospital of emergency medical care, Krasnoyarsk, Russia.,Voino-Yasenetsky Krasnoyarsk state medical University, Krasnoyarsk, Russia
| | - B V Batotsyrenov
- Dzhanelidze St. Petersburg research Institute of emergency medicine, St-Petersburg, Russia
| | - A A Popov
- Karpovich Krasnoyarsk Interdistrict clinical hospital of emergency medical care, Krasnoyarsk, Russia.,Voino-Yasenetsky Krasnoyarsk state medical University, Krasnoyarsk, Russia
| | - M A Bolshakova
- Karpovich Krasnoyarsk Interdistrict clinical hospital of emergency medical care, Krasnoyarsk, Russia.,Voino-Yasenetsky Krasnoyarsk state medical University, Krasnoyarsk, Russia
| | - R M Rakhmanov
- Karpovich Krasnoyarsk Interdistrict clinical hospital of emergency medical care, Krasnoyarsk, Russia.,Voino-Yasenetsky Krasnoyarsk state medical University, Krasnoyarsk, Russia
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9
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Stellpflug SJ, Cole JB, Greller HA. Urine Drug Screens in the Emergency Department: The Best Test May Be No Test at All. J Emerg Nurs 2020; 46:923-931. [PMID: 32843202 DOI: 10.1016/j.jen.2020.06.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 05/11/2020] [Accepted: 06/03/2020] [Indexed: 11/27/2022]
Abstract
The manuscript purpose is to provide a resource for clinicians on the functionality and pitfalls of the rapid urine drug screen for clinical decision making. Many providers remain under-informed about the inherent inaccuracies. The rapid urine drug screen is the first, and often only, step of drug testing. In the majority of emergency departments the urine drug screen is a collection of immunoassays reliant on an interaction between the structure of a particular drug or metabolite and an antibody. Drugs in separate pharmacologic classes often have enough structural similarity to cause false positives. Conversely, drugs within the same pharmacologic class often have different enough structures that they may result in inappropriate negatives. This lack of sensitivity and specificity significantly reduces the test utility, and may cause decision-making confusion. The timing of the drug screen relative to the drug exposure also limits accuracy, as does detection threshold. Confirmatory steps following the initial immunoassay include chromatography and/or mass spectrometry. These are unavailable at many institutions and results rarely return while the patient is in the emergency department. In addition, institutional capabilities vary, even with confirmatory testing. Confirmation accuracy depends on a number of factors, including the extent of the catalog of drugs/metabolites that the facility is calibrated to detect and report. In summary, the standard emergency department urine drug screen is a test with extremely limited clinical utility with multiple properties contributing to poor sensitivity, specificity, and accuracy. The test should be used rarely, if ever, for clinical decision making.
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10
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Clancy L, Philp M, Shimmon R, Fu S. Development and validation of a color spot test method for the presumptive detection of 25-NBOMe compounds. Drug Test Anal 2020; 13:929-943. [PMID: 32744773 DOI: 10.1002/dta.2905] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/26/2020] [Accepted: 07/28/2020] [Indexed: 12/12/2022]
Abstract
The great increase of new psychoactive substances over the past decade has substantially transformed the illicit drug industry to an ever-changing dynamic market. 25-NBOMe compounds are just one of these new substance groups that pose a public health risk in many countries around the world. These highly potent, hallucinogenic phenethylamines have previously been sold as "legal highs" or "synthetic LSD" and the necessity to rapidly identify their presence is crucial. While there are many laboratory-based analytical methods capable of identifying these compounds, the lack of presumptive test methods indicates the need for a specific and timely test that could be used in the field. Herein we outline the developed chemical spot test that can selectively identify the presence of 25-NBOMe compounds and related analogs through the reaction with a substituted benzoquinone reagent under basic conditions. This test method has been comprehensively validated showing a high level of selectivity, specificity, and precision with only two other illicit substances producing similar positive results as 25-NBOMe and few false-negative results seen. The working limit of detection was determined to be 225 μg and there was no cross-reactivity from potential adulterants of significance. This test has also been shown to work directly with blotter papers containing 25-NBOMe compounds, indicating no interference from this common matrix and the ability to differentiate these compounds from LSD. This method shows a high potential to be translated to a field compatible test that is simple, rapid, and selective for 25-NBOMe compounds.
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Affiliation(s)
- Laura Clancy
- Centre for Forensic Science, University of Technology Sydney, Ultimo, NSW, Australia
| | - Morgan Philp
- Centre for Forensic Science, University of Technology Sydney, Ultimo, NSW, Australia
| | - Ronald Shimmon
- Centre for Forensic Science, University of Technology Sydney, Ultimo, NSW, Australia
| | - Shanlin Fu
- Centre for Forensic Science, University of Technology Sydney, Ultimo, NSW, Australia
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11
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Yoon KS, Gu SM, Cha HJ, Kim YH, Yun J, Lee JM. 25I-NBOMe, a phenethylamine derivative, induces adverse cardiovascular effects in rodents: possible involvement of p21 (CDC42/RAC)-activated kinase 1. Drug Chem Toxicol 2020; 45:898-906. [PMID: 32597268 DOI: 10.1080/01480545.2020.1784924] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Abuse of new psychoactive substances is an emerging social problem. Several phenethylamines are internationally controlled substances as they are likely to be abused and have adverse effects. Phenethylamine analog 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine (25I-NBOMe) has been reported as one of the most commonly abused psychoactive substance. However, the cardiotoxicity of this compound has not been extensively evaluated. Thus, in this study, we investigated the adverse cardiovascular effects of 25I-NBOMe, related to p21 (CDC42/RAC)-activated kinase 1 (PAK1). The cardiotoxicity of 25I-NBOMe was evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, live/dead cytotoxicity assay, PAK1/CDC42 kinase assay, and in vivo electrocardiography (ECG). Also, we analyzed the expression level of PAK1, which is known to play key roles in the cardiovascular system. In the MTT assay, cell viability of 25I-NBOMe-treated H9c2 cells or primary cardiomyocytes of ICR mice decreased in a concentration-dependent manner. Results from the in vitro cytotoxicity assay in cardiomyocytes showed that 25I-NBOMe decreased the viability of H9c2 rat cardiomyocytes, and TC50 of 25I-NBOMe was found to be 70.4 μM. We also observed that 25I-NBOMe reduced PAK1 activity in vitro. Surface ECG measurement revealed that intravenous injection of 25I-NBOMe (doses of 1.0 and 3.0 mg/kg, corresponding to serum concentrations of 18.1 and 28.6 ng/mL, respectively) prolonged the QTc interval in SD rats. Furthermore, treatment with 25I-NBOMe downregulated the expression of PAK1 in the hearts of SD rats and H9c2 cells. In summary, our findings indicate that PAK1-related adverse effects of 25I-NBOMe can cause toxicity to cardiomyocytes and induce an abnormal ECG pattern in animals.
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Affiliation(s)
- Kyung Sik Yoon
- Ministry of Food and Drug Safety, National Institute of Food and Drug Safety Evaluation, Cheongju-si, Republic of Korea
| | - Sun Mi Gu
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju-si, Republic of Korea
| | - Hye Jin Cha
- Ministry of Food and Drug Safety, National Institute of Food and Drug Safety Evaluation, Cheongju-si, Republic of Korea
| | - Young-Hoon Kim
- Ministry of Food and Drug Safety, National Institute of Food and Drug Safety Evaluation, Cheongju-si, Republic of Korea
| | - Jaesuk Yun
- College of Pharmacy and Medical Research Center, Chungbuk National University, Cheongju-si, Republic of Korea
| | - Jin-Moo Lee
- Ministry of Food and Drug Safety, National Institute of Food and Drug Safety Evaluation, Cheongju-si, Republic of Korea
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12
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Abstract
Psychoactive substances with chemical structures or pharmacological profiles that are similar to traditional drugs of abuse continue to emerge on the recreational drug market. Internet vendors may at least temporarily sell these so-called designer drugs without adhering to legal statutes or facing legal consequences. Overall, the mechanism of action and adverse effects of designer drugs are similar to traditional drugs of abuse. Stimulants, such as amphetamines and cathinones, primarily interact with monoamine transporters and mostly induce sympathomimetic adverse effects. Agonism at μ-opioid receptors and γ-aminobutyric acid-A (GABAA) or GABAB receptors mediates the pharmacological effects of sedatives, which may induce cardiorespiratory depression. Dissociative designer drugs primarily act as N-methyl-d-aspartate receptor antagonists and pose similar health risks as the medically approved dissociative anesthetic ketamine. The cannabinoid type 1 (CB1) receptor is thought to drive the psychoactive effects of synthetic cannabinoids, which are associated with a less desirable effect profile and more severe adverse effects compared with cannabis. Serotonergic 5-hydroxytryptamine-2A (5-HT2A) receptors mediate alterations of perception and cognition that are induced by serotonergic psychedelics. Because of their novelty, designer drugs may remain undetected by routine drug screening, thus hampering evaluations of adverse effects. Intoxication reports suggest that several designer drugs are used concurrently, posing a high risk for severe adverse effects and even death.
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13
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Lützen E, Holtkamp M, Stamme I, Schmid R, Sperling M, Pütz M, Karst U. Multimodal imaging of hallucinogens 25C‐ and 25I‐NBOMe on blotter papers. Drug Test Anal 2020; 12:465-471. [DOI: 10.1002/dta.2751] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 12/12/2019] [Accepted: 12/13/2019] [Indexed: 01/01/2023]
Affiliation(s)
- Elias Lützen
- University of MünsterInstitute of Inorganic and Analytical Chemistry Münster Germany
| | - Michael Holtkamp
- University of MünsterInstitute of Inorganic and Analytical Chemistry Münster Germany
| | - Imke Stamme
- Criminal Police Office (BKA)Forensic Science Institute Wiesbaden Germany
| | - Robin Schmid
- University of MünsterInstitute of Inorganic and Analytical Chemistry Münster Germany
| | - Michael Sperling
- University of MünsterInstitute of Inorganic and Analytical Chemistry Münster Germany
- European Virtual Institute for Speciation Analysis (EVISA) Münster Germany
| | - Michael Pütz
- Criminal Police Office (BKA)Forensic Science Institute Wiesbaden Germany
| | - Uwe Karst
- University of MünsterInstitute of Inorganic and Analytical Chemistry Münster Germany
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14
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Abstract
Recently, a new class of psychedelic compounds named NBOMe (or 25X-NBOMe) has appeared on the illegal drug market. NBOMes are analogs of the 2C family of phenethylamine drugs, originally synthesized by Alexander Shulgin, that contain a N-(2-methoxy)benzyl substituent. The most frequently reported drugs from this group are 25I-NBOMe, 25B-NBOMe, and 25C-NBOMe. NBOMe compounds are ultrapotent and highly efficacious agonists of serotonin 5-HT2A and 5-HT2C receptors (Ki values in low nanomolar range) with more than 1000-fold selectivity for 5-HT2A compared with 5-HT1A. They display higher affinity for 5-HT2A receptors than their 2C counterparts and have markedly lower affinity, potency, and efficacy at the 5-HT2B receptor compared to 5-HT2A or 5-HT2C. The drugs are sold as blotter papers, or in powder, liquid, or tablet form, and they are administered sublingually/buccally, intravenously, via nasal insufflations, or by smoking. Since their introduction in the early 2010s, numerous reports have been published on clinical intoxications and fatalities resulting from the consumption of NBOMe compounds. Commonly observed adverse effects include visual and auditory hallucinations, confusion, anxiety, panic and fear, agitation, uncontrollable violent behavior, seizures, excited delirium, and sympathomimetic signs such mydriasis, tachycardia, hypertension, hyperthermia, and diaphoresis. Rhabdomyolysis, disseminated intravascular coagulation, hypoglycemia, metabolic acidosis, and multiorgan failure were also reported. This survey provides an updated overview of the pharmacological properties, pattern of use, metabolism, and desired effects associated with NBOMe use. Special emphasis is given to cases of non-fatal and lethal intoxication involving these compounds. As the analysis of NBOMes in biological materials can be challenging even for laboratories applying modern sensitive techniques, this paper also presents the analytical methods most commonly used for detection and identification of NBOMes and their metabolites.
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Affiliation(s)
- Jolanta B Zawilska
- Department of Pharmacodynamics, Medical University of Łódź, Łódź, Poland
| | - Monika Kacela
- Department of Pharmacodynamics, Medical University of Łódź, Łódź, Poland
| | - Piotr Adamowicz
- Department of Forensic Toxicology, Institute of Forensic Research, Kraków, Poland
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15
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Abstract
New psychoactive substances (NPS) are a heterogeneous group of substances. They are associated with a number of health and social harms on an individual and societal level. NPS toxicity and dependence syndromes are recognised in primary care, emergency departments, psychiatric inpatient and community care settings. One pragmatic classification system is to divide NPS into one of four groups: synthetic stimulants, synthetic cannabinoids, synthetic hallucinogens and synthetic depressants (which include synthetic opioids and benzodiazepines). We review these four classes of NPS, including their chemical structures, mechanism of action, modes of use, intended intoxicant effects, and their associated physical and mental health harms. The current challenges faced by laboratory testing for NPS are also explored, in the context of the diverse range of NPS currently available, rate of production and emergence of new substances, the different formulations, and methods of acquisition and distribution.
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Affiliation(s)
- Abu Shafi
- East London Foundation Trust, London, UK
| | - Alex J Berry
- Division of Psychiatry, University College London, UK
| | | | - David M Wood
- Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Derek K Tracy
- Consultant Psychiatrist, Oxleas NHS Foundation Trust, London, UK
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16
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Miliano C, Marti M, Pintori N, Castelli MP, Tirri M, Arfè R, De Luca MA. Neurochemical and Behavioral Profiling in Male and Female Rats of the Psychedelic Agent 25I-NBOMe. Front Pharmacol 2019; 10:1406. [PMID: 31915427 PMCID: PMC6921684 DOI: 10.3389/fphar.2019.01406] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 11/05/2019] [Indexed: 11/13/2022] Open
Abstract
4-Iodo-2,5-dimethoxy-N-(2-methoxybenzyl)phenethylamine (25I-NBOMe), commonly called “N-Bomb,” is a synthetic phenethylamine with psychedelic and entactogenic effects; it was available on the Internet both as a legal alternative to lysergic acid diethylamide (LSD) and as a surrogate of 3,4-methylenedioxy-methamphetamine (MDMA), but now it has been scheduled among controlled substances. 25I-NBOMe acts as full agonist on serotonergic 5-HT2A receptors. Users are often unaware of ingesting fake LSD, and several cases of intoxication and fatalities have been reported. In humans, overdoses of “N-Bomb” can cause tachycardia, hypertension, seizures, and agitation. Preclinical studies have not yet widely investigated the rewarding properties and behavioral effects of this compound in both sexes. Therefore, by in vivo microdialysis, we evaluated the effects of 25I-NBOMe on dopaminergic (DA) and serotonergic (5-HT) transmissions in the nucleus accumbens (NAc) shell and core, and the medial prefrontal cortex (mPFC) of male and female rats. Moreover, we investigated the effect of 25I-NBOMe on sensorimotor modifications as well as body temperature, nociception, and startle/prepulse inhibition (PPI). We showed that administration of 25I-NBOMe affects DA transmission in the NAc shell in both sexes, although showing different patterns; moreover, this compound causes impaired visual responses in both sexes, whereas core temperature is heavily affected in females, and the highest dose tested exerts an analgesic effect prominent in male rats. Indeed, this drug is able to impair the startle amplitude with the same extent in both sexes and inhibits the PPI in male and female rats. Our study fills the gap of knowledge on the behavioral effects of 25I-NBOMe and the risks associated with its ingestion; it focuses the attention on sex differences that might be useful to understand the trend of consumption as well as to recognize and treat intoxication and overdose symptoms.
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Affiliation(s)
- Cristina Miliano
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Matteo Marti
- National Institute of Neuroscience (INN), Universirty of Cagliari, Cagliari, Italy.,Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy.,Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Rome, Italy
| | - Nicholas Pintori
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Maria Paola Castelli
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,National Institute of Neuroscience (INN), Universirty of Cagliari, Cagliari, Italy
| | - Micaela Tirri
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Raffaella Arfè
- Department of Morphology, Experimental Medicine and Surgery, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy.,Institute of Public Health, Section of Legal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Maria Antonietta De Luca
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,National Institute of Neuroscience (INN), Universirty of Cagliari, Cagliari, Italy
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17
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Spoelder AS, Louwerens JKG, Krens SD, Jager N, LeCouffe NE, de Ruijter W, Brunt TM. Unexpected Serotonin Syndrome, Epileptic Seizures, and Cerebral Edema Following 2,5-dimethoxy-4-bromophenethylamine Ingestion. J Forensic Sci 2019; 64:1950-1952. [PMID: 31643086 PMCID: PMC6900031 DOI: 10.1111/1556-4029.14214] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 09/26/2019] [Accepted: 09/27/2019] [Indexed: 12/12/2022]
Abstract
4‐bromo‐2,5‐dimethoxyphenethylamine (2C‐B) is a designer drug. In Europe, 2C‐B is easily obtained and used for recreational purposes. It is known for its stimulating effects similar to those of 3,4‐methylenedioxymethamphetamine, although in higher doses it has more hallucinogenic effects. Here, we report a case of 2C‐B ingestion, confirmed by liquid chromatography‐tandem mass spectrometry, in an 18‐year‐old man. The neurological consequences were severe, including the development of serotonin syndrome and severe brain edema. Supportive therapy resulted in a stable condition, although, after several months, the patient still suffered from severe neurological impairment due to the drug‐induced toxicity. This case showed that 2C‐B could not be identified with the drugs of abuse screening routinely used in Dutch hospitals. The use of 2C‐B carries many risks, with potentially profound neurological damage, that both consumers and healthcare physicians are unaware of.
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Affiliation(s)
- Antoinette S Spoelder
- Department Intensive Care, Northwest Clinics (Noordwest Ziekenhuisgroep), Postbus 501, 1800 AM, Alkmaar, The Netherlands
| | - Jan K G Louwerens
- Department Intensive Care, Northwest Clinics (Noordwest Ziekenhuisgroep), Postbus 501, 1800 AM, Alkmaar, The Netherlands
| | - Stefanie D Krens
- Department Intensive Care, Northwest Clinics (Noordwest Ziekenhuisgroep), Postbus 501, 1800 AM, Alkmaar, The Netherlands.,Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Nynke Jager
- Department Intensive Care, Northwest Clinics (Noordwest Ziekenhuisgroep), Postbus 501, 1800 AM, Alkmaar, The Netherlands
| | - Natalie E LeCouffe
- Department Intensive Care, Northwest Clinics (Noordwest Ziekenhuisgroep), Postbus 501, 1800 AM, Alkmaar, The Netherlands.,Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Wouter de Ruijter
- Department Intensive Care, Northwest Clinics (Noordwest Ziekenhuisgroep), Postbus 501, 1800 AM, Alkmaar, The Netherlands
| | - Tibor M Brunt
- Amsterdam University Medical Centre, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.,Radboud Universiteit, Behavourial Science Institute, Montessorilaan 3, 6525 HR, Nijmegen, The Netherlands
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18
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Elbardisy H, Foster CW, Marron J, Mewis RE, Sutcliffe OB, Belal TS, Talaat W, Daabees HG, Banks CE. Quick Test for Determination of N-Bombs (Phenethylamine Derivatives, NBOMe) Using High-Performance Liquid Chromatography: A Comparison between Photodiode Array and Amperometric Detection. ACS Omega 2019; 4:14439-14450. [PMID: 31528797 PMCID: PMC6740171 DOI: 10.1021/acsomega.9b01366] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Accepted: 07/23/2019] [Indexed: 05/02/2023]
Abstract
The emergence of a new class of novel psychoactive substances, N-benzyl-substituted phenethylamine derivatives so-called "NBOMes" or "Smiles", in the recreational drug market has forced the development of new sensitive analytical methodologies for their detection and quantitation. NBOMes' hallucinogenic effects mimic those of the illegal psychedelic drug lysergic acid diethylamide (LSD) and are typically sold as LSD on blotter papers, resulting in a remarkable number of fatalities worldwide. In this article, four halide derivatives of NBOMe, namely, 2-(4-fluoro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethan-1-amine, 2-(4-chloro-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethan-1-amine, 2-(4-bromo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethan-1-amine, and 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethan-1-amine, were detected and quantified simultaneously using a high-performance liquid chromatographic method, and two detection systems were compared: photodiode array detection (detection system I) and amperometric detection via a commercially available impinging jet flow-cell system incorporating embedded graphite screen-printed macroelectrodes (detection system II). Under optimized experimental conditions, linear calibration plots were obtained in the concentration range of 10-300 and 20-300 μg mL-1, for detection systems I and II, respectively. Detection limit (limit of detection) values were between 4.6-6.7 and 9.7-18 μg mL-1, for detection systems I and II, respectively. Both detectors were employed for the analysis of the four NBOMe derivatives in the bulk form, in the presence of LSD and adulterants commonly found in street samples (e.g. paracetamol, caffeine, and benzocaine). Furthermore, the method was applied for the analysis of simulated blotter papers, and the obtained percentage recoveries were satisfactory, emphasizing its advantageous applicability for the routine analysis of NBOMes in forensic laboratories.
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Affiliation(s)
- Hadil
M. Elbardisy
- Faculty
of Science and Engineering and MANchester DRug Analysis and Knowledge
Exchange (MANDRAKE), Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, U.K.
- Pharmaceutical Analysis Department, Faculty of Pharmacy and Pharmaceutical
Chemistry Department, Faculty of Pharmacy, Damanhour University, Damanhour 22511, Egypt
| | - Christopher W. Foster
- Faculty
of Science and Engineering and MANchester DRug Analysis and Knowledge
Exchange (MANDRAKE), Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, U.K.
| | - Jack Marron
- Faculty
of Science and Engineering and MANchester DRug Analysis and Knowledge
Exchange (MANDRAKE), Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, U.K.
| | - Ryan E. Mewis
- Faculty
of Science and Engineering and MANchester DRug Analysis and Knowledge
Exchange (MANDRAKE), Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, U.K.
| | - Oliver B. Sutcliffe
- Faculty
of Science and Engineering and MANchester DRug Analysis and Knowledge
Exchange (MANDRAKE), Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, U.K.
| | - Tarek S. Belal
- Department
of Pharmaceutical Analytical Chemistry, Faculty of Pharmacy, Alexandria University, Alexandria 21521, Egypt
| | - Wael Talaat
- Pharmaceutical Analysis Department, Faculty of Pharmacy and Pharmaceutical
Chemistry Department, Faculty of Pharmacy, Damanhour University, Damanhour 22511, Egypt
| | - Hoda G. Daabees
- Pharmaceutical Analysis Department, Faculty of Pharmacy and Pharmaceutical
Chemistry Department, Faculty of Pharmacy, Damanhour University, Damanhour 22511, Egypt
| | - Craig E. Banks
- Faculty
of Science and Engineering and MANchester DRug Analysis and Knowledge
Exchange (MANDRAKE), Faculty of Science and Engineering, Manchester Metropolitan University, Chester Street, Manchester M1 5GD, U.K.
- E-mail: . Tel: ++(0)1612471196. Website: www.craigbanksresearch.com
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19
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Davidson JT, Jackson GP. The differentiation of 2,5-dimethoxy-N-(N-methoxybenzyl)phenethylamine (NBOMe) isomers using GC retention indices and multivariate analysis of ion abundances in electron ionization mass spectra. Forensic Chem 2019. [DOI: 10.1016/j.forc.2019.100160] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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20
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Moreira AMDS, de Oliveira HL, Allochio Filho JF, Florez DHÂ, Borges MMC, Lacerda V, Romão W, Borges KB. NBOMe compounds: An overview about analytical methodologies aiming their determination in biological matrices. Trends Analyt Chem 2019; 114:260-77. [DOI: 10.1016/j.trac.2019.02.034] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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21
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Ng XQ, Hamzah A, Goh MLE, Moy HY, Yao YJ, Lui CP. Qualitative analysis of synthetic opioids, synthetic hallucinogens and LSD in urine using LC-MS/MS. AUST J FORENSIC SCI 2019. [DOI: 10.1080/00450618.2019.1568565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Xue Qin Ng
- Health Sciences Authority Singapore, Analytical Toxicology Laboratory, Singapore, Singapore
| | - Asimah Hamzah
- Health Sciences Authority Singapore, Analytical Toxicology Laboratory, Singapore, Singapore
| | - Mei Ling Evelyn Goh
- Health Sciences Authority Singapore, Analytical Toxicology Laboratory, Singapore, Singapore
| | - Hooi Yan Moy
- Health Sciences Authority Singapore, Analytical Toxicology Laboratory, Singapore, Singapore
| | - Yi Ju Yao
- Health Sciences Authority Singapore, Analytical Toxicology Laboratory, Singapore, Singapore
| | - Chi Pang Lui
- Health Sciences Authority Singapore, Analytical Toxicology Laboratory, Singapore, Singapore
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22
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Abstract
Novel drugs of abuse are synthetic illicit drugs, or analogues of known illicit drugs, that can be more potent. Novel drugs of abuse are often labeled as designer drugs, research chemicals, legal highs, or psychoactive substances. They are often sold as designated legal or nondrug products, such as incense, plant food, or bath salts, with labeling such as "Not for Human Consumption" or "For Use in Research Only." The prevalence of use of novel drugs of abuse is difficult to determine because specific drugs, compounds, and availability of these drugs are constantly evolving. Changes in chemical structures lead to heterogeneity in physiologic response and clinical symptoms, even within the same category of drug. Pediatricians and emergency medicine physicians should be knowledgeable about novel drugs of abuse and their resulting symptoms for prevention and identification of their use.
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Affiliation(s)
- George Sam Wang
- Section of Emergency Medicine and Medical Toxicology, Department of Pediatrics, University of Colorado Anschutz Medical Campus, Children's Hospital Colorado, Aurora, CO.,Rocky Mountain Poison and Drug Center, Denver Health Hospital, Denver, CO
| | - Christopher Hoyte
- Rocky Mountain Poison and Drug Center, Denver Health Hospital, Denver, CO.,Department of Emergency Medicine and Medical Toxicology, University of Colorado Anschutz Medical Campus, University Hospital, Aurora, CO
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23
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Nisbet LA, Wylie FM, Logan BK, Scott KS. Gas Chromatography-Mass Spectrometry Method for the Quantitative Identification of 23 New Psychoactive Substances in Blood and Urine. J Anal Toxicol 2019; 43:346-52. [DOI: 10.1093/jat/bky109] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 10/30/2018] [Accepted: 12/29/2018] [Indexed: 11/14/2022] Open
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24
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Marchi NC, Scherer JN, Fara LS, Remy L, Ornel R, Reis M, Zamboni A, Paim M, Fiorentin TR, Wayhs CAY, Von Diemen L, Pechansky F, Kessler FHP, Limberger RP. Clinical and Toxicological Profile of NBOMes: A Systematic Review. Psychosomatics 2019; 60:129-38. [PMID: 30606495 DOI: 10.1016/j.psym.2018.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Revised: 11/06/2018] [Accepted: 11/06/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND NBOMes are a new class of potent hallucinogens widely present in illicit drugs. Little is known about this class of drugs, regarding its detection and clinical manifestations of intoxication. OBJECTIVE This study aims to enhance care involving NBOMes by reviewing the literature on their clinical manifestations and laboratorydetection. METHODS A systematic review was performed on the clinical manifestations and laboratory tests of NBOMEs ingestion. Embase, Pubmed, PsycINFO, and Cochrane databases were employed in this analysis. RESULTS Forty-five articles met the inclusion criteria out of the 2814 nonduplicated studies on the theme. Seventy case reports of intoxication were found in the analyzed articles (64.3% were men and 11.4% were women, mean age of 22.5). The technique most employed for NBOMes identification was chromatography of blood, urine, and oral fluids. Moreover, the studies identified 13 chemical structures differentfrom the NBOMes on their toxicological analyses.According to these studies, most of these drugs were ingested orally-nasal use was the second preferred administration route, followed by intravenous administration. CONCLUSION Better identification of the clinicalmanifestations and laboratory profile of NBOMes is crucial to the recognition of intoxication as well as to its effective treatment.
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25
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Göl E, Çok I. New psychoactive substances in Turkey: Narcotics cases assessed by the Council of Forensic Medicine between 2016 and 2017 in Ankara, Turkey. Forensic Sci Int 2019; 294:113-123. [DOI: 10.1016/j.forsciint.2018.11.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Revised: 11/02/2018] [Accepted: 11/04/2018] [Indexed: 11/30/2022]
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26
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Thornton SL, Hoehn S, Gerona RR. Seizures, Systemic Inflammatory Response, and Rhabdomyolysis Associated With Laboratory-Confirmed 2C-I and 25-I Exposure. Pediatr Emerg Care 2018; 34:e181-3. [PMID: 28376067 DOI: 10.1097/PEC.0000000000001117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The 2C drugs are hallucinogenic phenethylamines. They and their n-benzyloxymethyl analogs have become popular as "legal highs," and significant toxicity has been attributed to their use. We report on a case of seizures, systemic inflammatory response, and rhabdomyolysis associated with laboratory-confirmed 4-iodo-2,5-dimethoxyphenethylamine and 4-iodo-2,5-dimethoxy-N-(2-methoxybenzyl) phenethylamine exposure. A 17-year-old male teenager developed seizures after taking "2 strips of acid." The seizures resolved with midazolam, but he became apneic and was intubated. His head computed tomography was unremarkable. Initial creatinine level was 1.5 mg/dL, with a creatine kinase of 112 U/L. His urine immunoassay drug screen was negative. He was extubated within 12 hours but had elevated temperatures for 48 hours. He was treated with antibiotics, but no source of infection was identified. His creatinine level peaked at 2.46 mg/dL. His creatine kinase peaked 72 hours later at 14579 U/L. He was treated with intravenous fluids and did not require renal replacement therapy. He recovered fully and was discharged after 5 days. Serum and urine samples were tested using liquid chromatography time-of-flight mass spectrometry. We detected 4-iodo-2,5-dimethoxyphenethylamine and 4-iodo-2,5-dimethoxy-N-(2-methoxybenzyl) phenethylamine in both serum and urine. No other substances were detected. The 2C drugs and their n-benzyloxymethyl analogs are potent serotonergic agents. Their use has been associated with multiple adverse effects including seizures, rhabdomyolysis, and death. They should be considered in differential diagnosis for drug-induced seizures and as a cause for systemic inflammatory response. This case highlights the significant toxicity seen with these compounds.
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27
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Temporal KDH, Scott KS, Mohr ALA, Logan BK. Metabolic Profile Determination of NBOMe Compounds Using Human Liver Microsomes and Comparison with Findings in Authentic Human Blood and Urine. J Anal Toxicol 2017; 41:646-657. [PMID: 28472358 DOI: 10.1093/jat/bkx029] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Indexed: 11/13/2022] Open
Abstract
The emergence of novel psychoactive substances (NPS) such as hallucinogenic NBOMes (N-methoxybenzyl derivatives of 2C phenethylamines) in the past few years into the recreational drug market has introduced various challenges in forensic analytical toxicology in regard to adequate and timely detection of these compounds. This is especially true in samples from individuals who have experienced severe and fatal intoxications. The aim of this research was to identify the major Phase I metabolites of selected NBOMe compounds to generate a predicted human metabolic pathway of these substances. An in vitro incubation method of pooled human liver microsomes (HLMs) with four (4) NBOMes was used to identify major metabolites. These metabolic products were identified and confirmed from accurate mass findings of samples analyzed by Ultra Performance Liquid Chromatography/Quadrupole Time-of-Flight Mass Spectrometry. The most common biotransformations observed among this group of NBOMes include O-demethylations at the three methoxy groups, hydroxylations and reduction at the amine group. Other metabolic products observed include positional isomers from various hydroxylation possibilities on the benzene ring and alkyl chains, and secondary metabolism resulting in multiple combinations of the reactions. Many of the major metabolites were subsequently identified in authentic human samples of blood and urine from drug users.
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Affiliation(s)
| | - Karen S Scott
- Arcadia University, 450 S. Easton Road, Glenside, PA 19038, USA
| | - Amanda L A Mohr
- The Center for Forensic Science Research and Education, 2300 Stratford Avenue, Willow Grove, PA 19090, USA
| | - Barry K Logan
- Arcadia University, 450 S. Easton Road, Glenside, PA 19038, USA.,The Center for Forensic Science Research and Education, 2300 Stratford Avenue, Willow Grove, PA 19090, USA.,NMS Labs, 3701 Welsh Road, Willow Grove, PA 19090, USA
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28
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Bade R, White JM, Gerber C. Qualitative and quantitative temporal analysis of licit and illicit drugs in wastewater in Australia using liquid chromatography coupled to mass spectrometry. Anal Bioanal Chem 2017; 410:529-542. [DOI: 10.1007/s00216-017-0747-2] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 11/02/2017] [Accepted: 11/05/2017] [Indexed: 11/30/2022]
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29
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Zygowiec J, Solomon S, Jaworski A, Bloome M, Gotlib A. 25C-NBOMe Ingestion. Clin Pract Cases Emerg Med 2017; 1:295-297. [PMID: 29849316 PMCID: PMC5965197 DOI: 10.5811/cpcem.2017.5.33994] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 05/07/2017] [Accepted: 05/15/2017] [Indexed: 11/12/2022] Open
Abstract
The popularity of recreational synthetic drug use has increased within the past several years. Emergency physicians, along with prehospital providers, are often the first to interact with patients who use these new drugs. We report the case of a 27-year-old male with two emergency department visits with confirmed ingestion of a relatively new synthetic drug of abuse. We discuss symptom management as well as the identification process of the ingestant.
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Affiliation(s)
- Jonathan Zygowiec
- Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan
| | - Spencer Solomon
- Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan
| | - Anthony Jaworski
- Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan
| | - Michael Bloome
- Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan
| | - Ari Gotlib
- Henry Ford Wyandotte Hospital, Department of Emergency Medicine, Wyandotte, Michigan
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30
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Morini L, Bernini M, Vezzoli S, Restori M, Moretti M, Crenna S, Papa P, Locatelli C, Osculati AMM, Vignali C, Groppi A. Death after 25C-NBOMe and 25H-NBOMe consumption. Forensic Sci Int 2017; 279:e1-e6. [PMID: 28893436 DOI: 10.1016/j.forsciint.2017.08.028] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Revised: 08/22/2017] [Accepted: 08/29/2017] [Indexed: 10/18/2022]
Abstract
A teenager male was found dead in a waterway after he was spotted jumping off into the water stream. The boy looked agitated and confused after a party with friends. At the gathering place, investigators seized packages of blotter papers. A complete autopsy and a histological evaluation of the main tissues were performed; although the death occurred by drowning, the prosecutor requested toxicological exams, in order to evaluate the potential role of drugs of abuse in the episode. Blood (both peripheral and central) and urine samples as well as seized blotter papers were collected and analyzed as follows. The blotter paper, analyzed through a GC-MS method, revealed the presence of 25-NBOMes. A liquid chromatography tandem mass spectrometric (LC-MS/MS) system was used to identify and quantify 5 different 25-NBOMes (namely 25B-NBOMe, 25C-NBOMe, 25D-NBOMe, 25H-NBOMe, 25I-NBOMe) in blood and urine. 25E-NBOMe was used as internal standard (IS). 1mL of urine and 1mL of blood (both peripheral and cardiac) were diluted in 2mL phosphate buffer at pH 6.0, containing IS and purified on a solid phase extraction (SPE) cartridge. LOD and LOQ for the five 25-NBOMes were calculated at 0.05 and 0.1ng/mL respectively. Linearity, accuracy, precision, ion suppression, carry over and recovery were tested and all parameters fulfilled the acceptance criteria. Blood and urine provided positive results for 25C-NBOMe and 25H-NBOMe. Eventually, the seized blotter papers were analyzed by means of LC-MS/MS and the presence of the two NBOMes was confirmed: 25C-NBOMe and 25H-NBOMe were measured at the concentration of 2.80 and 0.29ng/mL in peripheral blood, of 1.43 and 0.13ng/mL in central blood and of 0.94 and 0.14ng/mL in urine, respectively. THC and THCCOOH were also detected in biological fluids, at the concentration of 15.5 and 56.0ng/mL in peripheral blood, 9.9 and 8.5ng/mL in central blood, respectively. NBOMes can produce severe hallucination even at very low doses, and the 25C-NBOMe levels measured in the subject's blood are considered potentially toxic.
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Affiliation(s)
- Luca Morini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy.
| | - Marzia Bernini
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedale Civili 1, 25123 Brescia, Italy
| | - Sara Vezzoli
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazzale Spedale Civili 1, 25123 Brescia, Italy
| | - Mario Restori
- Forensic Medicine Unit, ASST Spedali Civili di Brescia, Piazzale Spedale Civili 1, 25123 Brescia, Italy
| | - Matteo Moretti
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Stefano Crenna
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Pietro Papa
- Analytical Toxicological Laboratory, IRCCS Policlinico San Matteo Foundation, Viale Golgi 19, 27100 Pavia, Italy
| | - Carlo Locatelli
- Poison Control Centre and National Toxicology Information Centre, Toxicology Unit, Istituti Clinici Scientifici Maugeri Spa-SB, IRCCS Pavia Hospital and University of Pavia, via Maugeri 10, 27100 Pavia, Italy
| | - Antonio Marco Maria Osculati
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Claudia Vignali
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
| | - Angelo Groppi
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, via Forlanini, 12, 27100 Pavia, Italy
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31
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Caspar AT, Westphal F, Meyer MR, Maurer HH. LC-high resolution-MS/MS for identification of 69 metabolites of the new psychoactive substance 1-(4-ethylphenyl-)-N-[(2-methoxyphenyl)methyl] propane-2-amine (4-EA-NBOMe) in rat urine and human liver S9 incubates and comparison of its screening power with further MS techniques. Anal Bioanal Chem 2017; 410:897-912. [PMID: 28762065 DOI: 10.1007/s00216-017-0526-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 07/07/2017] [Accepted: 07/14/2017] [Indexed: 11/29/2022]
Abstract
4-EA-NBOMe (N-(2-methoxybenzyl)-4-ethylamphetamine, 1-(4-ethylphenyl-)-N-[(2-methoxyphenyl)methyl]propane-2-amine) is an amphetamine-derived new psychoactive substance (NPS) of the N-methoxybenzyl (NBOMe) group first seized by German custom authorities. In contrast to the phenethylamine NBOMes, studies on the pharmacological, toxicological, or metabolic properties are not yet published. The aims of the presented work were the use of LC-HR-MS/MS for identification of the phase I and II metabolites of 4-EA-NBOMe in rat urine and pooled human S9 fraction (pS9) incubations, to compare metabolite formation in both models, to identify involved monooxygenases, and to elucidate its detectability in standard urine screening approaches (SUSAs) using GC-MS, LC-MSn, and LC-HR-MS/MS. 4-EA-NBOMe was mainly metabolized by oxidation of the ethyl group to phenyl acetaldehyde, to benzoic acid, or to phenylacetic acid, by hydroxylation, and all combined with O-demethylation as well as by glucuronidation and sulfation of the main phase I metabolites in rats. With the exception of the oxidation to benzoic acid, all main metabolic reactions could be confirmed in the incubations with pS9. In total, 36 phase I and 33 phase II metabolites could be identified. Monooxygenase activity screenings revealed the general involvement of cytochrome-P450 (CYP) 1A2, CYP2B6, and CYP3A4. An intake of 4-EA-NBOMe was detectable only via its metabolites by all SUSAs after low-dose administration. The main targets for both LC-MS screenings should be the phenylacetic acid derivative, the mandelic acid derivative both with and without additional O-demethylation, and, for GC-MS, the hydroxy metabolite after conjugate cleavage.
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Affiliation(s)
- Achim T Caspar
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, 66421, Homburg, Saarland, Germany
| | - Folker Westphal
- Section Narcotics/Toxicology, State Bureau of Criminal Investigation Schleswig-Holstein, Mühlenweg 166, 24116, Kiel, Germany
| | - Markus R Meyer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, 66421, Homburg, Saarland, Germany
| | - Hans H Maurer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Saarland University, 66421, Homburg, Saarland, Germany.
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32
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Hermanns-Clausen M, Angerer V, Kithinji J, Grumann C, Auwärter V. Bad trip due to 25I-NBOMe: a case report from the EU project SPICE II plus. Clin Toxicol (Phila) 2017; 55:922-924. [DOI: 10.1080/15563650.2017.1319572] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Maren Hermanns-Clausen
- Poisons Information Centre, Centre for Pediatrics, Medical Center – University of Freiburg, Germany
| | - Verena Angerer
- Department of Forensic Toxicology, Institute of Forensic Medicine, Medical Center – University of Freiburg, Germany
| | - Josephine Kithinji
- Poisons Information Centre, Centre for Pediatrics, Medical Center – University of Freiburg, Germany
| | - Christina Grumann
- Department of Forensic Toxicology, Institute of Forensic Medicine, Medical Center – University of Freiburg, Germany
| | - Volker Auwärter
- Department of Forensic Toxicology, Institute of Forensic Medicine, Medical Center – University of Freiburg, Germany
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33
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Logan BK, Mohr AL, Friscia M, Krotulski AJ, Papsun DM, Kacinko SL, Ropero-Miller JD, Huestis MA. Reports of Adverse Events Associated with Use of Novel Psychoactive Substances, 2013–2016: A Review. J Anal Toxicol 2017; 41:573-610. [DOI: 10.1093/jat/bkx031] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Indexed: 01/25/2023] Open
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34
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Pasin D, Cawley A, Bidny S, Fu S. Characterization of hallucinogenic phenethylamines using high-resolution mass spectrometry for non-targeted screening purposes. Drug Test Anal 2017; 9:1620-1629. [DOI: 10.1002/dta.2171] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Revised: 01/22/2017] [Accepted: 01/23/2017] [Indexed: 02/02/2023]
Affiliation(s)
- Daniel Pasin
- Centre for Forensic Science; University of Technology Sydney; Broadway NSW 2007 Australia
| | - Adam Cawley
- Australian Racing Forensic Laboratory; Racing NSW Sydney NSW 2000 Australia
| | - Sergei Bidny
- Forensic Toxicology Laboratory; NSW Forensic and Analytical Science Service; Lidcombe NSW 2141 Australia
| | - Shanlin Fu
- Centre for Forensic Science; University of Technology Sydney; Broadway NSW 2007 Australia
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35
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Richeval C, Boucher A, Humbert L, Phanithavong M, Wiart J, Moulsma M, Citterio-quentin A, Coulon T, Hernu R, Vial T, Allorge D, Gaulier J. Retrospective identification of 25I-NBOMe metabolites in an intoxication case. Toxicologie Analytique et Clinique 2017; 29:71-81. [DOI: 10.1016/j.toxac.2017.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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36
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Caspar AT, Brandt SD, Stoever AE, Meyer MR, Maurer HH. Metabolic fate and detectability of the new psychoactive substances 2-(4-bromo-2,5-dimethoxyphenyl)- N- [(2-methoxyphenyl)methyl]ethanamine (25B-NBOMe) and 2-(4-chloro-2,5-dimethoxyphenyl)- N- [(2-methoxyphenyl)methyl]ethanamine (25C-NBOMe) in human and rat urine by GC–MS, LC–MS n , and LC–HR–MS/MS approaches. J Pharm Biomed Anal 2017; 134:158-169. [DOI: 10.1016/j.jpba.2016.11.040] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 11/04/2016] [Indexed: 10/20/2022]
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37
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Andrade AFB, Mamo SK, Gonzalez-Rodriguez J. Rapid Screening Method for New Psychoactive Substances of Forensic Interest: Electrochemistry and Analytical Determination of Phenethylamines Derivatives (NBOMe) via Cyclic and Differential Pulse Voltammetry. Anal Chem 2017; 89:1445-1452. [DOI: 10.1021/acs.analchem.6b02426] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Ana Flávia B. Andrade
- Criminalistic
Institute, Federal District Civil Police, SPO, lote 23, bloco E, 70.610-200, Brasilia, DF, Brazil
- School
of Chemistry, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, U.K
| | - Samuel Kasahun Mamo
- School
of Chemistry, University of Lincoln, Brayford Pool, Lincoln LN6 7TS, U.K
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38
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Abstract
Serotonergic hallucinogens induce profound changes in perception and cognition. The characteristic effects of hallucinogens are mediated by 5-HT2A receptor activation. One class of hallucinogens are 2,5-dimethoxy-substituted phenethylamines, such as the so-called 2C-X compounds 2,5-dimethoxy-4-bromophenethylamine (2C-B) and 2,5-dimethoxy-4-iodophenethylamine (2C-I). Addition of an N-benzyl group to phenethylamine hallucinogens produces a marked increase in 5-HT2A-binding affinity and hallucinogenic potency. N-benzylphenethylamines ("NBOMes") such as N-(2-methoxybenzyl)-2,5-dimethoxy-4-iodophenethylamine (25I-NBOMe) show subnanomolar affinity for the 5-HT2A receptor and are reportedly highly potent in humans. Several NBOMEs have been available from online vendors since 2010, resulting in numerous cases of toxicity and multiple fatalities. This chapter reviews the structure-activity relationships, behavioral pharmacology, metabolism, and toxicity of members of the NBOMe hallucinogen class. Based on a review of 51 cases of NBOMe toxicity reported in the literature, it appears that rhabdomyolysis is a relatively common complication of severe NBOMe toxicity, an effect that may be linked to NBOMe-induced seizures, hyperthermia, and vasoconstriction.
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Affiliation(s)
- Adam L Halberstadt
- Department of Psychiatry, University of California San Diego, 9500 Gilman Drive, La Jolla, CA, 92093-0804, USA.
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA.
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39
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Abstract
BACKGROUND New psychoactive substances (NPSs) are substitutes for classical drugs of abuse and there are now compounds available from all groups of classical drugs of abuse. During 2014, the number of synthetic cathinones increased dramatically and, together with phenylethylamines, they dominate the NPS markets in the European Union. In total, 31 cathinones and 9 phenylethylamines were encountered in 2014. The aim of this article was to summarize the existing knowledge about the basic pharmacology, metabolism, and human toxicology of relevant synthetic cathinones and phenylethylamines. Compared with existing reviews, we have also compiled the existing case reports from both fatal and nonfatal intoxications. METHODS We performed a comprehensive literature search using bibliographic databases PubMed and Web of Science, complemented with Google Scholar. The focus of the literature search was on original articles, case reports, and previously published review articles published in 2014 or earlier. RESULTS The rapid increase of NPSs is a growing concern and sets new challenges not only for societies in drug prevention and legislation but also in clinical and forensic toxicology. In vivo and in vitro studies have demonstrated that the pharmacodynamic profile of cathinones is similar to that of other psychomotor stimulants. Metabolism studies show that cathinones and phenylethylamines are extensively metabolized; however, the parent compound is usually detectable in human urine. In vitro studies have shown that many cathinones and phenylethylamines are metabolized by CYP2D6 enzymes. This indicates that these drugs may have many possible drug-drug interactions and that genetic polymorphism may influence their toxicity. However, the clinical and toxicological relevance of CYP2D6 in adverse effects of cathinones and phenylethylamines is questionable, because these compounds are metabolized by other enzymes as well. The toxidromes commonly encountered after ingestion of cathinones and phenylethylamines are mainly of sympathomimetic and hallucinogenic character with a risk of excited delirium and life-threatening cardiovascular effects. CONCLUSIONS The acute and chronic toxicity of many NPSs is unknown or very sparsely investigated. There is a need for evidence-based-treatment recommendations for acute intoxications and a demand for new strategies to analyze these compounds in clinical and forensic cases.
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Affiliation(s)
- Elli Tyrkkö
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, Linköping, Sweden
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Poklis JL, Dempsey SK, Liu K, Ritter JK, Wolf C, Zhang S, Poklis A. Identification of Metabolite Biomarkers of the Designer Hallucinogen 25I-NBOMe in Mouse Hepatic Microsomal Preparations and Human Urine Samples Associated with Clinical Intoxication. J Anal Toxicol 2016; 39:607-16. [PMID: 26378134 DOI: 10.1093/jat/bkv079] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
'NBOMe' (dimethoxyphenyl-N-[(2-methoxyphenyl)methyl]ethanamine) derivatives are a new class of designer hallucinogenic drugs widely available on the Internet. Currently, 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine (25I-NBOMe) is the most popular abused derivative in the USA. There are little published data on the absorption, metabolism and elimination of 25I-NBOMe, or any of the other NBOMe derivatives. Therefore, there are no definitive metabolite biomarkers. We present the identification of fifteen 25I-NBOMe metabolites in phase I and II mouse hepatic microsomal preparations, and analysis of two human urine samples from 25I-NBOMe-intoxicated patients to test the utility of these metabolites as biomarkers of 25I-NBOMe use. The synthesis of two major urinary metabolites, 2-iodo-4-methoxy-5-[2-[(2-methoxyphenyl) methylamino]ethyl]phenol (2-O-desmethyl-5-I-NBOMe, M5) and 5-iodo-4-methoxy-2-[2-[(2-methoxyphenyl)methylamino]ethyl]phenol (5-O-desmethyl-2-I-NBOMe), is also presented. Seven phase II glucuronidated metabolites of the O-desmethyl or the hydroxylated phase I metabolites were identified. One human urine sample contained 25I-NBOMe as well as all 15 metabolites identified in mouse hepatic microsomal preparations. Another human urine sample contained no parent 25I-NBOMe, but was found to contain three O-desmethyl metabolites. We recommend β-glucuronidase enzymatic hydrolysis of urine prior to 25I-NBOMe screening and the use of M5 as the primary biomarker in drug testing.
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Affiliation(s)
- Justin L Poklis
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, PO Box 980613, Richmond, VA 23298-0613, USA
| | - Sara K Dempsey
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Kai Liu
- Department of Medicinal Chemistry, Virginia Commonwealth University, Richmond, VA, USA
| | - Joseph K Ritter
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, PO Box 980613, Richmond, VA 23298-0613, USA
| | - Carl Wolf
- Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA Departments of Pathology, Virginia Commonwealth University, Richmond, VA, USA
| | - Shijun Zhang
- Department of Medicinal Chemistry, Virginia Commonwealth University, Richmond, VA, USA
| | - Alphonse Poklis
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, PO Box 980613, Richmond, VA 23298-0613, USA Department of Forensic Science, Virginia Commonwealth University, Richmond, VA, USA Departments of Pathology, Virginia Commonwealth University, Richmond, VA, USA
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41
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Abstract
Over the last few years, NBOMe substances have been used either as a legal alternative to lysergic acid diethylamide (LSD) or sold surreptitiously as LSD to unknown users. These NBOMe substances have been detected in blotter papers, powders, capsules and liquids. We report the deaths of two teenage male subjects that were related to 25B-NBOMe and 25I-NBOMe in Indiana during 2014. Samples were extracted via a solvent protein precipitation with acetonitrile and analyzed via ultra-performance liquid chromatography with tandem mass spectrometry. For these two cases, we describe the NBOMe instrumental analysis, toxicological results for postmortem heart blood and urine specimens and the relevant case history and pathological findings at autopsy. In the first case, 25B-NBOMe was detected in postmortem heart blood at 1.59 ng/mL; in the second case, 25I-NBOMe was detected in postmortem heart blood at 19.8 ng/mL. We also review relevant published casework from clinical toxicology and postmortem toxicology in which analytically confirmed 25B-NBOMe and 25I-NBOMe were determined to be causative agents in intoxications or deaths.
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Affiliation(s)
| | - Thomas Sozio
- Marion County Coroner's Office, Indianapolis, IN 46225, USA
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42
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Poklis JL, Raso SA, Alford KN, Poklis A, Peace MR. Analysis of 25I-NBOMe, 25B-NBOMe, 25C-NBOMe and Other Dimethoxyphenyl-N-[(2-Methoxyphenyl) Methyl]Ethanamine Derivatives on Blotter Paper. J Anal Toxicol 2016; 39:617-23. [PMID: 26378135 DOI: 10.1093/jat/bkv073] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
In recent years, N-methoxybenzyl-methoxyphenylethylamine (NBOMe) derivatives, a class of designer hallucinogenic drugs, have become popular drugs of abuse. These drugs have been the cause of severe intoxications and even deaths. They act as 5-HT2A receptors agonists and have been reported to produce serotonin-like syndrome with bizarre behavior, severe agitation and seizures persisting for as long as 3 days. The most commonly reported derivatives are 25I-NBOMe, 25B-NBOMe and 25C-NBOMe, respectively 2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl) methyl]ethanamine, N-(2-methoxybenzyl)-2,5-dimethoxy-4-bromophenethylamine and N-(2-methoxybenzyl)-2,5-dimethoxy-4-chlorophenethylamine. Like many low dose hallucinogenic drugs these compounds are often sold on blotter paper. Three different types of commercially available blotter papers reported to contain NBOMe derivatives were obtained. These blotter papers were screened using Direct Analysis in Real Time AccuTOF(TM) mass spectrometry followed by confirmation and quantification by high-performance liquid chromatography triple quadrapole mass spectrometry. The major drug present on each of the three blotter products was different, 25I-NBOMe, 25C-NBOMe or 25B-NBOMe. The blotter papers were also found to have minute amounts of two or three NBOMe derivative impurities of 25H-NBOMe, 25I-NBOMe, 25C-NBOMe, 25B-NBOMe and/or 25D-NBOMe.
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Affiliation(s)
- Justin L Poklis
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA
| | - Stephen A Raso
- Department of Forensic Science, Virginia Commonwealth University, PO Box 843079, 1015 Floyd Avenue, Room 2015, Richmond 23284, VA, USA
| | - Kylie N Alford
- Department of Forensic Science, Virginia Commonwealth University, PO Box 843079, 1015 Floyd Avenue, Room 2015, Richmond 23284, VA, USA
| | - Alphonse Poklis
- Department of Pharmacology and Toxicology, Virginia Commonwealth University, Richmond, VA, USA Department of Forensic Science, Virginia Commonwealth University, PO Box 843079, 1015 Floyd Avenue, Room 2015, Richmond 23284, VA, USA Department of Pathology, Virginia Commonwealth University, Richmond, VA, USA
| | - Michelle R Peace
- Department of Forensic Science, Virginia Commonwealth University, PO Box 843079, 1015 Floyd Avenue, Room 2015, Richmond 23284, VA, USA
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43
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Lowe LM, Peterson BL, Couper FJ. A Case Review of the First Analytically Confirmed 25I-NBOMe-Related Death in Washington State. J Anal Toxicol 2016; 39:668-71. [PMID: 26378143 DOI: 10.1093/jat/bkv092] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
This case was submitted to the Washington State Patrol Toxicology Laboratory in September 2014. A 15-year-old male went to a party where he ingested 25I-NBOMe and mushrooms. A short time later, he started to vomit and began seizing until he eventually passed out. Resuscitation efforts were made, but were unsuccessful. He was transported to a local hospital, where he died three days later of multi-system organ failure following cardiopulmonary arrest. The hospital admission samples were negative for ethanol and basic drugs and their metabolites. The hospital serum confirmed positive for delta-9-tetrahydrocannabinol (THC) and carboxy-THC at 4.1 and 83 ng/mL, respectively. On the basis of the case history, the hospital blood and urine were sent to NMS Labs for NBOMe and psilocin confirmation. The blood was positive for 25I-NBOMe, and the urine was positive for 25C-, 25H- and 25I-NBOMe, as well as, psilocin. Antemortem and postmortem blood were also sent to AIT Laboratories for NBOMe confirmation. The antemortem blood confirmed positive for 25I-NBOMe with a concentration of 0.76 ng/mL. The manner of death was ruled an accident as a result of combined 25I-NBOMe and psilocin intoxication.
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Affiliation(s)
- Lyndsey M Lowe
- Toxicology Laboratory Division, Washington State Patrol, 2203 Airport Way S. Ste. 360, Seattle, WA 98134, USA
| | - Brianna L Peterson
- Toxicology Laboratory Division, Washington State Patrol, 2203 Airport Way S. Ste. 360, Seattle, WA 98134, USA
| | - Fiona J Couper
- Toxicology Laboratory Division, Washington State Patrol, 2203 Airport Way S. Ste. 360, Seattle, WA 98134, USA
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Wohlfarth A, Roman M, Andersson M, Kugelberg FC, Diao X, Carlier J, Eriksson C, Wu X, Konradsson P, Josefsson M, Huestis MA, Kronstrand R. 25C-NBOMe and 25I-NBOMe metabolite studies in human hepatocytes, in vivo mouse and human urine with high-resolution mass spectrometry. Drug Test Anal 2016; 9:680-698. [PMID: 27448631 DOI: 10.1002/dta.2044] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Revised: 07/18/2016] [Accepted: 07/18/2016] [Indexed: 12/25/2022]
Abstract
25C-NBOMe and 25I-NBOMe are potent hallucinogenic drugs that recently emerged as new psychoactive substances. To date, a few metabolism studies were conducted for 25I-NBOMe, whereas 25C-NBOMe metabolism data are scarce. Therefore, we investigated the metabolic profile of these compounds in human hepatocytes, an in vivo mouse model and authentic human urine samples from forensic cases. Cryopreserved human hepatocytes were incubated for 3 h with 10 μM 25C-NBOMe and 25I-NBOMe; samples were analyzed by liquid chromatography high-resolution mass spectrometry (LC-HRMS) on an Accucore C18 column with a Thermo QExactive; data analysis was performed with Compound Discoverer software (Thermo Scientific). Mice were administered 1.0 mg drug/kg body weight intraperitoneally, urine was collected for 24 h and analyzed (with or without hydrolysis) by LC-HRMS on an Acquity HSS T3 column with an Agilent 6550 QTOF; data were analyzed manually and with WebMetabase software (Molecular Discovery). Human urine samples were analyzed similarly. In vitro and in vivo results matched well. 25C-NBOMe and 25I-NBOMe were predominantly metabolized by O-demethylation, followed by O-di-demethylation and hydroxylation. All methoxy groups could be demethylated; hydroxylation preferably occurred at the NBOMe ring. Phase I metabolites were extensively conjugated in human urine with glucuronic acid and sulfate. Based on these data and a comparison with synthesized reference standards for potential metabolites, specific and abundant 25C-NBOMe urine targets are 5'-desmethyl 25C-NBOMe, 25C-NBOMe and 5-hydroxy 25C-NBOMe, and for 25I-NBOMe 2' and 5'-desmethyl 25I-NBOMe and hydroxy 25I-NBOMe. These data will help clinical and forensic laboratories to develop analytical methods and to interpret results. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Ariane Wohlfarth
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, 58758, Linköping, Sweden.,Division of Drug Research, Department of Medical Health Sciences, Linköping University, 58185, Linköping, Sweden
| | - Markus Roman
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, 58758, Linköping, Sweden
| | - Mikael Andersson
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, 58758, Linköping, Sweden
| | - Fredrik C Kugelberg
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, 58758, Linköping, Sweden.,Division of Drug Research, Department of Medical Health Sciences, Linköping University, 58185, Linköping, Sweden
| | - Xingxing Diao
- Chemistry and Drug Metabolism Section, Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Jeremy Carlier
- Chemistry and Drug Metabolism Section, Clinical Pharmacology & Therapeutics Research Branch, Intramural Research Program, National Institute on Drug Abuse, National Institutes of Health, Baltimore, MD, 21224, USA
| | - Caroline Eriksson
- Department of Physics, Chemistry and Biology, Linköping University, 58183, Linköping, Sweden
| | - Xiongyu Wu
- Department of Physics, Chemistry and Biology, Linköping University, 58183, Linköping, Sweden
| | - Peter Konradsson
- Department of Physics, Chemistry and Biology, Linköping University, 58183, Linköping, Sweden
| | - Martin Josefsson
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, 58758, Linköping, Sweden.,Department of Physics, Chemistry and Biology, Linköping University, 58183, Linköping, Sweden
| | - Marilyn A Huestis
- School of Medicine, University of Maryland, Baltimore, MD, 21201, USA
| | - Robert Kronstrand
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, 58758, Linköping, Sweden.,Division of Drug Research, Department of Medical Health Sciences, Linköping University, 58185, Linköping, Sweden
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45
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Nielsen LM, Holm NB, Leth-Petersen S, Kristensen JL, Olsen L, Linnet K. Characterization of the hepatic cytochrome P450 enzymes involved in the metabolism of 25I-NBOMe and 25I-NBOH. Drug Test Anal 2016; 9:671-679. [PMID: 27400739 DOI: 10.1002/dta.2031] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2016] [Revised: 06/14/2016] [Accepted: 06/16/2016] [Indexed: 12/29/2022]
Abstract
The dimethoxyphenyl-N-((2-methoxyphenyl)methyl)ethanamine (NBOMe) compounds are potent serotonin 5-HT2A receptor agonists and have recently been subject to recreational use due to their hallucinogenic effects. Use of NBOMe compounds has been known since 2011, and several non-fatal and fatal intoxication cases have been reported in the scientific literature. The aim of this study was to determine the importance of the different cytochrome P450 enzymes (CYP) involved in the metabolism of 2-(4-iodo-2,5-dimethoxyphenyl)-N-(2methoxybenzyl)ethanamine (25I-NBOMe) and 2-[[2-(4-iodo-2,5dimethoxyphenyl)ethylamino]methyl]phenol (25I-NBOH) and to characterize the metabolites. The following approaches were used to identify the main enzymes involved in primary metabolism: incubation with a panel of CYP and monoamine oxidase (MAO) enzymes and incubation in pooled human liver microsomes (HLM) with and without specific CYP chemical inhibitors. The study was further substantiated by an evaluation of 25I-NBOMe and 25I-NBOH metabolism in single donor HLM. The metabolism pathways of 25I-NBOMe and 25I-NBOH were NADPHdependent with intrinsic clearance values of (CLint) of 70.1 and 118.7 mL/min/kg, respectively. The biotransformations included hydroxylation, O-demethylation, N-dealkylation, dehydrogenation, and combinations thereof. The most abundant metabolites were all identified by retention time and spectrum matching with synthesized reference standards. The major CYP enzymes involved in the metabolism of 25I-NBOMe and 25INBOH were identified as CYP3A4 and CYP2D6, respectively. The compound 25I-NBOH was also liable to direct glucuronidation, which may diminish the impact of CYP2D6 genetic polymorphism. Users of 25I-NBOMe may be subject to drug-drug interactions (DDI) if 25I-NBOMe is taken with a strong CYP3A4 inhibitor. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Line Marie Nielsen
- Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Frederik V's vej 11, 3, DK-2100, Denmark.,Section of Biostructural Research, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Niels Bjerre Holm
- Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Frederik V's vej 11, 3, DK-2100, Denmark
| | - Sebastian Leth-Petersen
- Medicinal Chemistry Research, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Jesper Langgaard Kristensen
- Medicinal Chemistry Research, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Lars Olsen
- Section of Biostructural Research, Department of Drug Design and Pharmacology, Faculty of Health and Medical Sciences, University of Copenhagen, Universitetsparken 2, DK-2100 Copenhagen, Denmark
| | - Kristian Linnet
- Section of Forensic Chemistry, Department of Forensic Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Frederik V's vej 11, 3, DK-2100, Denmark
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Kristofic JJ, Chmiel JD, Jackson GF, Vorce SP, Holler JM, Robinson SL, Bosy TZ. Detection of 25C-NBOMe in Three Related Cases. J Anal Toxicol 2016; 40:466-72. [DOI: 10.1093/jat/bkw035] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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47
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Abstract
Psychedelics (serotonergic hallucinogens) are powerful psychoactive substances that alter perception and mood and affect numerous cognitive processes. They are generally considered physiologically safe and do not lead to dependence or addiction. Their origin predates written history, and they were employed by early cultures in many sociocultural and ritual contexts. After the virtually contemporaneous discovery of (5R,8R)-(+)-lysergic acid-N,N-diethylamide (LSD)-25 and the identification of serotonin in the brain, early research focused intensively on the possibility that LSD and other psychedelics had a serotonergic basis for their action. Today there is a consensus that psychedelics are agonists or partial agonists at brain serotonin 5-hydroxytryptamine 2A receptors, with particular importance on those expressed on apical dendrites of neocortical pyramidal cells in layer V. Several useful rodent models have been developed over the years to help unravel the neurochemical correlates of serotonin 5-hydroxytryptamine 2A receptor activation in the brain, and a variety of imaging techniques have been employed to identify key brain areas that are directly affected by psychedelics. Recent and exciting developments in the field have occurred in clinical research, where several double-blind placebo-controlled phase 2 studies of psilocybin-assisted psychotherapy in patients with cancer-related psychosocial distress have demonstrated unprecedented positive relief of anxiety and depression. Two small pilot studies of psilocybin-assisted psychotherapy also have shown positive benefit in treating both alcohol and nicotine addiction. Recently, blood oxygen level-dependent functional magnetic resonance imaging and magnetoencephalography have been employed for in vivo brain imaging in humans after administration of a psychedelic, and results indicate that intravenously administered psilocybin and LSD produce decreases in oscillatory power in areas of the brain's default mode network.
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Affiliation(s)
- David E Nichols
- Eschelman School of Pharmacy, University of North Carolina, Chapel Hill, North Carolina
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48
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Zawilska JB, Andrzejczak D. Next generation of novel psychoactive substances on the horizon - A complex problem to face. Drug Alcohol Depend 2015; 157:1-17. [PMID: 26482089 DOI: 10.1016/j.drugalcdep.2015.09.030] [Citation(s) in RCA: 127] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Revised: 09/30/2015] [Accepted: 09/30/2015] [Indexed: 11/23/2022]
Abstract
BACKGROUND The last decade has seen a rapid and continuous growth in the availability and use of novel psychoactive substances (NPS) across the world. Although various products are labeled with warnings "not for human consumption", they are intended to mimic psychoactive effects of illicit drugs of abuse. Once some compounds become regulated, new analogues appear in order to satisfy consumers' demands and at the same time to avoid criminalization. This review presents updated information on the second generation of NPS, introduced as replacements of the already banned substances from this class, focusing on their pharmacological properties and metabolism, routes of administration, and effects in humans. METHODS Literature search, covering years 2013-2015, was performed using the following keywords alone or in combination: "novel psychoactive substances", "cathinones", "synthetic cannabinoids", "benzofurans", "phenethylamines", "2C-drugs", "NBOMe", "methoxetamine", "opioids", "toxicity", and "metabolism". RESULTS More than 400 NPS have been reported in Europe, with 255 detected in 2012-2014. The most popular are synthetic cannabimimetics and psychostimulant cathinones; use of psychedelics and opioids is less common. Accumulating experimental and clinical data indicate that potential harms associated with the use of second generation NPS could be even more serious than those described for the already banned drugs. CONCLUSIONS NPS are constantly emerging on the illicit drug market and represent an important health problem. A significant amount of research is needed in order to fully quantify both the short and long term effects of the second generation NPS, and their interaction with other drugs of abuse.
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Affiliation(s)
- Paul Gee
- Emergency Physician, Christchurch Hospital, Christchurch, New Zealand
| | - Leo J. Schep
- Toxicologist National Poisons Centre, University of Otago, Dunedin, New Zealand
| | - Berit P. Jensen
- Scientific Officer, Toxicology, Specialist Cluster, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Grant Moore
- Toxicology Section Head, Specialist Cluster, Canterbury Health Laboratories, Christchurch, New Zealand
| | - Stuart Barrington
- Emergency Physician, Christchurch Hospital, Christchurch, New Zealand
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50
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Hieger M, Rose S, Cumpston K, Stromberg P, Miller S, Wills B. 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. Am J Emerg Med 2015; 33:1843.e1-3. [DOI: 10.1016/j.ajem.2015.04.065] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 04/09/2015] [Indexed: 11/19/2022] Open
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