Mephedrone (meow-meow): first confirmed case report

April 7, 2010, 11:30 pm

★★★½☆

Recreational Use of Mephedrone (4-Methylmethcathinone, 4-MMC) with Associated Sympathomimetic Toxicity.  Wood DM et al.  J Med Toxicol (published online 01 April 2010).

Abstract

Back in January TPR reported on the alarming reports that were appearing in the British dailies about meow meow (mephedrone), a new synthetic drug that was a derivative of khat (cathinone).  Articles tabloids such as the Sun — but also in more mainstream papers such as the Times — reported many deaths associated with mephedrone, as well as reactions so severe that, according to an unconfirmed  web post that may have been a hoax, one agitated user ripped off his own scrotum.  At that time we noted that there were no medical papers in English describing the clinical effects of mephedrone.  This paper, from London,  is thus the first publication to report a case of mephedrone toxicity confirmed by toxicological tests.

A 22-year-old male bought 4 g of mephdrone powder online  and injected 3.8 g into his thighs after ingesting 200 mg and feeling no effect.  He rapidly developed palpitations, blurred vision, chest pressure, and diaphoresis.  On presentation to the emergency department, he exhibited manifestations of the sympathomimetic syndrome, with tachycardia (105 bpm), hypertension (177/111 mmHg), and mydriasis.  The remainder of his physical examination was unremarkable, and he had no significant laboratory abnormalities.  he responded to 1 mg of oral lorazepam and was discharged 6 hours after presentation.  Urine and serum samples both contained 4-methylmethcatinone (mephedrone).

In a related post, Nic Fleming this week on the website of the Guardian (U.K.) analyzes the media’s alarmist  reaction to mephedrone. He points out that there has not yet been even one death that a coroner claimed was caused by mephedrone. (Although if coroners over the pond are like those in the States, their analyses can not always be trusted.)  Fleming also debunks other media stories related to mephedrone, including the infamous scrotum-ripping report.

On the basis of the J Med Toxicol paper, even the parenteral injection of a seemingly large dose of mephedrone results in only mild-moderate clinical symptoms.  Of course, we are not sure of the actual dose injected. or the identity of any unknown possible adulterants that could not be tested for.

To read my column on khat in Emergency Medicine News, click here.

One Comment:

  1. Neuroskeptic Says:

    “A 22-year-old male bought 4 g of mephdrone powder online and injected 3.8 g into his thighs after ingesting 200 mg and feeling no effect…”

    I believe this is what’s called “epic fail” on the internet.