The Poison Review

Clinical characteristics of mephedrone toxicity reported to the UK National Poisons Information Service. James D et al. Emerg Med J [Published online August 25, 2010 in advance of print]

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Mephedrone (4-methylmethcathinone, 4-MMC) is a synthetic stimulant with structural similarities to both methamphetamine and the alkaloid cathinone. Although mephedrone seems to act as a stimulant, there have been almost no scientific studies into its physiologic and toxicologic effects.  To my knowledge, there has been only one report of confirmed mephedrone exposure.

This paper, from the National Poisons Information Service in the U.K., purports to collate and describe clinical features seen in 131 cases of exposure to mephedrone (alone or combined with alcohol) on which the service was consulted.  This would seem to be very valuable data indeed.  Unfortunately, the entire paper is nullified by the same problem that plagues many studies based on poison center data — we have no idea what these 131 people were actually exposed to.  The authors try to fast-step their way around this problem, stating:

The data analysed relies on user and healthcare professionals knowing and providing accurate information on the agents involved since toxicological confirmation is not generally available.

There is, of course, no way such accurate information could be known or provided, and it is rather disingenuous to publish a paper relying on the medical equivalent of hearsay.