The Poison Review

Mephedrone toxicity in a Scottish emergency department. Regan L et al. Emerg Med J 2010 Dec 23; [Epub ahead of print]

Abstract

Mephedrone (aka Meow meow, MCAT, Bubbles, drone, and Meph) is the synthetic amphetamine 4-methylmethcathinone.  It has sympathomimetic properties, causing peripheral vasoconstriction as well as anxiety, paranoia, hallucinations, and panic attacks.  Unfortunately, there is scant scientific literature describing the effects of this drug.

This paper — from the Aberdeen Royal Infirmary — set out to review the literature on mephedrone, and report of the experience with the drug in their emergency department.  They found 6 relevant papers, including 4 case reports.  There were two deaths — one involving mephedrone and marijuana, the other mephedrone and heroin.

In reviewing records from their emergency department they found 89 cases of reported mephedrone ingestion over approximately 4-1/2 months.  Thirty (33%) patients described ingestion of mephedrone alone and 27 patients (30%) reported ingesting mephedrone with ethanol.  The authors’ findings are not unexpected, considering what we already knew about mephedrone — common presenting manifestations were cardiovascular and psychoactive, including tachycardia, hypertension, anxiety/agitation, and paranoia.  Five of the 89 patients reported hallucinations.  There were no cases with temperature > 39.0^oC.

I really wanted to like this paper, since there is such scant material that has been published on the topic. Unfortunately, a review of inadequate scientific data is still inadequate,  and the summary of their 89 cases is less helpful than a few good representative case descriptions would have been.  Note also that their case selection was based merely on the patient’s history of ingesting mephedrone; no confirmatory testing was done.

Related posts:

Confirmed mephedrone-associated fatality

Mephedrone toxicity? Where is the evidence?

How does the body handle mephedrone and other designed drugs?

Mephedrone not responsible for two deaths in Britain

Mephedrone after the ban

Mephedrone (meow meow): first confirmed case report

Meow-meow: How dangerous is mephedrone?

Meow Meow (Mephedrone): coming soon to an ER near you

Life in the Fast Lane has posted a very nice complete review of mephedrone toxicity.