Review: 23 patients with laboratory-confirmed MDPV exposure
March 24, 2015, 7:48 pm
Acute Methylenedioxypyrovalerone Toxicity. Fruberg BA et al. J Med Toxicol 2014 Dec 3 [Epub ahead of print]
This is an impressive paper, but for reasons the authors thoroughly discuss in their limitations sections, there is somewhat less here than meets the eye.
The authors retrospectively reviewed patients seen over a 2-year period at 10 different hospitals who were entered into the ToxIC Registry and coded under a term consistent with “bath salt” exposure. Cases were eligible for the study if they had blood and/or urine laboratory confirmation positive for a synthetic cathinone (methylenedioxypyrovalerone (MDPV), mephedrone, methcathinone, methylone, or methedrone.)
The review identified 23 patients. All were positive for MDPV on confirmatory testing. One patient died. (For a paper reporting that fatal case, click here.)
The authors extracted a boatload of data from these cases (something that’s easy to do using a computerized registry database). Much of what they found is not surprising: most patients were young males, the most common findings were tachycardia and agitation, the patient who died presented with severe hyperthermia (> 104oF).
For the rest, very little is generalizable because factors such as referral bias, selection bias, co-ingestants, and the relatively small number of cases. Probably the most interesting finding is that, contrary to expectations, none of the patients had seizure activity.
Despite the flaws, this paper is worth looking at because all the patients had laboratory confirmation of exposure to synthetic cathinones.