Deaths related to the use of diarylethylamines, with a focus on the United Kingdom: A systematic review and case series report.
John Martin Corkery, Caroline Copeland, Fabrizio Schifano
Journal of psychopharmacology (Oxford, England) July 1, 2025 DOI: 10.1177/02698811251349203 via PubMed
Summary
Diarylethylamine drugs, including diphenidine and methoxyphenidine (MXP), are dissociative substances with strong addictive potential. A systematic review of global mortality data found 48 deaths involving these drugs, with 37 occurring in the UK between 2014 and 2019. Most decedents were male (91%), White (95%), with a mean age of 37.2 years. Deaths were primarily accidental (89%) from acute drug toxicity (92%), often involving polysubstance poisoning with opioids, benzodiazepines, or stimulants. One-third of deaths involved MXP or diphenidine alone, suggesting these molecules are relatively toxic. Although diarylethylamine deaths are rare, these substances remain available, indicating ongoing risk.
Study at a glance
| Characteristics | Systematic review Case report Peer reviewed |
|---|---|
| Sample size | 48 |
| Population | Decedents from diarylethylamine-related deaths globally, with detailed data from the UK |
| Keywords | Diarylethylamines United Kingdom UK Deaths Diphenidine Ephenidine |
| Citations | 2 |
| Key finding | Globally, 48 deaths involved diarylethylamines, with 37 in the UK from 2014 to 2019; most were accidental acute drug toxicity, and one-third involved these drugs alone, suggesting relative toxicity. |
Abstract
Diarylethylamine drugs possess dissociative properties. These emerged as drugs of misuse, with reports of strong addictive potential, high tolerance and compulsive intake. Since one of these drugs, diphenidine, was added to the 1971 Convention on Psychotropic Substances, the United Kingdom (UK) had to consider its control. The Advisory Council on the Misuse of Drugs 2023 advice included toxicity and mortality involving this and related molecules. Relevant mortality data were collated to understand the international and UK situations. A systematic review was employed: PubMed, Scopus and Google Scholar searches were conducted on 29/30 August 2022 using the terms 'overdose', 'death', 'fatal*', 'toxic*', 'poison*' with molecules' chemical names. UK Mortality Registers (MRs) provided statistical data. The Scottish MR and National Programme on Substance Use Mortality provided case-level information. Eleven studies were identified. Most decedents were male. The mean death age was 35.3 (range: 17-55) years. Death was commonly from polysubstance poisoning. Globally, 48 deaths involved these drugs (Europe n = 40). Of these, 37 occurred in the UK in 2014-2019. Key characteristics were as follows: male (91%); White (95%), mean age 37.2 (range: 19-65) years; drug use history (72%). Most deaths (89%) were accidental from acute drug toxicity (92%). Diphenidine/methoxyphenidine (MXP) was implicated with other substances (opioids/opiates, benzodiazepines, stimulants) in 66% of cases. Most deaths were accidental - thus preventable. One-third of deaths involved MXP/diphenidine alone - suggesting they are relatively toxic. Diarylethylamines deaths are rare. These molecules remain available - deaths could occur.