The Clinical Toxicology of 4-Bromo-2,5-dimethoxyphenethylamine (2C-B): The Severity of Poisoning After Exposure to Low to Moderate and High Doses.
Johanna J Nugteren-van Lonkhuyzen, Dylan W de Lange, Antoinette J H P van Riel, Ruben Q Vrolijk, Dana Ohana, Laura Hondebrink
Annals of emergency medicine September 1, 2020 Peer reviewed DOI: 10.1016/j.annemergmed.2020.04.022 via PubMed
Summary
Surprisingly, even high doses of the substance 2C-B rarely lead to severe poisoning. Researchers tracked patients exposed to varying amounts, from low to very high, to understand its effects. Their findings showed that most individuals experienced only moderate symptoms, such as hallucinations, agitation, and mild physical changes, which typically resolved within 24 hours. Crucially, no severe poisonings were observed, indicating a generally manageable clinical course for this substance.
Abstract
We studied the severity of poisoning after exposure to low to moderate and high doses of 4-bromo-2,5-dimethoxyphenethylamine (2C-B). Patients for whom the Dutch Poisons Information Centre was consulted for 2C-B exposure from 2016 to 2018 were included in a prospective cohort study. Data were collected through telephone interviews with the physician or patient. Patients were categorized according to the reported 2C-B dose: low to moderate (up to 20 mg), high (greater than 20 mg), or unknown. Presence of 2C-B was analyzed in leftover drug and biological samples with liquid/gas chromatography-mass spectrometry. The severity of poisoning was graded with the Poisoning Severity Score. We included 59 patients, of whom 32 could be followed up. Low to moderate 2C-B doses were reported by 9 patients (28%), high doses by 17 (53%), and unknown doses by 6 (19%). Poisoning was moderate in the majority of patients in both the low- to moderate-dose and high-dose groups. Frequently reported symptoms included mydriasis, agitation or aggression, hallucinations, confusion, anxiety, hypertension, and tachycardia. The presence of 2C-B was confirmed in 5 patients in urine (n=3) or drug samples (n=4). In this study, most 2C-B poisonings resulted in moderate toxicity even at high reported doses up to 192 mg. No severe cases were observed. The clinical course was usually short-lived (up to 24 hours) and typically involved hallucinations in addition to mild somatic effects.