Journal of Intensive Care Medicine
May 28, 2012
Patil Armenian, Tanya M. Mamantov, Ben Tsutaoka et al.
81 citations
Twelve people who took MDMA at a single rave were hospitalized in the San Francisco Bay area with life-threatening complications including seizures and hyperthermia. Eight needed emergency breathing tubes, and six had dangerously low blood pressure. Most had high potassium levels, acute kidney injury, and muscle breakdown. Two died, four survived with permanent neurological, muscle, or kidney damage, and six recovered without lasting harm. Ten had hyperthermia, with seven reaching extreme temperatures between 40.9°C and 43°C. Cooling took an average of 2.7 hours. Drug analysis of two confiscated capsules showed they contained 82% and 98% pure MDMA, with one capsule holding 270 mg—more than twice a typical dose. The MDMA-induced hyperthermia, worsened by large doses, a warm environment, and physical exertion, was a major cause of death and injury.
The Journal of emergency medicine
October 1, 2019
James Grogan, Roy Gerona, Jerry W Snow et al.
16 citations
Ibogaine, a psychoactive indole alkaloid used experimentally for opioid addiction and available via Internet suppliers, can cause life-threatening cardiac effects. A 34-year-old woman with heroin and cocaine use disorder ingested 2 g of ibogaine powder, experienced hallucinations and seizure-like episodes, and developed QTc prolongation and torsade de pointes. Qualitative analysis confirmed ibogaine in the ingested material. As more people with opioid use disorder seek ibogaine, emergency physicians need to recognize and treat this dangerous exposure.
The American journal of emergency medicine
February 1, 2025
Skyler Kessler, Bernard Weigel, Ross Ellison et al.
5 citations
A 61-year-old man with open skin ulcers from pyoderma gangrenosum developed ketamine toxicity after applying a large amount of a compounded analgesic cream containing 10% ketamine, 5% lidocaine, and 5% amitriptyline to his perineal and sacral region. He was brought to the emergency department with agitation, altered mental status, and torsional nystagmus after erratic driving. Urine testing showed a ketamine concentration of 32,300 ng/mL. His symptoms resolved spontaneously within a few hours. This case demonstrates that dermal application of ketamine cream can cause systemic toxicity when skin barrier function is impaired.
Clinical Toxicology
February 20, 2025
Courtney Temple, Matthew S. Correia, Ma Gonzaga et al.
3 citations
An analysis of psychoactive mushroom gummies found that their labeling was generally inaccurate. Products that suggested they contained Amanita muscaria instead contained serotonergic tryptamines, and some falsely claimed to be free of psilocybin.