The American journal of emergency medicine
July 1, 2015
Charles W O'Connell, Roy R Gerona, Matthew W Friesen et al.
16 citations
Ibogaine, a psychotropic indole alkaloid used in some medical subcultures for its anti-addictive properties, can cause serious health risks including altered mental status, ataxia, gastrointestinal distress, ventricular arrhythmias, and sudden death. A 33-year-old man overdosed on ibogaine while attempting to quit heroin, experiencing altered consciousness, tremor, ataxia, nausea, vomiting, and transient QT interval prolongation, which resolved as the substance cleared. Ibogaine was confirmed in his urine and serum, with a peak serum concentration of 377 ng/mL. Nonlinear elimination kinetics and the presence of its active metabolite noribogaine were also observed. This case provides serial serum concentrations and product-confirmed ibogaine toxicity with transient QT interval prolongation.
The American journal of emergency medicine
November 1, 2014
Patil Armenian, Roy R Gerona
15 citations
NBOMe derivatives, which are modified versions of the 2C class of phenethylamines, have recently appeared as designer drugs in the US market. While cases of toxicity from one derivative, 2C-I-NBOMe, have been documented, no reports have yet described the clinical effects of another derivative, 2C-C-NBOMe, leaving its toxicity profile unknown.
Pediatric emergency care
October 1, 2018
Stephen L Thornton, Sarah Hoehn, Roy R Gerona
6 citations
A 17-year-old male experienced seizures, systemic inflammatory response, and rhabdomyolysis after taking what he thought was LSD, but laboratory testing confirmed exposure to the designer drugs 4-iodo-2,5-dimethoxyphenethylamine (2C-I) and its n-benzyloxymethyl analog (25I-NBOMe). Seizures resolved with midazolam, but he required intubation. His urine drug screen was negative. Creatine kinase peaked at 14,579 U/L, and creatinine at 2.46 mg/dL. He recovered fully with intravenous fluids and was discharged after five days. The 2C drugs and their analogs are potent serotonergic agents associated with severe toxicity including seizures, rhabdomyolysis, and death, and should be considered in cases of drug-induced seizures.
Journal of psychoactive drugs
January 1, 2016
Michael A Darracq, Stephen L Thornton, Alicia B Minns et al.
2 citations
A 19-year-old woman had two seizures and dangerously low sodium after taking "ecstasy" at a rave. Laboratory analysis of her blood and urine showed she had taken both MDMA and 3,4-DMA, and that her body produced very low levels of MDMA's CYP2D6 metabolites, indicating impaired metabolism through that pathway. The case suggests that combining MDMA with 3,4-DMA can lead to severe toxicity, including hyponatremia and seizures. Healthcare providers should be aware that people using illicit drugs may take multiple substances, and that such combinations can cause serious harm.