A 40-year-old man with no prior mental illness was brought to an emergency room in a delusional, psychotic state after ingesting a liquid labeled 'Vanilla aroma' to enhance sexual pleasure. The substance contained 2C-T-4, a phenethylamine analog hallucinogen not detected by standard urine screening. He recovered with neuroleptic medication within 17 hours. This is the first reported clinical case of acute psychosis caused by 2C-T-4, which is not legally controlled in many countries including Japan and the USA, and is difficult to detect on routine drug screens.
A 22-year-old man with no prior mental illness committed a homicide during a severe psychotic state induced by the designer drugs 5-MeO-DIPT and 5-MeO-MIPT, which he purchased online. He ingested unknown quantities of 'Wild Game' and 'Mipty' to enhance sexual pleasure, but within 1.5 hours experienced palpitations, nausea, delusions, visual distortions, and loss of consciousness. Police found him naked and confused 3 hours later; his girlfriend had been killed with a kitchen knife. Laboratory tests confirmed the tryptamine derivatives in his urine and her body; no other substances were detected. Clinical recovery occurred after 17 hours, with amnesia for the event. This is the first reported homicide linked to these drugs, and the authors suggest that simultaneous intake of both analogues may prolong serotoninergic overactivation, causing severe psychosis.