Morbidity involving the hallucinogenic designer amines MDA and 2C-I.
Julia C Drees, Judy A Stone, Alan H B Wu
Journal of forensic sciences November 1, 2009 DOI: 10.1111/j.1556-4029.2009.01199.x via PubMed
Summary
AI-generated from the abstractA 39-year-old woman suffered a severe hemorrhagic stroke after using cocaine, MDMA, and 2C-I, a novel designer amine. Multi-targeted LC-MS/MS urine testing detected 2C-I and MDA, but ruled out MDMA. The stroke was caused by an underlying cerebrovascular condition called Moyamoya, exacerbated by substance abuse. Standard clinical confirmation tests often target only amphetamine, methamphetamine, MDMA, and MDA. This case demonstrates the value of broader LC-MS/MS testing to better identify and understand the prevalence and toxic effects of emerging novel amines like 2C-I.
Study at a glance
| Characteristics | Case study Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 39-year-old woman with hemorrhagic stroke and substance abuse |
| Keywords | Drug testing Drug screening Lc-ms/ms Advanced urine testing Drug identification |
| Citations | 34 |
| Key finding | Broad LC-MS/MS testing detected 2C-I and MDA, ruled out MDMA, and helped identify Moyamoya disease as the underlying cause of stroke, highlighting the need for expanded drug screening to capture novel amines. |
Abstract
A case is presented of a 39-year-old woman who suffered severe debilitation because of a hemorrhagic stroke in the context of substance abuse. The patient presented to the emergency room with rapidly diminishing mental status, hypertension, and vasoconstriction; her friends provided a history of ingestion of cocaine, 3,4-methylenedioxymethamphetamine (MDMA), and 2C-I, a novel designer amine. A multi-targeted LC-MS/MS method for sympathomimetic amines and related drugs in urine detected and quantified 2C-I and MDA, while ruling out MDMA. The cause of the stroke was determined to be an underlying cerebrovascular abnormality called Moyamoya, secondary to substance abuse. In clinical laboratories, gas chromatography-mass spectrometry or liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmation of a positive amphetamine immunoassay is usually directed only towards amphetamine, methamphetamine, MDMA and MDA. This report demonstrates the utility of testing for a wider menu of compounds using LC-MS/MS in order to better characterize the prevalence and toxicities of novel amines such as 2C-I.