Toxicology and Analysis of Psychoactive Tryptamines

Tryptamines are 5-HT2A receptor agonists that alter perceptions of reality. Their prevalence in drug overdoses is low but increasing, yet they are not part of typical toxicology testing, so their contribution may be underestimated. From 2015 to 2020, 22 new analytical methods, primarily liquid chromatography tandem mass spectrometry, were developed to identify tryptamines and metabolites in biological samples. The most prevalent tryptamines are 5-MeO-DiPT, 5-MeO-DALT, and DMT. Morbidity from tryptamine intake is considerable, and clinicians and laboratorians need updated data on this public health threat.

Study at a glance

Abstract

Our understanding of tryptamines is poor due to the lack of data globally. Tryptamines currently are not part of typical toxicology testing regimens and their contribution to drug overdoses may be underestimated. Although their prevalence was low, it is increasing. There are few published data on the many new compounds, their mechanisms of action, onset and duration of action, toxicity, signs and symptoms of intoxication and analytical methods to identify tryptamines and their metabolites. We review the published literature and worldwide databases to describe the newest tryptamines, their toxicology, chemical structures and reported overdose cases. Tryptamines are 5-HT2A receptor agonists that produce altered perceptions of reality. Currently, the most prevalent tryptamines are 5-methoxy-N,N-diisopropyltryptamine (5-MeO-DiPT), 5-methoxy-N,N- diallyltryptamine (5-MeO-DALT) and dimethyltryptamine (DMT). From 2015 to 2020, 22 new analytical methods were developed to identify/quantify tryptamines and metabolites in biological samples, primarily by liquid chromatography tandem mass spectrometry. The morbidity accompanying tryptamine intake is considerable and it is critical for clinicians and laboratorians to be informed of the latest data on this public health threat.