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Severe Toxicity to the New Psychoactive Substances 3-Hydroxyphencyclidine and N-Ethylhexedrone: an Analytically Confirmed Case Report

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Abstract

Introduction

3-Hydroxyphencyclidine (3-HO-PCP) is a new psychoactive substance (NPS) and a hydroxy derivative of phencyclidine (PCP), and N-ethylhexedrone (Hexen) is a synthetic cathinone. We describe an analytically confirmed case of acute toxicity related to the use of both 3-hydroxyphencyclidine and N-ethylhexedrone.

Case Report

A 56-year-old male was brought to the Emergency Department by ambulance with hyperthermia (39.9 °C), sinus tachycardia (150 beats per minute), reduced consciousness, ocular clonus, and vertical nystagmus. He was treated with cooled intravenous (IV) fluids and IV benzodiazepines. Following 1 hour of treatment, his temperature fell to 37.7 °C, he developed rhabdomyolysis (creatine kinase peaked at 5999 IU (normal range < 229 IU)): he was managed with supportive measures and was discharged after 25 hours. The patient admitted regular use of Hexen and recent use of 3-HO-PCP. Analysis of urine and serum identified 3-hydroxyphencyclidine and metabolites, N-ethylhexedrone and metabolites, and clephedrone and metabolites.

Discussion

This is a case of analytically confirmed toxicity to 3-HO-PCP and N-ethylhexedrone. The acute toxicity reported in this patient is consistent with the use of 3-HO-PCP, but there were sympathomimetic and serotonergic features potentially consistent with the cathinone N-ethylhexedrone. The description of the acute toxicity of NPS, such as these, is vital to aid medical toxicologists and emergency medicine physicians treating patients who use them.

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Authors and Affiliations

  1. Guys and St Thomas’ NHS Foundation, London, UK

    Lisa Christine Dunlop

  2. Guys and St Thomas’ NHS Foundation, Faculty of Life Sciences and Medicine, King’s College London, London, UK

    David Wood, John Archer & Paul Dargan

  3. LGC, Cambridgeshire, UK

    Simon Hudson

Authors
  1. Lisa Christine Dunlop
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  2. David Wood
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  3. John Archer
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  4. Simon Hudson
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  5. Paul Dargan
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Corresponding author

Correspondence to Lisa Christine Dunlop.

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Supervising Editor: Supervising Editor: Mark B. Mycyk, MD

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Dunlop, L.C., Wood, D., Archer, J. et al. Severe Toxicity to the New Psychoactive Substances 3-Hydroxyphencyclidine and N-Ethylhexedrone: an Analytically Confirmed Case Report. J. Med. Toxicol. 16, 67–70 (2020). https://doi.org/10.1007/s13181-019-00734-x

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  • DOI: https://doi.org/10.1007/s13181-019-00734-x

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