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Acute Methylenedioxypyrovalerone Toxicity

  • Toxicology Investigation
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Abstract

The objective of this study was to characterize the acute clinical effects, laboratory findings, complications, and disposition of patients presenting to the hospital after abusing synthetic cathinone. We conducted a retrospective multicenter case series of patients with synthetic cathinone abuse by searching for the terms bath salts, MDPV, methylenedioxypyrovalerone, mephedrone, methcathinone, methylone, methedrone, and cathinone within the “agent” field of a national clinical toxicology database (ToxIC). The medical records of these patients were obtained and abstracted by investigators at each study site. Patients with confirmatory testing that identified a synthetic cathinone in either blood or urine were included in the series. Patients who had either an undetectable synthetic cathinone test or no confirmatory testing were excluded. A data abstraction sheet was used to obtain information on each patient. We entered data into an Excel spreadsheet and calculated descriptive statistics. We identified 23 patients with confirmed synthetic cathinone exposure—all were positive for methylenedioxyprovalerone (MDPV). Eighty-three percent were male and 74 % had recreational intent. The most common reported clinical effects were tachycardia (74 %), agitation (65 %), and sympathomimetic syndrome (65 %). Acidosis was the most common laboratory abnormality (43 %). Seventy-eight percent of patients were treated with benzodiazepines and 30 % were intubated. Ninety-six percent of patients were hospitalized and 87 % were admitted to the ICU. The majority (61 %) of patients was discharged home but 30 % required inpatient psychiatric care. There was one death in our series. The majority of patients presenting to the hospital after abusing MDPV have severe sympathomimetic findings requiring hospitalization. A number of these patients require inpatient psychiatric care after their acute presentation.

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Authors and Affiliations

  1. Departments of Pediatrics and Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Blake A. Froberg

  2. Department of Medical Toxicology, Banner Good Samaritan Medical Center, Phoenix, AZ, USA

    Michael Levine

  3. Department of Emergency Medicine, University of Southern California, Los Angeles, CA, USA

    Michael Levine

  4. Department of Emergency Medicine, Carolinas Medical Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Michael C. Beuhler

  5. Department of Emergency Medicine, Michigan State University College of Human Medicine, Grand Rapids, MI, USA

    Bryan S. Judge

  6. Department of Medicine, PinnacleHealth, Harrisburg, PA, USA

    Philip W. Moore

  7. Department of Emergency Medicine, Regions Hospital, St. Paul, MN, USA

    Kristin M. Engebretsen

  8. Oregon Poison Center and Portland VA Medical Center, Portland, OR, USA

    Nathanael J. Mckeown

  9. Department of Emergency Medicine, Tufts University School of Medicine, Boston, MA, USA

    Christopher D. Rosenbaum

  10. Department of Emergency Medicine, University of Texas Southwestern Medical Center at Dallas, Dallas, TX, USA

    Amy C. Young

  11. Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN, USA

    Daniel E. Rusyniak

  12. Pediatrics and Emergency Medicine, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA

    Blake A. Froberg

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  1. Blake A. Froberg
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On behalf of the ACMT Toxicology Investigators Consortium (ToxIC)

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Correspondence to Blake A. Froberg.

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Froberg, B.A., Levine, M., Beuhler, M.C. et al. Acute Methylenedioxypyrovalerone Toxicity. J. Med. Toxicol. 11, 185–194 (2015). https://doi.org/10.1007/s13181-014-0446-8

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  • DOI: https://doi.org/10.1007/s13181-014-0446-8

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