Acute confusional state after designer tryptamine abuse.
A 23-year-old Japanese woman was brought to the emergency department about 6.5 h after taking liquid and later a half tablet purchased on the street. About 4.5 h prior to presentation, she displayed excited and disorganized behavior. On examination, she was not alert or oriented, with a Glasgow Coma Scale score of 13, did not answer any questions from doctors while smirking and looking around restlessly, and sometimes exhibited echolalia, imitating the speech of doctors. She was given intravenous infusion of fluid for 8 h, then discharged. Gas chromatography-mass spectrometry of urine revealed 5-methoxy-diisopropyltryptamine, 5-methoxy-N-methyltryptamine and an unidentified tryptamine. Identifying chemical products based solely on information of users is insufficient, and urinalysis is necessary in cases potentially involving designer drugs.
Itokawa
Masanari
M
Schizophrenia Research Project, Tokyo Institute of Psychiatry, Tokyo, Japan. mitokawa@prit.go.jp
Iwata
Ken
K
Takahashi
Misako
M
Sugihara
Gen-Ichi
G
Sasaki
Takeshi
T
Abe
Yu-Ichiro
Y
Uno
Minari
M
Hobo
Mizue
M
Jitoku
Daisuke
D
Inoue
Kikue
K
Arai
Makoto
M
Yasuda
Ichiro
I
Shintani
Masahiro
M
D008735:5-Methoxytryptamine / Q000009:adverse effects / Q000031:analogs & derivatives / Q000652:urine; D000328:Adult; D003221:Confusion / Q000139:chemically induced* / Q000523:psychology*; D015198:Designer Drugs / Q000009:adverse effects*; D005260:Female; D008401:Gas Chromatography-Mass Spectrometry; D015600:Glasgow Coma Scale; D006801:Humans; D012701:Serotonin / Q000009:adverse effects / Q000031:analogs & derivatives / Q000652:urine; D019966:Substance-Related Disorders / Q000523:psychology*; D014363:Tryptamines / Q000009:adverse effects* / Q000652:urine
D015198:Designer Drugs; D014363:Tryptamines; C026864:5-methoxy-alpha-methyltryptamine; C033696:5-methoxy-N,N-diisopropyltryptamine; D012701:Serotonin; D008735:5-Methoxytryptamine