title: Acute confusional state after designer tryptamine abuse.
abstract: 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.
authors.affiliation: Schizophrenia Research Project, Tokyo Institute of Psychiatry, Tokyo, Japan. mitokawa@prit.go.jp
authors.forename: Masanari
authors.initials: M
authors.lastname: Itokawa
authors.forename: Ken
authors.initials: K
authors.lastname: Iwata
authors.forename: Misako
authors.initials: M
authors.lastname: Takahashi
authors.forename: Gen-Ichi
authors.initials: G
authors.lastname: Sugihara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sasaki
authors.forename: Yu-Ichiro
authors.initials: Y
authors.lastname: Abe
authors.forename: Minari
authors.initials: M
authors.lastname: Uno
authors.forename: Mizue
authors.initials: M
authors.lastname: Hobo
authors.forename: Daisuke
authors.initials: D
authors.lastname: Jitoku
authors.forename: Kikue
authors.initials: K
authors.lastname: Inoue
authors.forename: Makoto
authors.initials: M
authors.lastname: Arai
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yasuda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shintani
mesh_terms: 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
chemical_list: D015198:Designer Drugs; D014363:Tryptamines; C026864:5-methoxy-alpha-methyltryptamine; C033696:5-methoxy-N,N-diisopropyltryptamine; D012701:Serotonin; D008735:5-Methoxytryptamine