Morbidity involving the hallucinogenic designer amines MDA and 2C-I.
A case is presented of a 39-year-old woman who suffered severe debilitation because of a hemorrhagic stroke in the context of substance abuse. The patient presented to the emergency room with rapidly diminishing mental status, hypertension, and vasoconstriction; her friends provided a history of ingestion of cocaine, 3,4-methylenedioxymethamphetamine (MDMA), and 2C-I, a novel designer amine. A multi-targeted LC-MS/MS method for sympathomimetic amines and related drugs in urine detected and quantified 2C-I and MDA, while ruling out MDMA. The cause of the stroke was determined to be an underlying cerebrovascular abnormality called Moyamoya, secondary to substance abuse. In clinical laboratories, gas chromatography-mass spectrometry or liquid chromatography-tandem mass spectrometry (LC-MS/MS) confirmation of a positive amphetamine immunoassay is usually directed only towards amphetamine, methamphetamine, MDMA and MDA. This report demonstrates the utility of testing for a wider menu of compounds using LC-MS/MS in order to better characterize the prevalence and toxicities of novel amines such as 2C-I.
Drees
Julia C
JC
Department of Laboratory Medicine, University of California-San Francisco, San Francisco, CA, USA.
Stone
Judy A
JA
Wu
Alan H B
AH
D015104:3,4-Methylenedioxyamphetamine / Q000009:adverse effects* / Q000032:analysis; D000328:Adult; D002849:Chromatography, Gas; D015198:Designer Drugs / Q000009:adverse effects* / Q000032:analysis; D004118:Dimethoxyphenylethylamine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000032:analysis; D005260:Female; D053593:Forensic Toxicology; D008401:Gas Chromatography-Mass Spectrometry; D006213:Hallucinogens / Q000009:adverse effects* / Q000032:analysis; D006801:Humans; D020300:Intracranial Hemorrhages / Q000209:etiology*; D009072:Moyamoya Disease / Q000150:complications / Q000175:diagnosis; D011782:Quadriplegia / Q000209:etiology; D020521:Stroke / Q000209:etiology*; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000150:complications
D015198:Designer Drugs; D004118:Dimethoxyphenylethylamine; D006213:Hallucinogens; D015104:3,4-Methylenedioxyamphetamine; C521995:4-iodo-2,5-dimethoxy-beta-phenethylamine