Multiorgan failure from 1-benzylpiperazine ingestion--legal high or lethal high?
BACKGROUND
1-benzylpiperazine (BZP) is synthetic stimulant. It was legal and openly sold in New Zealand before October 1, 2008. Two cases of life-threatening toxicity associated with BZP use are reported in detail in this article.


METHODS
Case one describes an adult female who developed status epilepticus, hyperthermia, disseminated intravascular coagulation, rhabdomyolysis, and renal failure associated with a BZP ingestion. Case two developed a similar pattern of toxicity from the combined use of BZP and 3,4-methylenedioxy-N-methylamphetamine. Both cases required prolonged hospital care but survived.


CONCLUSIONS
There have been reports of deaths associated with the combined ingestion of BZP and 3,4-methylenedioxy-N-methylamphetamine. The effects may possibly be synergistic when co-ingested. Case one suggests that BZP alone has the potential to cause serious sympathomimetic toxicity.
Gee
Paul
P
Department of Emergency Medicine, Christchurch Hospital, Christchurch, New Zealand. paul.gee@cdhb.govt.nz
Jerram
Tom
T
Bowie
David
D
D004357:Drug Synergism; D005260:Female; D006213:Hallucinogens / Q000633:toxicity; D006801:Humans; D013287:Illicit Drugs / Q000633:toxicity*; D008297:Male; D009102:Multiple Organ Failure / Q000139:chemically induced*; D018817:N-Methyl-3,4-methylenedioxyamphetamine / Q000633:toxicity*; D010879:Piperazines / Q000633:toxicity*; D019966:Substance-Related Disorders / Q000150:complications; D055815:Young Adult
D006213:Hallucinogens; D013287:Illicit Drugs; D010879:Piperazines; C006737:1-benzylpiperazine; D018817:N-Methyl-3,4-methylenedioxyamphetamine