Clinical characteristics of mephedrone toxicity reported to the U.K. National Poisons Information Service.
OBJECTIVE
To describe the patterns and clinical features of toxicity related to recreational use of mephedrone and other cathinones in the U.K. using data collected by the National Poisons Information Service (NPIS).


METHODS
The number of accesses to TOXBASE, the NPIS online poisons information database, details of consecutive cases uploaded onto TOXBASE and the number and details of telephone enquiries made to the NPIS by health professionals in the U.K. were collected for the period March 2009 to February 2010.


RESULTS
Over the year of study there were 2901 TOXBASE accesses and 188 telephone enquiries relating to cathinones, the majority relating to mephedrone (TOXBASE 1664, telephone 157), with a month-on-month increase in numbers. In 131 telephone enquiries concerning mephedrone, alone or in combination with alcohol, common clinical features reported included agitation or aggression (n=32, 24%, 95% CI 18% to 33%), tachycardia (n=29, 22%, 95% CI 16% to 30%), confusion or psychosis (n=18, 14%, 95% CI 9% to 21%), chest pain (n=17, 13%, 95% CI 8% to 20%), nausea (n=15, 11%, 95% CI 7% to 18%), palpitations (n=14, 11%, 95% CI 6% to 18%), peripheral vasoconstriction (n=10, 8%, 95% CI 4% to 14%) and headache (n=7, 5%, 95% CI 2% to 11%). Convulsions were reported in four cases (3%, 95% CI 1% to 8%). One exposed person died following cardiac arrest (1%, 95% CI 0% to 4%), although subsequent investigation suggested that mephedrone was not responsible.


CONCLUSIONS
Toxicity associated with recreational mephedrone use is increasingly common in the UK. Sympathomimetic adverse effects are common and severe effects are also reported. Structured data collected by the NPIS may be of use in identifying trends in poisoning and in establishing toxidromes for new drugs of abuse.
James
D
D
National Poisons Information Service, Newcastle Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK.
Adams
R D
RD
Spears
R
R
Cooper
G
G
Lupton
D J
DJ
Thompson
J P
JP
Thomas
S H L
SH
D000697:Central Nervous System Stimulants / Q000506:poisoning*; D006801:Humans; D013287:Illicit Drugs / Q000506:poisoning; D008694:Methamphetamine / Q000031:analogs & derivatives* / Q000506:poisoning; D011039:Poison Control Centers; D019966:Substance-Related Disorders / Q000453:epidemiology*; D006113:United Kingdom / Q000453:epidemiology
D000697:Central Nervous System Stimulants; D013287:Illicit Drugs; D008694:Methamphetamine; C548233:mephedrone
Pharmacol Biochem Behav. 1987 Mar;26(3):547-51
3575369
Anal Bioanal Chem. 2010 Jun;397(3):1225-33
20333362
N Engl J Med. 2008 Mar 6;358(10):1009-17
18322282
Br J Clin Pharmacol. 2005 May;59(5):574-81
15842556
BMC Med. 2005 Feb 12;3:5
15707502
Clin Pharmacol Ther. 1994 May;55(5):556-62
7910126
Eur J Pharmacol. 1999 Sep 17;381(1):63-9
10528135
Pharmacol Toxicol. 2003 Nov;93(5):219-25
14629733
Clin Pharmacol Ther. 1971 Nov-Dec;12(6):889-96
4944167
Xenobiotica. 2006 Aug;36(8):709-23
16891251
Br J Clin Pharmacol. 2003 Jul;56(1):125-30
12848785
BMJ. 2010 Mar 23;340:c1605
20332508
Pharmacol Biochem Behav. 1997 Dec;58(4):1109-16
9408221
Arch Dis Child. 2009 Jun;94(6):417-20
19131421
Pharmacol Toxicol. 1992 Feb;70(2):77-86
1508843
Emerg Med J. 2002 Jan;19(1):31-4
11777868
Lakartidningen. 2009 Oct 21-27;106(43):2769-71
19960905
J Pharmacol Exp Ther. 1996 Nov;279(2):1043-52
8930215