title: Mephedrone (4-methylmethcathinone; 'meow meow'): chemical, pharmacological and clinical issues.
abstract: BACKGROUND
  Recently, those substances deriving from the active ingredient of the Khat plant, cathinone, have been rising in popularity. Indeed, 4-methylmethcathinone (mephedrone; 'meow meow' and others) has been seen by some as a cheaper alternative to other classified recreational drugs.
  
  
  OBJECTIVE
  We aimed here at providing a state-of-the-art review on mephedrone history and prevalence of misuse, chemistry, pharmacology, legal status, product market appearance, clinical/management and related fatalities.
  
  
  METHODS
  Because of the limited evidence, some of the information here presented has been obtained from user reports/drug user-orientated web sites. The most common routes for mephedrone recreational use include insufflation and oral ingestion. It elicits stimulant and empathogenic effects similar to amphetamine, methylamphetamine, cocaine and MDMA. Due to its sympathomimetic actions, mephedrone may be associated with a number of both physical and psychopathological side effects. Recent preliminary analysis of recent UK data carried out in 48 related cases have provided positive results for the presence of mephedrone at postmortem.
  
  
  CONCLUSIONS
  Within the UK, diffusion of mephedrone may have been associated with an unprecedented combination of a particularly aggressive online marketing policy and a decreasing availability/purity of both ecstasy and cocaine. Mephedrone has been recently classified in both the UK and in a number of other countries as a measure to control its availability. Following this, a few other research psychoactives have recently entered the online market as yet unregulated substances that may substitute for mephedrone. Only international collaborative efforts may be able to tackle the phenomenon of the regular offer of novel psychoactive drugs.
authors.affiliation: School of Pharmacy, College Lane Campus, University of Hertfordshire, Hatfield, Herftordshire, AL10 9AB, UK. F.Schifano@herts.ac.uk
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Schifano
authors.forename: Antonio
authors.initials: A
authors.lastname: Albanese
authors.forename: Suzanne
authors.initials: S
authors.lastname: Fergus
authors.forename: Jackie L
authors.initials: JL
authors.lastname: Stair
authors.forename: Paolo
authors.initials: P
authors.lastname: Deluca
authors.forename: Ornella
authors.initials: O
authors.lastname: Corazza
authors.forename: Zoe
authors.initials: Z
authors.lastname: Davey
authors.forename: John
authors.initials: J
authors.lastname: Corkery
authors.forename: Holger
authors.initials: H
authors.lastname: Siemann
authors.forename: Norbert
authors.initials: N
authors.lastname: Scherbaum
authors.forename: Magi'
authors.initials: M
authors.lastname: Farre'
authors.forename: Marta
authors.initials: M
authors.lastname: Torrens
authors.forename: Zsolt
authors.initials: Z
authors.lastname: Demetrovics
authors.forename: A Hamid
authors.initials: AH
authors.lastname: Ghodse
mesh_terms: D000818:Animals; D015198:Designer Drugs / Q000009:adverse effects / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D004333:Drug Administration Routes; D006801:Humans; D008694:Methamphetamine / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000737:chemistry / Q000494:pharmacology / Q000627:therapeutic use; D019966:Substance-Related Disorders / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control
chemical_list: D015198:Designer Drugs; D008694:Methamphetamine; C548233:mephedrone