title: Two fatal intoxications with the new designer drug methedrone (4-methoxymethcathinone).
abstract: We report two fatalities involving the new designer drug methedrone, 4-methoxymethylcathinone. Blood was extracted with ethyl acetate after the addition of sodium hydroxide followed by evaporation and derivatization with TFAA before gas chromatography-mass spectrometry analysis. Hair was decontaminated and cut into segments, and after overnight extraction with acetonitrile/methanol/20 mM ammonium formate buffer (pH 3) (10:10:80), samples were analyzed by liquid chromatography-tandem mass spectrometry. The first case was treated in hospital, and blood was collected for drug screening. The concentration of methedrone in antemortem blood was 13.2 μg/g and in postmortem femoral blood 8.4 μg/g. The second case presented with 9.6 μg methedrone/g femoral blood, and in a hair sample, methedrone was detected in five short segments suggesting exposure to the drug during the months prior to death. In living abusers, the blood concentration range was 0.2-4.8 μg/g (n = 11). We conclude that use of methedrone may result in accidental death owing to its toxic properties and that the blood concentrations found in the two cases are close to those seen in the living. This suggests a rather narrow "therapeutic" window and emphasizes the danger in taking this kind of drug for recreational purposes.
authors.affiliation: National Board of Forensic Medicine, Department of Forensic Genetics and Forensic Toxicology, SE-58758 Linköping, Sweden. maria.wikstrom@rmv.se
authors.forename: Maria
authors.initials: M
authors.lastname: Wikström
authors.forename: Gunilla
authors.initials: G
authors.lastname: Thelander
authors.forename: Ingrid
authors.initials: I
authors.lastname: Nyström
authors.forename: Robert
authors.initials: R
authors.lastname: Kronstrand
mesh_terms: D000328:Adult; D053000:Analytic Sample Preparation Methods; D002851:Chromatography, High Pressure Liquid; D015198:Designer Drugs / Q000032:analysis / Q000737:chemistry / Q000506:poisoning*; D017809:Fatal Outcome; D053593:Forensic Toxicology / Q000379:methods; D006197:Hair / Q000737:chemistry; D006801:Humans; D008297:Male; D015394:Molecular Structure; D009294:Narcotics / Q000032:analysis / Q000097:blood / Q000737:chemistry / Q000506:poisoning; D011427:Propiophenones / Q000032:analysis / Q000097:blood / Q000737:chemistry / Q000506:poisoning*; D011619:Psychotropic Drugs / Q000032:analysis / Q000097:blood / Q000737:chemistry / Q000506:poisoning*; D015813:Substance Abuse Detection; D053719:Tandem Mass Spectrometry; D055815:Young Adult
chemical_list: D015198:Designer Drugs; D009294:Narcotics; D011427:Propiophenones; D011619:Psychotropic Drugs; C558328:4-methoxymethcathinone