title: First European case of convulsions related to analytically confirmed use of the synthetic cannabinoid receptor agonist AM-2201.
abstract: OBJECTIVE
  There is increasing reported use of synthetic cannabinoid receptor agonists (SCRA) across Europe. To date, there is limited information on the acute toxicity (harm) related to the use of these products. We describe here a case in which an individual developed convulsions related to the use of the SCRA AM-2201.
  
  
  METHODS
  A 20 year old male smoked a "Spice" (SCRA-containing) product called "Black Mamba," and rapidly after smoking, he had a generalised self-terminating tonic-clonic convulsion. After a 2 h observation period in the Emergency Department (ED), he self-discharged against medical advice. Subsequent analysis of urine collected at the time of presentation to the ED detected metabolites of AM-2201; no other drugs were detected on extensive analytic screening.
  
  
  CONCLUSIONS
  This is the first case of convulsions related to the use of SCRA described in Europe, and the first case of convulsions related to the use the SCRA AM-2201 confirmed by analysis of biological samples. It is important for emergency physicians, clinical toxicologists and clinical pharmacologists managing those presenting with acute toxicity related to the use of SCRA to analytically confirm the exact compound(s) involved, to enable accurate description of the acute toxicity associated with individual SCRA.
authors.affiliation: Emergency Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: McQuade
authors.forename: Simon
authors.initials: S
authors.lastname: Hudson
authors.forename: Paul I
authors.initials: PI
authors.lastname: Dargan
authors.forename: David M
authors.initials: DM
authors.lastname: Wood
mesh_terms: D063386:Cannabinoid Receptor Agonists / Q000009:adverse effects* / Q000138:chemical synthesis / Q000493:pharmacokinetics / Q000652:urine; D002186:Cannabinoids / Q000009:adverse effects* / Q000138:chemical synthesis / Q000493:pharmacokinetics / Q000652:urine; D002851:Chromatography, High Pressure Liquid; D004636:Emergency Service, Hospital; D004830:Epilepsy, Tonic-Clonic / Q000139:chemically induced*; D006801:Humans; D013287:Illicit Drugs / Q000009:adverse effects*; D008297:Male; D013058:Mass Spectrometry; D012907:Smoking; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000150:complications*; D006113:United Kingdom; D055815:Young Adult
chemical_list: D063386:Cannabinoid Receptor Agonists; D002186:Cannabinoids; D013287:Illicit Drugs