title: Intoxications of the new psychoactive substance 5-(2-aminopropyl)indole (5-IT): a case series from the Swedish STRIDA project.
abstract: BACKGROUND
  5-(2-aminopropyl)indole (5-IT) is a new psychoactive substance (NPS; "legal high" or "research chemical") structurally related to indoleamines and substituted phenethylamines and implicated in several fatalities. We describe the clinical characteristics and results of laboratory investigations of 14 analytically confirmed nonfatal cases of 5-IT intoxication within the Swedish STRIDA project.
  
  
  METHODS
  Observational case series of consecutive patients with admitted or suspected intake of NPS presenting to hospitals in Sweden in 2012.
  
  
  METHODS
  Blood and/or urine samples were collected from intoxicated patients presenting to emergency departments and intensive care units over the country. Analysis of NPS was performed using an LC-MS/MS multi-component method. Clinical data were collected when caregivers consulted the Poisons Information Centre and also retrieved from medical records. The severity of poisoning was graded retrospectively using the Poisoning Severity Score (PSS).
  
  
  RESULTS
  Eleven male and three female patients (age: 21-53 years, median: 27) tested positive for 5-IT in 2012, all cases appearing in April-July. The 5-IT concentration in serum ranged between 0.015 and 0.59 μg/mL (median: 0.22; n = 8) and in urine between 0.005 and 24.7 μg/mL (median: 5.95; n = 12). Five intoxications were indicated to be caused by 5-IT alone, whereas additional psychoactive substances were detected in the other nine cases. Six (43%) of fourteen cases were graded as severe (PSS 3), five (36%) as moderate (PSS 2), and three (21%) as minor (PSS 1) poisonings. In the severe cases, agitation, hallucinations, dilated pupils without light reaction, tachycardia, hypertension, hyperthermia, myoclonus, muscle rigidity, arrhythmias, seizures, rhabdomyolysis, and/or renal failure were noted.
  
  
  CONCLUSIONS
  The results demonstrated that severe clinical toxicity was commonly present in patients with analytically confirmed 5-IT exposure. The clinical features are consistent with a sympathomimetic toxidrome, and some patients also displayed symptoms associated with serotonin toxicity.
authors.affiliation: Swedish Poisons Information Centre , Stockholm , Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Bäckberg
authors.forename: O
authors.initials: O
authors.lastname: Beck
authors.forename: P
authors.initials: P
authors.lastname: Hultén
authors.forename: J
authors.initials: J
authors.lastname: Rosengren-Holmberg
authors.forename: A
authors.initials: A
authors.lastname: Helander
mesh_terms: D000328:Adult; D015198:Designer Drugs / Q000032:analysis / Q000506:poisoning*; D005260:Female; D006801:Humans; D007211:Indoles / Q000097:blood / Q000506:poisoning* / Q000652:urine; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D055815:Young Adult
chemical_list: D015198:Designer Drugs; D007211:Indoles; C583009:5-(2-aminopropyl)indole
keywords: Designer drugs; Legal highs; Mass spectrometry methods; Phenethylamines; Research chemicals; Serotonergic toxicity; Tryptamines