title: Acute toxicity associated with the recreational use of the novel dissociative psychoactive substance methoxphenidine.
abstract: BACKGROUND
  Methoxphenidine is a novel dissociative designer drug of the diarylethylamine class which shares structural features with phencyclidine (PCP), and is not at present subject to restrictive regulations. There is very limited information about the acute toxicity profile of methoxphenidine and the only sources are anonymous internet sites and a 1989 patent of the Searle Company. We report a case of analytically confirmed oral methoxphenidine toxicity.
  
  
  METHODS
  A 53-year-old man was found on the street in a somnolent and confusional state. Observed signs and symptoms such as tachycardia (112 bpm), hypertension (220/125 mmHg), echolalia, confusion, agitation, opisthotonus, nystagmus and amnesia were consistent with phencyclidine-induced adverse effects. Temperature (99.1°F (37.3°C)) and peripheral oxygen saturation while breathing room air (99%) were normal. Laboratory analysis revealed an increase of creatine kinase (max 865 U/L), alanine aminotransferase (72 U/L) and gamma-glutamyl transpeptidase (123 U/L). Methoxphenidine was identified by a liquid chromatography tandem mass spectrometry toxicological screening method using turbulent flow online extraction in plasma and urine samples collected on admission. The clinical course was favourable and signs and symptoms resolved with symptomatic treatment.
  
  
  CONCLUSIONS
  Based on this case report and users' web reports, and compatible with the chemical structure, methoxphenidine produces effects similar to those of the arylcyclohexylamines, as PCP.
authors.affiliation: Swiss Toxicological Information Centre, Associated Institute of the University of Zurich , Zurich , Switzerland.
authors.forename: Katharina E
authors.initials: KE
authors.lastname: Hofer
authors.forename: Colette
authors.initials: C
authors.lastname: Degrandi
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Müller
authors.forename: Ursina
authors.initials: U
authors.lastname: Zürrer-Härdi
authors.forename: Schirin
authors.initials: S
authors.lastname: Wahl
authors.forename: Christine
authors.initials: C
authors.lastname: Rauber-Lüthy
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ceschi
mesh_terms: D015415:Biomarkers / Q000097:blood / Q000652:urine; D001711:Biotransformation; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D002319:Cardiovascular System / Q000187:drug effects / Q000503:physiopathology; D002853:Chromatography, Liquid; D003221:Confusion / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D013287:Illicit Drugs / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning* / Q000652:urine; D008297:Male; D008875:Middle Aged; D009420:Nervous System / Q000187:drug effects / Q000503:physiopathology; D020258:Neurotoxicity Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D010880:Piperidines / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning* / Q000652:urine; D011619:Psychotropic Drugs / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning* / Q000652:urine; D019966:Substance-Related Disorders / Q000150:complications*; D053719:Tandem Mass Spectrometry; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D013287:Illicit Drugs; D010880:Piperidines; D011619:Psychotropic Drugs; C000595747:1-(1-(2-methoxyphenyl)-2-phenylethyl)piperidine
keywords: 2-MeO-diphenidine; Designer drug; Diarylethylamine; Drug of abuse; Ketamine; NMDA receptor; Phencyclidine; Psychedelic