title: 4-methyl-5-(4-methylphenyl)-4,5-dihydrooxazol-2-amine (4,4'-DMAR, 4,4'-dimethylaminorex): availability, prevalence of use, desired effects and acute toxicity.
abstract: OBJECTIVE
  4-Methyl-5-(4-methylphenyl)-4,5-dihydrooxazol-2-amine (4,4'-dimethylaminorex (4,4'-DMAR)) is a derivative of the controlled substances aminorex and 4-methylaminorex marketed as a potential novel psychoactive substance. This paper brings together the published scientific and 'grey' literature to understand 4,4'-DMAR as a novel psychoactive substance.
  
  
  METHODS
  Searches of the published scientific and 'grey' literature, using the keywords '4-methyl-euphoria', '4-methyl-U4Euh', '4-M-4-MAR', '4,4-dimethylaminorex', '4,4'-DMAR', 'para-methyl-4-aminorex' and 'Serotoni', were undertaken to identify information on the availability, prevalence of use and desired/unwanted effects of 4,4'-DMAR.
  
  
  RESULTS
  No studies have reported the prevalence of use of 4,4'-DMAR. Internet snapshot studies in April and May 2014 showed availability of 4,4'-DMAR from one and two Internet suppliers respectively. Price decreased with increasing purchase amounts from €12/g for a 1-g purchase to €2.20/g for a 100-g purchase in April 2014. Internet discussion fora suggest that the desired and unwanted effects of 4,4'-DMAR are similar to those seen with other sympathomimetic drugs such as 3,4-methylenedioxy-methamphetamine and mephedrone, although the duration of unwanted effects and 'comedown' appear to be longer. Unwanted effects were reported at doses of 5-200 mg, which overlaps with the reported doses (10-200 mg) associated with desired effects. 4,4'-DMAR has been detected, along with other drugs, in 27 deaths in Europe; the contribution of the 4,4'-DMAR in these deaths has not been established.
  
  
  CONCLUSIONS
  Currently, there appears to limited availability of 4,4'-DMAR; therefore, use is likely to be low. Its desired and unwanted effects appear similar to other sympathomimetic recreational drugs such as methylenedioxy-methamphetamine or mephedrone.
authors.affiliation: General Medicine, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK; Clinical Toxicology, Guy's and St Thomas' NHS Foundation Trust and King's Health Partners, London, UK.
authors.forename: James
authors.initials: J
authors.lastname: Glanville
authors.forename: Paul I
authors.initials: PI
authors.lastname: Dargan
authors.forename: David M
authors.initials: DM
authors.lastname: Wood
mesh_terms: D000818:Animals; D004305:Dose-Response Relationship, Drug; D006801:Humans; D013287:Illicit Drugs / Q000600:supply & distribution* / Q000633:toxicity; D020407:Internet; D010080:Oxazoles / Q000008:administration & dosage* / Q000600:supply & distribution / Q000633:toxicity; D015995:Prevalence; D019966:Substance-Related Disorders / Q000453:epidemiology*
chemical_list: D013287:Illicit Drugs; D010080:Oxazoles; C000598109:para-methyl-4-methylaminorex
keywords: 4,4′-dimethylaminorex; novel psychoactive substance; recreational drugs; toxicity