title: Acute Toxicity Associated With the Recreational Use of the Novel Psychoactive Benzofuran N-methyl-5-(2 aminopropyl)benzofuran.
abstract: N-methyl-5-(2 aminopropyl)benzofuran (5-MAPB) is a novel psychoactive benzofuran, created by N-methylation of 5-(2-aminopropyl)benzofuran (5-APB), which shares structural features with methylenedioxymethamphetamine (MDMA). To our knowledge, no case of 5-MAPB-related toxicity has been published in the scientific literature. We report a case of oral 5-MAPB exposure confirmed by liquid chromatography-tandem mass spectrometry in a 24-year-old previously healthy white man. Observed symptoms and signs such as paleness, cold and clammy skin, hypertension, elevated high-sensitive troponin T level, tachycardia, ECG change, diaphoresis, mild hyperthermia, mydriasis, tremor, hyperreflexia, clonus, agitation, disorientation, hallucinations, convulsions, reduced level of consciousness, and creatine kinase level elevation (305 IU/L) were compatible with undesired effects related to 5-APB or MDMA exposure. Signs and symptoms resolved substantially within 14 hours with aggressive symptomatic treatment, including sedation with benzodiazepines, external cooling, analgesia and sedation with fentanyl-propofol, and treatment with urapidil, an α-receptor-blocking agent. 5-MAPB showed first-order elimination kinetics with a half-life of 6.5 hours, comparable to the half-life of MDMA. According to the chemical structure, this case report, and users' Web reports, 5-MAPB appears to have an acute toxicity profile similar to that of 5-APB and MDMA, with marked vasoconstrictor effect.
authors.affiliation: National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland. Electronic address: katharina.hofer@toxinfo.ch.
authors.forename: Katharina E
authors.initials: KE
authors.lastname: Hofer
authors.affiliation: National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.
authors.forename: Katrin
authors.initials: K
authors.lastname: Faber
authors.affiliation: Institute for Clinical Chemistry, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Müller
authors.affiliation: Division of Medical Intensive Care Unit, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Till
authors.initials: T
authors.lastname: Hauffe
authors.affiliation: Division of Medical Intensive Care Unit, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Urs
authors.initials: U
authors.lastname: Wenger
authors.affiliation: National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.
authors.forename: Hugo
authors.initials: H
authors.lastname: Kupferschmidt
authors.affiliation: National Poisons Centre, Tox Info Suisse, Associated Institute of the University of Zurich, Zurich, Switzerland.
authors.forename: Christine
authors.initials: C
authors.lastname: Rauber-Lüthy
mesh_terms: D017109:Akathisia, Drug-Induced / Q000209:etiology; D001572:Benzofurans / Q000633:toxicity*; D015198:Designer Drugs / Q000633:toxicity*; D015600:Glasgow Coma Scale; D006212:Hallucinations / Q000139:chemically induced; D006801:Humans; D008297:Male; D008694:Methamphetamine / Q000031:analogs & derivatives* / Q000633:toxicity; D011619:Psychotropic Drugs / Q000633:toxicity*; D055815:Young Adult
chemical_list: D001572:Benzofurans; D015198:Designer Drugs; C000620874:N-methyl-5-(2 aminopropyl)benzofuran; D011619:Psychotropic Drugs; D008694:Methamphetamine