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Clinical characteristics of mephedrone toxicity reported to the UK National Poisons Information Service
  1. D James1,
  2. R D Adams2,
  3. R Spears3,
  4. G Cooper3,
  5. D J Lupton2,
  6. J P Thompson3,
  7. S H L Thomas1 on behalf of the National Poisons Information Service
  1. 1National Poisons Information Service, Newcastle Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Wolfson Unit, Newcastle upon Tyne, UK
  2. 2National Poisons Information Service, Edinburgh Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
  3. 3National Poisons Information Service, Cardiff Unit, University Hospital Llandough, Vale of Glamorgan, UK
  1. Correspondence to Professor S H L Thomas, Institute of Cellular Medicine, Wolfson Unit of Clinical Pharmacology, Newcastle University, Newcastle upon Tyne NE2 4HH, UK; simon.thomas{at}ncl.ac.uk

Abstract

Objective To describe the patterns and clinical features of toxicity related to recreational use of mephedrone and other cathinones in the UK using data collected by the National Poisons Information Service (NPIS).

Methods The number of accesses to TOXBASE, the NPIS online poisons information database, details of consecutive cases uploaded onto TOXBASE and the number and details of telephone enquiries made to the NPIS by health professionals in the UK were collected for the period March 2009 to February 2010.

Results Over the year of study there were 2901 TOXBASE accesses and 188 telephone enquiries relating to cathinones, the majority relating to mephedrone (TOXBASE 1664, telephone 157), with a month-on-month increase in numbers. In 131 telephone enquiries concerning mephedrone, alone or in combination with alcohol, common clinical features reported included agitation or aggression (n=32, 24%, 95% CI 18% to 33%), tachycardia (n=29, 22%, 95% CI 16% to 30%), confusion or psychosis (n=18, 14%, 95% CI 9% to 21%), chest pain (n=17, 13%, 95% CI 8% to 20%), nausea (n=15, 11%, 95% CI 7% to 18%), palpitations (n=14, 11%, 95% CI 6% to 18%), peripheral vasoconstriction (n=10, 8%, 95% CI 4% to 14%) and headache (n=7, 5%, 95% CI 2% to 11%). Convulsions were reported in four cases (3%, 95% CI 1% to 8%). One exposed person died following cardiac arrest (1%, 95% CI 0% to 4%), although subsequent investigation suggested that mephedrone was not responsible.

Conclusions Toxicity associated with recreational mephedrone use is increasingly common in the UK. Sympathomimetic adverse effects are common and severe effects are also reported. Structured data collected by the NPIS may be of use in identifying trends in poisoning and in establishing toxidromes for new drugs of abuse.

  • Toxicology

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Footnotes

  • Funding The National Poisons Information Service is commissioned by the Health Protection Agency. No specific research funding was allocated for this project.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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