{"title":"N,N-dimethylpentylone poisoning: Clinical manifestations, analytical detection, and metabolic characterization","authors":"H.S. Leung , Magdalene H.Y. Tang , H.F. Tong , Y.K. Chong","doi":"10.1016/j.forsciint.2024.112116","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>The proliferation of new psychoactive substances (NPS) poses a significant challenge to clinical and forensic toxicology laboratories. <em>N,N</em>-dimethylpentylone, a novel synthetic cathinone, has emerged as a public health concern. The aims of this study are to describe the clinical presentation of <em>N,N</em>-dimethylpentylone poisoning, to describe detection methods, and to deduce its metabolic pathways.</p></div><div><h3>Methods</h3><p>Clinical data was collected and reviewed retrospectively from patients with confirmed <em>N,N</em>-dimethylpentylone exposure. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to identify <em>N,N</em>-dimethylpentylone and its metabolites in urine samples. The metabolic pathway was characterised by comparison of the detected substances with reference standards.</p></div><div><h3>Results</h3><p>Eight cases were included in the case series. Seven different metabolites of <em>N,N</em>-dimethylpentylone were identified in <em>in vivo</em> patient urine samples, where the two major metabolic pathways were proposed to be opening of the 5-membered ring and reduction of carboxide. All patients presented with neuropsychiatric and/or cardiovascular symptoms. Co-ingestion with other substances was reported in all cases. One patient requiring intensive care was described in detail. All patients eventually recovered. The analytical method allowed the simultaneous identification of <em>N,N</em>-dimethylpentylone, pentylone and bisdesmethyl-<em>N,N</em>-dimethylpentylone, as well as other drugs of abuse in patient samples.</p></div><div><h3>Conclusion</h3><p><em>N,N</em>-dimethylpentylone appears to be less potent than its metabolite pentylone. Co-ingestion with other drugs of abuse is common. Poisoning cases have neuropsychiatric and cardiovascular manifestations. An updated and comprehensive laboratory method is needed for its detection.</p></div>","PeriodicalId":12341,"journal":{"name":"Forensic science international","volume":null,"pages":null},"PeriodicalIF":2.2000,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Forensic science international","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S037907382400197X","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, LEGAL","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
The proliferation of new psychoactive substances (NPS) poses a significant challenge to clinical and forensic toxicology laboratories. N,N-dimethylpentylone, a novel synthetic cathinone, has emerged as a public health concern. The aims of this study are to describe the clinical presentation of N,N-dimethylpentylone poisoning, to describe detection methods, and to deduce its metabolic pathways.
Methods
Clinical data was collected and reviewed retrospectively from patients with confirmed N,N-dimethylpentylone exposure. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used to identify N,N-dimethylpentylone and its metabolites in urine samples. The metabolic pathway was characterised by comparison of the detected substances with reference standards.
Results
Eight cases were included in the case series. Seven different metabolites of N,N-dimethylpentylone were identified in in vivo patient urine samples, where the two major metabolic pathways were proposed to be opening of the 5-membered ring and reduction of carboxide. All patients presented with neuropsychiatric and/or cardiovascular symptoms. Co-ingestion with other substances was reported in all cases. One patient requiring intensive care was described in detail. All patients eventually recovered. The analytical method allowed the simultaneous identification of N,N-dimethylpentylone, pentylone and bisdesmethyl-N,N-dimethylpentylone, as well as other drugs of abuse in patient samples.
Conclusion
N,N-dimethylpentylone appears to be less potent than its metabolite pentylone. Co-ingestion with other drugs of abuse is common. Poisoning cases have neuropsychiatric and cardiovascular manifestations. An updated and comprehensive laboratory method is needed for its detection.
期刊介绍:
Forensic Science International is the flagship journal in the prestigious Forensic Science International family, publishing the most innovative, cutting-edge, and influential contributions across the forensic sciences. Fields include: forensic pathology and histochemistry, chemistry, biochemistry and toxicology, biology, serology, odontology, psychiatry, anthropology, digital forensics, the physical sciences, firearms, and document examination, as well as investigations of value to public health in its broadest sense, and the important marginal area where science and medicine interact with the law.
The journal publishes:
Case Reports
Commentaries
Letters to the Editor
Original Research Papers (Regular Papers)
Rapid Communications
Review Articles
Technical Notes.