Reporting two fatalities associated with the use of 4-methylethcathinone (4-MEC) and a review of the literature

P. R. Smith, R. Cole, S. Hamilton, K. West, S. R. Morley, P. D. Maskell*

*Corresponding author for this work

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

We report two fatalities that are related to the cathinone 4-methylethcathinone (4-MEC) and review the current knowledge of 4-MEC. Qualitative and quantitative analysis of 4-MEC was performed by validated high performance liquid chromatography-tandem mass spectrometry methods. In the first case a 22-year-old male died in hospital following collapse and seizures after using 4-MEC. Toxicological analysis of postmortem femoral blood revealed the presence of 4-MEC (0.167 mg/L), ethanol (27 mg/100 mL) and paracetamol (5 mg/L). Death was attributed solely to 4-MEC toxicity. The second case involved a 54-year-old man found with a taped plastic bag over his head. Toxicological analysis of postmortem femoral blood revealed the presence of 4-MEC (1.73 mg/L) along with ethanol (229 mg/100 mL), propranolol (0.036 mg/L), venlafaxine (0.284 mg/L) and its metabolite O-desmethylvenlafaxine (0.205 mg/L), and diazepam (<0.005 mg/L) and its metabolite nordiazepam (0.033 mg/L). Death was attributed primarily to asphyxiation. These cases and a review of the current knowledge of 4-MEC pharmacology/toxicology adds to the body of case material for 4-MEC and will assist with interpretation in postmortem toxicology cases in which 4-MEC is detected.

Original languageEnglish
Article numberbkw061
Pages (from-to)553-560
Number of pages8
JournalJournal of Analytical Toxicology
Volume40
Issue number7
Early online date16 Aug 2016
DOIs
Publication statusPublished - Sep 2016
Externally publishedYes

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    Smith, P. R., Cole, R., Hamilton, S., West, K., Morley, S. R., & Maskell, P. D. (2016). Reporting two fatalities associated with the use of 4-methylethcathinone (4-MEC) and a review of the literature. Journal of Analytical Toxicology, 40(7), 553-560. [bkw061]. https://doi.org/10.1093/jat/bkw061