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Pelletier R, Gicquel T, Carvelli J, Balaz P, Pelissier-Alicot AL, Morel I, Bottinelli C, Solas C, Le Daré B, Fabresse N. Severe 25E-NBOH intoxication associated with MDPHP intake: a case report, metabolism study, and literature review. Int J Legal Med 2024; 138:815-822. [PMID: 38117418 DOI: 10.1007/s00414-023-03151-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
N-Benzylphenethylamine derivatives are 5-HT2A receptor agonists with hallucinogenic properties, including NBOMe (N-(2-methoxybenzyl)-2-(3,4,5-trimethoxyphenyl)ethan-1-amine) and NBOH (2-(((2,5-dimethoxyphenethyl)amino)methyl)phenol). We reported here the case of a 23-year-old man who presented a serotoninergic syndrome and a loss of consciousness following the consumption of a powder labelled as 25I-NBOH. Toxicological analyses of biological samples were carried out using a liquid chromatography high-resolution mass spectrometry. Two new psychoactive substances were identified and confirmed with certified reference materials: 25E-NBOH (2-(((4-ethyl-2,5-dimethoxyphenethyl)amino)methyl)phenol) and MDPHP (1-(benzo[d][1,3]dioxol-5-yl)-2-(pyrrolidin-1-yl)hexan-1-one). Pharmaceuticals administered to the patient during his medical care were found in plasma and urine. 25E-NBOH and MDPHP concentrations were respectively at 2.3 ng/mL and 3.4 ng/mL in plasma, and 25.7 ng/mL and 30.5 ng/mL in urine. 25I-NBOH (2-(((4-iodo-2,5-dimethoxyphenethyl)amino)methyl)phenol) was specifically searched in both samples and was not detected. These results are discussed along with a literature review on human cases of exposure to N-benzylphenethylamine derivatives. Using molecular networking approach, we propose the first 25E-NBOH metabolism study using authentic biological samples (plasma and urine). We described seven metabolites (M1 to M7), including two phase I (m/z 330.172; m/z 288.160) and five phase II metabolites (m/z 464.191, m/z 478.207, m/z 492.223, m/z 508.218; m/z 396.156). The M6 (m/z 492.223) was the most intense ion detected in plasma and urine and could be proposed as a relevant 25E-NBOH consumption marker. Overall, we described an original case of 25E-NBOH poisoning and identified metabolites that could potentially be used as consumption markers to detect 25E-NBOH intoxications with a higher confidence level and probably a longer detection window.
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Affiliation(s)
- Romain Pelletier
- INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer), PREVITOX Network, F-35033, Rennes, France.
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, F-35033, Rennes, France.
| | - Thomas Gicquel
- INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer), PREVITOX Network, F-35033, Rennes, France
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, F-35033, Rennes, France
| | - Julien Carvelli
- AP-HM, DepaICMrtment of Intensive Care, Réanimation des Urgences, Medicine Intensive & Reanimation, Timone University Hospital, Marseille, France
| | - Pierre Balaz
- Bataillon des Marins Pompiers, Groupement Santé, Service Médical d'Urgence, 9 Boulevard de Strasbourg, 13233, Marseille Cedex 20, France
| | - Anne-Laure Pelissier-Alicot
- Aix Marseille Univ, APHM, INSERM, INMED UMR 901, La Timone University Hospital, Legal Medicine Department, 13005, Marseille, France
| | - Isabelle Morel
- INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer), PREVITOX Network, F-35033, Rennes, France
- Rennes University Hospital, Clinical and Forensic Toxicology Laboratory, F-35033, Rennes, France
| | | | - Caroline Solas
- Laboratory of Pharmacokinetics and Toxicology, La Timone University Hospital, 264 rue Saint Pierre, 13385, Marseille Cedex 5, France
| | - Brendan Le Daré
- INSERM, INRAE, CHU Rennes, Institut NuMeCan (Nutrition, Metabolism and Cancer), PREVITOX Network, F-35033, Rennes, France
- Rennes University Hospital, Pharmacy department, F-35033, Rennes, France
| | - Nicolas Fabresse
- Laboratory of Pharmacokinetics and Toxicology, La Timone University Hospital, 264 rue Saint Pierre, 13385, Marseille Cedex 5, France
- Aix Marseille University, INSERM, IRD, SESSTIM, Economic and Social Sciences of Health and Medical Information Processing, Marseille, France
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