Cluster of acute poisonings associated with an emerging ketamine analogue, 2-oxo-PCE.
Forensic Science International September 1, 2018 Magdalene H Y Tang, Y K Chong, Candace Y Chan et al.
In October 2017, a cluster of acute intoxications presented with ketamine-like symptoms, but standard toxicology screens did not detect ketamine. An unidentified substance was consistently found and later identified as 2-oxo-PCE, a new arylcyclohexylamine analogue. Chart review revealed 56 cases of 2-oxo-PCE-associated acute poisoning between October and November 2017. Laboratory analysis confirmed 2-oxo-PCE in all patients' urine; nasal swabs from three patients showed only 2-oxo-PCE. Urine immunoassay for ketamine did not cross-react with 2-oxo-PCE. In 55% of cases, other drugs were also detected; in the remainder, 2-oxo-PCE was used alone. Main symptoms with sole use included impaired consciousness (84%), confusion (60%), abnormal behavior (44%), hypertension (80%), and tachycardia (40%). Convulsion occurred in 16%. Management was supportive; three patients required intensive care. All recovered uneventfully.