Clinical toxicology (Philadelphia, Pa.)
March 1, 2025
Joep J. J. Ouwerkerk, David M Wood, Alison M. Dines et al.
1 citation
When 3,4-methylenedioxymetamfetamine (MDMA) is taken with alcohol, emergency department visits show higher odds of agitation, drowsiness, and vomiting compared to MDMA alone. Co-intoxication with other substances increases odds of bradycardia, psychosis, and coma. Mortality rates remain low across all groups. Female patients report less chest pain but more vomiting, headache, and hypotension than males. These variations suggest that physicians should consider both the type of co-intoxication and patient sex to optimize treatment.
Drug and Alcohol Dependence
January 1, 2020
Yasmin Schmid, Irene Scholz, Laura Mueller et al.
A retrospective analysis of 717 emergency department visits for acute cannabis toxicity at three Swiss hospitals found that 26% involved cannabis alone. Most lone-cannabis cases were minor (61%), with common symptoms including nausea/vomiting (26%), palpitations (25%), anxiety (23%), and chest pain (15%). No fatalities occurred. However, severe complications such as psychosis (7%), coma (6%), and seizures (5%) were reported, and 1% required intensive care. Patients using cannabis alone more often experienced palpitations, anxiety, and panic attacks, while those co-using other substances had more impaired consciousness, agitation, and respiratory depression. The authors conclude that cannabis alone can pose considerable health risks.
Clinical toxicology (Philadelphia, Pa.)
December 1, 2014
Katharina E Hofer, Colette Degrandi, Daniel Müller et al.
Methoxphenidine, a novel dissociative designer drug of the diarylethylamine class with structural features similar to phencyclidine (PCP), produced PCP-like adverse effects in a 53-year-old man found on the street in a somnolent and confusional state. Observed signs included tachycardia (112 bpm), hypertension (220/125 mmHg), echolalia, confusion, agitation, opisthotonus, nystagmus, and amnesia. Temperature and oxygen saturation were normal. Laboratory findings showed elevated creatine kinase (max 865 U/L), alanine aminotransferase (72 U/L), and gamma-glutamyl transpeptidase (123 U/L). Methoxphenidine was confirmed in plasma and urine via liquid chromatography tandem mass spectrometry. The patient recovered with symptomatic treatment.
Annals of emergency medicine
July 1, 2012
Katharina E Hofer, Bettina Grager, Daniel Müller et al.
Methoxetamine, a chemical relative of ketamine, is a new recreational drug not yet tightly regulated in most countries. This report describes the first confirmed case of intravenous methoxetamine abuse, in a 19-year-old man. His symptoms—rapid heart rate, high blood pressure, confusion, agitation, stupor, poor coordination, dilated pupils, and involuntary eye movements—matched known ketamine effects and resolved with supportive treatment. Based on this case, user reports, and the drug's structure, methoxetamine produces ketamine-like effects, and full recovery is expected with medical care.