A combined toxicokinetic and metabolic approach to investigate deschloro-N-ethylketamine exposure in a multidrug user.
Romain Magny, Bruno Mégarbane, Lucie Chevillard, Emmanuel Roulland, Benoit Bardèche-Trystram, Véronique Dumestre-Toulet, Laurence Labat, Pascal Houzé
Journal of Pharmaceutical and Biomedical Analysis June 15, 2024 DOI: 10.1016/j.jpba.2024.116086 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | A chronic GHB, 3-MMC, and methoxetamine consumer in a chemsex context |
| Duration | 29.5-hour period of plasma sampling |
| Topics | Ketamine |
| Keywords | 2-deschloro-n-ethylketamine Arylcyclohexylamine Molecular networking Multidrug user Toxicokinetics Designer drugs Research chemicals Drug testing Drug screening Drug metabolism pharmacokinetics Biotransformation |
| Citations | 7 |
| Key findings | A multidrug exposure including the new psychoactive substance O-PCE was confirmed, with 27 metabolites identified and an elimination half-life of about 5 hours. |
Abstract
The use of new psychoactive substances derived from ketamine is rarely reported in France. A chronic GHB, 3-MMC, and methoxetamine consumer presented a loss of consciousness in a chemsex context and was referred to the intensive care unit with a rapid and favorable outcome. To investigate the chemicals responsible for the intoxication, a comprehensive analysis was conducted on the ten plasma samples collected over a 29.5-hour period, urine obtained upon admission, a 2-cm hair strand sample, and a seized crystal. These analyses were performed using liquid chromatography hyphenated to high resolution tandem mass spectrometry operating in targeted and untargeted modes. Additionally, analyses using gas chromatography coupled to mass spectrometry and nuclear magnetic resonance were conducted to probe the composition of the seized crystal. The molecular network-based approach was employed for data processing in non-targeted analyses. It allowed to confirm a multidrug exposure encompassing GHB, methyl-(aminopropyl)benzofuran (MAPB), (aminopropyl)benzofuran (APB), methylmethcathinone, chloromethcathinone, and a new psychoactive substance belonging to the arylcyclohexylamine family namely deschloro-N-ethyl-ketamine (O-PCE). Molecular network analysis facilitated the annotation of 27 O-PCE metabolites, including phase II compounds not previously reported. Plasma kinetics of O-PCE allowed the estimation of the elimination half-life of ∼5 hours. Kinetics of O-PCE metabolites was additionally characterized, possibly useful as surrogate biomarkers of consumption. We also observed marked alterations in lipid metabolism related to poly consumption of drugs. In conclusion, this case report provides a comprehensive analysis of exposure to O-PCE in a multidrug user including kinetic and metabolism data in human.
Comparable studies
Other case reports and case series on ketamine, most cited first.
Citations in the library
Cites 25
- Ketamine and Ketamine Metabolite Pharmacology: Insights into Therapeutic Mechanisms Pharmacological Reviews June 26, 2018
- Ketamine use: a review Addiction July 21, 2011
- Designer drugs: mechanism of action and adverse effects Archives of Toxicology April 1, 2020
- From PCP to MXE: a comprehensive review of the non-medical use of dissociative drugs. Drug Testing and Analysis 2014
- Mechanisms of Ketamine and its Metabolites as Antidepressants Biochemical Pharmacology December 1, 2021
and 20 more in the library