Zoletil 50-induced mental and behavioral abnormalities: a case report and literature review
Frontiers in Psychology July 8, 2026 DOI: 10.3389/fpsyg.2026.1884471 (opens in new tab) via OpenAlex
Summary
AI-generated from the abstractA 22-year-old man who used the veterinary anesthetic Zoletil 50 (a mix of tiletamine and zolazepam) recreationally by insufflation about once or twice a week developed a 4-month history of low mood, loss of interest, and feelings of detachment from self and surroundings. After repeated use, he experienced acute episodes of intense panic, terror, rapid heartbeat, and palpitations lasting 30–60 minutes. The case suggests that recreational use of Zoletil 50 or tiletamine-containing e-cigarettes can lead to addiction, depressed mood, panic attacks, and other psychiatric symptoms, and overdose can be fatal.
Study at a glance
| Characteristics | Case report Peer reviewed |
|---|---|
| Sample size | 1 |
| Population | 22-year-old male with no prior medical or psychiatric history |
| Duration | 4-month history |
| Keywords | Feeling Panic Presentation obstetrics Recreation Psychiatric history |
| Key finding | Recreational use of Zoletil 50 was associated with depressed mood, depersonalization/derealization, and panic attacks in a young man. |
Abstract
Background Zoletil 50, mixed with tiletamine and zolazepam, a veterinary anesthetic, has increasingly been used as a substitute drug by substance abusers in recent years. Recently, it has been found in China that tiletamine has been added to electronic cigarettes as a stimulant, highlighting the need for further evaluation of its safety. Case presentation A 22-year-old, previously healthy, unmarried male presented to a psychiatric outpatient clinic with a 4-month history of progressive low mood, anhedonia, and feelings of detachment from self and surroundings (depersonalization/derealization). He reported recreational use of powdered Zoletil 50, insufflated approximately 1–2 times per week. Following repeated use, he began experiencing acute, paroxysmal episodes characterized by intense panic, terror, tachycardia, and palpitations, lasting 30–60 min. There was no significant past medical or psychiatric history. Physical examination was unremarkable. Routine blood tests, thyroid function, and ECG were within normal limits. Conclusion The use of Zoletil 50 or electronic cigarettes containing tiletamine can lead to addiction, suicidal tendencies, depressed mood, panic attacks. Long-term use of Zoletil 50 may result in various psychiatric and behavioral symptoms, while overdose can be fatal. There is an urgent need for society to strengthen regulations and oversight in this regard.