Self Medication with Methoxetamine as an Analgesic Resulting in Significant Toxicity.

A 29-year-old man who self-medicated with methoxetamine (MXE), an arylcyclohexylamine drug of abuse similar to ketamine, for chronic foot pain was brought to the emergency department with altered mental status. He exhibited agitation, combative behavior, white foam around the mouth, dysphoria, psychomotor agitation, vertical nystagmus, labile mood, and dissociative confusion with partial amnesia. After receiving 10 mg intravenous diazepam, he became calmer and more euphoric but remained labile. The case illustrates the toxic effects of MXE when used outside medical supervision.

Study at a glance

Abstract

Dear Editor, Methoxetamine (MXE) is a non-scheduled arylcyclohexylamine drug of abuse with clinical effects similar to ketamine or phencyclidine [1]. We report a case of MXE toxicity after self-medicating for treatment of chronic foot pain. A 29-year-old man was brought to the emergency department (ED) for altered mental status. He was apprehended by police after running into the street and lying down in front of oncoming traffic, including a police car. He was agitated and combative for emergency medical services (EMS), eventually requiring restraints. EMS also noted white foam around his mouth. A plastic bag containing white powder, labeled MXE with CAS number 1239943-76-0, was found in his pocket (see Figure 1). On presentation to the ED, vital signs included a heart rate of 117, blood pressure 140/81, respiratory rate 28, and temperature of 37.1 degrees celsius orally. Neurologic signs included dysphoria, psychomotor agitation, vertical nystagmus, labile mood, and dissociative confusion, including partial amnesia to the preceding events. The patient was given 10mg IV diazepam in the ED which resulted in a calmer, more euphoric state though his mood remained labile. He answered some questions appropriately but …