“Being with a Buddha”: A Case Report of Methoxetamine Use in a United States Veteran with PTSD

A US veteran with PTSD and heavy polysubstance use self-injected high doses of methoxetamine (MXE), a ketamine analogue, for its calming effect. MXE is a designer drug widely available online and not detected by routine urine screens. Because of MXE's structural similarity to ketamine and evidence that ketamine reduces PTSD symptoms, the authors hypothesize that MXE alleviated the veteran's PTSD through NMDA receptor action and influences on BDNF. This is the first reported case of self-reported MXE use in a US veteran. Greater awareness of designer drugs is needed to engage patients in addiction treatment in both military and civilian settings.

Study at a glance

Abstract

Methoxetamine (MXE) is a ketamine analogue with a high affinity for the N-methyl-D-aspartate (NMDA) receptor. MXE is a newly emerging designer drug of abuse and is widely available through on-line sources and is not detected by routine urine drug screens. In this report, we describe a United States (US) veteran with posttraumatic stress disorder (PTSD) and heavy polysubstance use, who injected high dose MXE for its calming effect. Given MXE's structural similarities to ketamine and recent work showing that ketamine reduces PTSD symptoms, we hypothesize that MXE alleviated this veteran's PTSD symptoms through action at the NMDA receptor and via influences on brain-derived neurotrophic factor (BDNF). To our knowledge, this is the first case report of self-reported use of MXE in the US veteran population. More awareness of designer drugs, such as MXE, is an important first step in engaging patients in the treatment of designer drug addiction in both military/veteran settings and civilian settings.