Pharmacology and toxicology of N-Benzyl-phenylethylamines (25X-NBOMe) hallucinogens

Abstract

Abstract 25X-NBOMe compounds are halogenated, phenethylamine-related novel psychoactive drugs, with hallucinogenic and stimulant effects. NBOMes are potent and highly efficacious agonists at the 5HT2a receptor with binding affinities in the low nanomolar range, accounting for their psychoactive and toxic effects. 25I-, 25B-, and 25C-NBOMes are the most frequently encountered compounds; they are typically sold as blotter papers, or in powder, liquid, or tablet forms, and administered by several routes including sublingual or buccal ingestion, nasal insufflation, through smoking or more rarely through intravenous injection. 25X-NBOMes have been identified worldwide and are associated with clinical presentations consistent with sympathomimetic, hallucinogenic, and possibly serotonergic toxidromes. 25X-NBOMEs have been associated with cases of severe toxicity and death, and therefore physicians should remain vigilant for features that may be consistent with toxicity, particularly in those who report ingesting using blotters or LSD. In this chapter, the current understanding of 25X-NBOMe pharmacology and toxicology is reviewed