A cluster of 25B-NBOH poisonings following exposure to powder sold as lysergic acid diethylamide (LSD)
S. Ivory, J. Rotella, Jennifer L. Schumann, Shaun L. Greene
Clinical Toxicology March 28, 2022 DOI: 10.1080/15563650.2022.2053150 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Case series Case report Peer reviewed |
|---|---|
| Sample size | 5 |
| Population | Patients presenting to an Emergency Department with altered conscious state after exposure to powder sold as powdered LSD |
| Topics | LSD |
| Key findings | Exposure to 25B-NBOH produced sympathomimetic toxicity including hallucinations, and insufflation led to rapid onset of status epilepticus in one case. |
Abstract
Abstract Introduction 25B-NBOH is a synthetic hallucinogen closely related to the “NBOMe” family of N-substituted 2C phenethylamine derivatives. There have been no published reports documenting the clinical toxicity of NBOH derivatives. Case series Five patients presented to the Emergency Department (ED) with altered conscious state following exposure to powder sold as “powdered LSD” at a party. A 24-year-old male who ingested the powder developed mydriasis, tachycardia, hypertension, and severe agitation requiring parenteral sedation. A 22-year-old male who insufflated the powder developed status epilepticus requiring intubation. Both patients developed acute kidney injury and one had rhabdomyolysis. In both cases, blood analysis detected 25-NBOH and no other illicit/licit drugs. Three other patients developed mild hallucinations. Hyperthermia was not documented in any case. Discussion Exposure to 25B-NBOH in a powdered form produced sympathomimetic toxicity, including hallucinations. Insufflation of 25B-NBOH led to rapid onset of status epilepticus in one case. Toxicity in all cases resolved within 12 h. Despite in vitro evidence of 5-HT2A receptor agonism, hyperthermia was not observed. Potent hallucinogens are often delivered via blotter paper to avoid excessive dosing. The severe clinical toxicity documented in these cases highlights the potential for development of adverse health effects with exposure to apparent small volumes of potent sympathomimetics.
Comparable studies
Other case reports and case series on LSD, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Lasting Neuropsychiatric Sequelae of (??)Methylenedioxymethamphetamine (???Ecstasy???) in Recreational Users Persons who ingested large doses of MDMA | 1991 | Case study | n = 2 |
| Further Studies in the Therapeutic Value of Lysergic Acid Diethylamide in Mental Illness Patients with mental illness | 1957 | Case series | |
| Coma, Hyperthermia, and Bleeding Associated with Massive LSD Overdose a Report of Eight Cases People who self-administered large amounts of pure LSD powder intranasally | 1975 | Case series | n = 8 |
| Using a MDMA- and LSD-Group Therapy Model in Clinical Practice in Switzerland and Highlighting the Treatment of Trauma-Related Disorders Patients with chronic complex post-traumatic stress disorder (c-PTSD), dissociative,... | 2022 | Case series | |
| Persistent Palinopsia Following Ingestion of Lysergic Acid Diethylamide (LSD) Patients who developed persistent palinopsia after LSD ingestion | 1996 | Case series | n = 3 |
Citations in the library
Cited by 2
Cites 5
- Modern Clinical Research on LSD Neuropsychopharmacology April 27, 2017
- NBOMes–Highly Potent and Toxic Alternatives of LSD Frontiers in Neuroscience February 26, 2020
- Effects of MDMA on body temperature in humans Temperature October 31, 2014
- Neurochemical pharmacology of psychoactive substituted N-benzylphenethylamines: high potency agonists at 5-HT2A receptors Biochemical Pharmacology September 25, 2018
- Characterization of the hepatic cytochrome P450 enzymes involved in the metabolism of 25I-NBOMe and 25I-NBOH. Drug Testing and Analysis May 1, 2017