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Cristalius: a case in designer drugs.

Jared Lenz, Jaime Brown, Seth Flagg, Robert Oh, Kenneth Batts, Thomas F. Ditzler, Jeremy Johnson

Military Medicine July 2013 DOI: 10.7205/milmed-d-12-00393 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 1
Population 22-year-old male Soldier
Dose 1 g
Key findings A 22-year-old soldier who snorted 1 g of the "bath salt" Cristalius presented with syncope, agitation, confusion, and tachycardia, along with elevated creatine kinase, creatinine, and troponin that normalized with supportive care. The authors propose that such products contain mephedrone and synthetic cathinones, and note that no treatment guidelines exist for mephedrone or MDPV toxicity, recommending cardiac evaluation regardless of age.

Abstract

Among recreational drug users, there is a new wave of designer drugs being marketed as "bath salts" and "plant food," which mimic the effects of cocaine/amphetamines and ecstasy (MDMA [3,4-methylenedioxy-N-methamphetamine]). Presented is the case of a patient who snorted a bath salt called Cristalius. A 22-year-old male Soldier was seen in an emergency department for syncope, agitation, confusion, and tachycardia. He reported snorting 1 g of Cristalius the night before. Significant labs included a creatine kinase of 668 U/L, serum creatinine of 1.35 mg/dL, and troponin of 0.516 ng/mL. His abnormal labs trended to normal and a computed tomography coronary angiogram was unremarkable. The main ingredients postulated in these products are mephedrone and a synthetic cathinone derivatives of the khat plant. The intended effects include euphoria, empathic connection, mood enhancement, increased sensory perception, with decreased inhibition. Unwanted sympathomimetic side effects include hypertension, tachycardia, chest pain, diaphoresis, dilated pupils, seizures, bruxism, and headaches. Neuropsychiatric symptoms include agitation, anxiety, paranoia, tremors, and insomnia. No treatment guidelines currently exist for mephedrone or MDPV (3,4-methylenedioxypyrovalerone) toxicity. If suspected, ensure adequate cardiac evaluation is completed regardless of age. Appropriate supportive care and addressing any complications is the primary treatment.

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