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The Clinical Toxicology of 4-Bromo-2,5-dimethoxyphenethylamine (2C-B): The Severity of Poisoning After Exposure to Low to Moderate and High Doses.

Johanna J Nugteren-Van Lonkhuyzen, Dylan W de Lange, Antoinette J H P van Riel, Ruben Q Vrolijk, Dana Ohana, Laura Hondebrink

Annals of emergency medicine September 1, 2020 DOI: 10.1016/j.annemergmed.2020.04.022 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Prospective cohort study Peer reviewed
Sample size 59
Population Patients for whom the Dutch Poisons Information Centre was consulted for 2C-B exposure from 2016 to 2018
Intervention 2C-B
Dose low to moderate (up to 20 mg), high (greater than 20 mg)
Duration Up to 24 hours
Keywords 2c-b substance 2c-b drug Substance toxicity Drug toxicity Overdose effects Clinical toxicology Clinical effects Adverse effects Psychoactive effects Hallucinogenic effects Drug effects Substance effects Patient symptoms Patient outcomes Clinical course Prognosis Substance recovery Drug recovery Poisoning outcomes
Citations 12
Key findings Most 2C-B poisonings resulted in moderate toxicity even at high reported doses up to 192 mg, with no severe cases observed.

Abstract

We studied the severity of poisoning after exposure to low to moderate and high doses of 4-bromo-2,5-dimethoxyphenethylamine (2C-B). Patients for whom the Dutch Poisons Information Centre was consulted for 2C-B exposure from 2016 to 2018 were included in a prospective cohort study. Data were collected through telephone interviews with the physician or patient. Patients were categorized according to the reported 2C-B dose: low to moderate (up to 20 mg), high (greater than 20 mg), or unknown. Presence of 2C-B was analyzed in leftover drug and biological samples with liquid/gas chromatography-mass spectrometry. The severity of poisoning was graded with the Poisoning Severity Score. We included 59 patients, of whom 32 could be followed up. Low to moderate 2C-B doses were reported by 9 patients (28%), high doses by 17 (53%), and unknown doses by 6 (19%). Poisoning was moderate in the majority of patients in both the low- to moderate-dose and high-dose groups. Frequently reported symptoms included mydriasis, agitation or aggression, hallucinations, confusion, anxiety, hypertension, and tachycardia. The presence of 2C-B was confirmed in 5 patients in urine (n=3) or drug samples (n=4). In this study, most 2C-B poisonings resulted in moderate toxicity even at high reported doses up to 192 mg. No severe cases were observed. The clinical course was usually short-lived (up to 24 hours) and typically involved hallucinations in addition to mild somatic effects.