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Unexpected Serotonin Syndrome, Epileptic Seizures, and Cerebral Edema Following 2,5-dimethoxy-4-bromophenethylamine Ingestion.

Antoinette S Spoelder, Jan K G Louwerens, Stefanie D Krens, Nynke Jager, Natalie E Lecouffe, Wouter De Ruijter, Tibor M Brunt

Journal of Forensic Sciences November 1, 2019 DOI: 10.1111/1556-4029.14214 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Case study Case report Peer reviewed
Sample size 1
Population 18-year-old man
Intervention supportive therapy
Duration Several months follow-up
Topics Serotonin
Keywords 2c-b Designer drugs Intoxication Phenethylamine Serotonin syndrome Substance-related brain damage Drug neurotoxicity Severe brain damage Brain swelling Synthetic drugs Recreational substances Club drugs Drug detection Substance analysis Advanced forensic science Drug screening Drug-induced serotonin excess
Citations 12
Key findings 2C-B ingestion caused serotonin syndrome and severe brain edema, leading to lasting neurological impairment, and was not detected by routine drug screening.

Abstract

4-bromo-2,5-dimethoxyphenethylamine (2C-B) is a designer drug. In Europe, 2C-B is easily obtained and used for recreational purposes. It is known for its stimulating effects similar to those of 3,4-methylenedioxymethamphetamine, although in higher doses it has more hallucinogenic effects. Here, we report a case of 2C-B ingestion, confirmed by liquid chromatography-tandem mass spectrometry, in an 18-year-old man. The neurological consequences were severe, including the development of serotonin syndrome and severe brain edema. Supportive therapy resulted in a stable condition, although, after several months, the patient still suffered from severe neurological impairment due to the drug-induced toxicity. This case showed that 2C-B could not be identified with the drugs of abuse screening routinely used in Dutch hospitals. The use of 2C-B carries many risks, with potentially profound neurological damage, that both consumers and healthcare physicians are unaware of.