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.
Comparable studies
Other case reports and case series on serotonin, 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 |
| Striatal serotonin is depleted in brain of a human MDMA (Ecstasy) user Chronic MDMA user | 2000 | Case study | n = 1 |
| Death following ingestion of MDMA (ecstasy) and moclobemide People who died after ingesting moclobemide and MDMA | 2003 | Case series | n = 4 |
| Ecstasy Intoxication: An Overlap Between Serotonin Syndrome and Neuroleptic Malignant Syndrome A 19-year-old woman and 15 other cases reported in the literature | 1996 | Case report and literature review | n = 16 |
| Recurrent seizures and serotonin syndrome following "2C-I" ingestion. 19-year-old male who insufflated 2C-I | 2013 | Case report | n = 1 |
Citations in the library
Cited by 6
- New psychoactive substances (NPS) and serotonin syndrome onset: A systematic review. Experimental Neurology May 1, 2021
- Molecular and clinical aspects of potential neurotoxicity induced by new psychoactive stimulants and psychedelics Experimental Neurology June 4, 2021
- Psychedelic Psychiatry and the Consult-Liaison Psychiatrist: A Primer Journal of the Academy of Consultation-Liaison Psychiatry January 21, 2021
- The Clinical Toxicology of 4-Bromo-2,5-dimethoxyphenethylamine (2C-B): The Severity of Poisoning After Exposure to Low to Moderate and High Doses. Annals of emergency medicine September 1, 2020
- Toxicology and Pharmacological Interactions of Classic Psychedelics. Current Topics in Behavioral Neurosciences July 24, 2024
and 1 more in the library
Cites 9
- Monitoring new psychoactive substances (NPS) in The Netherlands: data from the drug market and the Poisons Information Centre. Drug and Alcohol Dependence February 1, 2015
- Dihydrobenzofuran Analogues of Hallucinogens. 3. Models of 4-Substituted (2,5-Dimethoxyphenyl)alkylamine Derivatives with Rigidified Methoxy Groups Journal of Medicinal Chemistry 1996
- 2-(4-Iodo-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine (25I-NBOMe): clinical case with unique confirmatory testing. Journal of Medical Toxicology March 1, 2014
- Metabolic pathways of 4-bromo-2,5-dimethoxyphenethylamine (2C-B): analysis of phase I metabolism with hepatocytes of six species including human. Toxicology January 5, 2005
- Recurrent seizures and serotonin syndrome following "2C-I" ingestion. Journal of Medical Toxicology June 1, 2013
and 4 more in the library