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Synthetic Cathinones (“Bath Salts”)

Written by: Dr. Francisco Rojas

Synthetic cathinones, more commonly known as “bath salts,” are synthetic drugs chemically related to cathinone, an amphetamine-like stimulant found naturally in the khat plant. Khat is a shrub grown in East Africa and southern Arabia, and people sometimes chew its leaves for their mild stimulant effects. Synthetic variants of cathinone can be much stronger than the natural product.

Synthetic cathinones are marketed as cheap substitutes for other stimulants such as methamphetamine and cocaine, and products sold as Molly (MDMA) often contain synthetic cathinones instead. Chemically, they are similar to other amphetamines such as methamphetamine and to MDMA (Ecstasy).

Methcathinone or “Cat” is closely related to the naturally occurring compounds, cathinone and cathine. This psychoactive stimulant is known as a substituted cathinone. Chemically, methcathinone is 2-(methylamino)propiophenone or ephedrone, a monoamine alkaloid. Methcathinone has recently emerged and grown to be a popular drug of abuse.

The production of methcathinone utilizes the oxidation of pseudoephedrine or ephedrine.  The carbon skeleton of the final product is identical to pseudoephedrine and methamphetamine. It differs from pseudoephedrine in that the hydroxide beta to the aromatic ring is oxidized to a ketone. Also, methcathinone differs from methamphetamine only by the β-ketone substituent and from amphetamine by both a keto and N-methyl substituent.

Common man-made cathinones found in bath salts often contain various amphetamine-like chemicals, such as 3,4-methylenedioxypyrovalerone (MPDV), mephedrone(“Drone,” “Meph,” or “Meow Meow”), pyrovalerone and methylone, but there are many others.

People who have taken synthetic cathinones have reported energizing and often agitating effects. Synthetic cathinones can also raise heart rate and blood pressure. A recent study found that 3,4-methylenedioxypyrovalerone (MDPV), a common synthetic cathinone, affects the brain in a manner similar to cocaine but is at least 10 times more powerful. MDPV is the most common synthetic cathinone found in the blood and urine of patients admitted to emergency departments after taking “bath salts” (Baumann et al., 2013). The drug acts as a norepinephrine-dopamine reuptake inhibitor.

These drugs are typically administered orally, by inhalation, or by injection, with the worst outcomes apparently associated with snorting or intravenous administration. Like methamphetamine, amphetamine and cathinone, methcathinone achieves its mind-altering effects by changing normal levels of three key chemicals in the central nervous system-dopamine, norepinephrine, and serotonin-that function as neurotransmitters and relay the signals required for coordinated activity within this system. Methcathinone-related elevations in dopamine and norepinephrine levels trigger feelings of euphoria and overstimulation of the body’s natural “fight-or-flight” reflex. Methcathinone-related decreases in serotonin levels tend to produce irritability and other emotions associated with a bad mood.

Like any other drug that achieves its effects by altering dopamine levels inside the central nervous system, methcathinone can produce addiction in long-term users.

Intoxication with these drugs is difficult to diagnose because intoxication by synthetic cathinone derivatives induce misleading symptoms. As a result, documented reports of methcathinone intoxication that are based on reliable analyses are rare. Effects of short term intoxication are similar to those produced by crack cocaine or methamphetamine: stimulation of heart rate and respiration; feeling of euphoria; loss of appetite; increased alertness; pupils may be dilated; body temperature may be slightly elevated. Acute intoxication at higher doses may also result in: insomnia, tremors and muscle twitching, fever, headaches, convulsions, irregular heart rate and respirations, anxiety, restlessness, paranoia, and hallucinations and delusions.

The key to diagnose intoxication is the prompt detection of the drugs by a rapid immunoassay test. Pyxis is proud to be one the first laboratories to offer to the market both Methcathinone-BSA and MDPV-BSA. Please contact Pyxis Laboratories, Inc for inquiry.

References:

Addiction. 2014;109(10):1577-1579.

Forensic Sci Int. 2005 Oct 4;153(1):99-101