Manifestations and treatment of central nervous system complications associated with synthetic cathinone (“bath salts”) toxicities

Abstract

INTRODUCTION "Bath Salts" or synthetic cathinone derivatives have made waves during the past several years in the designer drug market as a new trend in drugs of abuse. Natural cathinones are psychoactive chemicals that have been historically consumed by chewing Khat, or Catha edulis, leaves and shoots in regions of Africa and the Arabian Peninsula. Traditionally, Khat has been utilized to increase alertness and enhance euphoria as CNS stimulants commonly used by religious leaders and militant factions. The pharmacologic effects of synthetic cathinones have been noted to be similar to cocaine, amphetamines, and 3,4-methylenedioxy-Nmethylamphetamine (MDMA/ecstasy) although each have their own unique profile. There are at least 12 different known synthetic cathinones that are currently available but 4-methylmethcathinone (mephedrone), 3,4methylenedioxypyrovalerone (MDPV), and 3,4methylenedioxymethcathinone (methylone) are three of the more common analogues. The DEA added mephedrone, methylone and MDPV to the list of Schedule 1 substances as part of the Control Substances Act in September 2011. This was an emergency scheduling and has not yet been made permanent. The other 9+ synthetic cathinones remain unscheduled.