Acute toxicity from the synthetic cathinone N-ethylpentylone (ephylone) in the United Kingdom

Abstract

Introduction

Acute toxicity caused by New Psychoactive Substances (NPS) has created a significant burden for Emergency Departments (EDs). Here we report characteristics of people presenting with toxicity after exposure to the synthetic cathinone N-ethylpentylone (NEP).

Methods

Adults presenting to hospital with severe acute toxicity after suspected NPS use were recruited between March 2015 and October 2020. Clinical features were recorded using consistent methodology and biological samples analysed using liquid chromatography-tandem mass-spectrometry.

Results

NEP was detected in at least one sample from 9 of 893 patients recruited during the period of study, all presenting between 2016 and 2019 and 8 presenting in southern England. Commonly reported clinical features included tachycardia (6), agitation (6), confusion (6), mydriasis (5), hallucinations (4), acidosis (3) and elevated creatine kinase (3). Co-used drugs, detected in 6 patients, may have contributed to these features, but agitation and hallucinations were also reported in all 3 patients without analytical evidence of co-use.

Conclusions

NEP was detected infrequently in episodes of drug toxicity in the UK between 2016 and 2019, especially in southern England. Clinical characteristics of toxicity are similar to those of other cathinones, although co-use of other drugs is common and may contribute to the features observed.

Keywords:

• N-ethylpentylone ephylone
• synthetic cathinones
• drug misuse
• acute toxicity
• novel psychoactive substances

Acknowledgements

The authors are grateful to the clinicians and research nurses in hospitals enrolled in the IONA study for their essential contribution in recruiting patients and collecting samples and clinical data.

Disclosure statement

The authors report no declarations of interest.

Additional information

Funding

This research was funded by the National Institute for Health Research (NIHR) Health Protection Research Unit in Chemical and Radiation Threats and Hazards and by Public Health England. The views expressed are those of the author(s) and not necessarily those of the National Health Service, the NIHR, the Department of Health or Public Health England.