• Johanna J Nugteren-van Lonkhuyzen, Dylan W de Lange, Antoinette J H P van Riel, Ruben Q Vrolijk, Dana Ohana, and Laura Hondebrink.
• Dutch Poisons Information Center, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands. Electronic address: a.vanlonkhuyzen@umcutrecht.nl.
• Ann Emerg Med. 2020 Sep 1; 76 (3): 303-317.

Study ObjectiveWe studied the severity of poisoning after exposure to low to moderate and high doses of 4-bromo-2,5-dimethoxyphenethylamine (2C-B).MethodsPatients for whom the Dutch Poisons Information Centre was consulted for 2C-B exposure from 2016 to 2018 were included in a prospective cohort study. Data were collected through telephone interviews with the physician or patient. Patients were categorized according to the reported 2C-B dose: low to moderate (up to 20 mg), high (greater than 20 mg), or unknown. Presence of 2C-B was analyzed in leftover drug and biological samples with liquid/gas chromatography-mass spectrometry. The severity of poisoning was graded with the Poisoning Severity Score.ResultsWe included 59 patients, of whom 32 could be followed up. Low to moderate 2C-B doses were reported by 9 patients (28%), high doses by 17 (53%), and unknown doses by 6 (19%). Poisoning was moderate in the majority of patients in both the low- to moderate-dose and high-dose groups. Frequently reported symptoms included mydriasis, agitation or aggression, hallucinations, confusion, anxiety, hypertension, and tachycardia. The presence of 2C-B was confirmed in 5 patients in urine (n=3) or drug samples (n=4).ConclusionIn this study, most 2C-B poisonings resulted in moderate toxicity even at high reported doses up to 192 mg. No severe cases were observed. The clinical course was usually short-lived (up to 24 hours) and typically involved hallucinations in addition to mild somatic effects.Copyright © 2020 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

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