• Laura Hondebrink, Johanna J Nugteren-van Lonkhuyzen, Saskia J Rietjens, Tibor M Brunt, Bastiaan Venhuis, Vidija Soerdjbalie-Maikoe, Beitske E Smink, Antoinette J H P van Riel, and Irma de Vries.
• Dutch Poisons Information Center, University Medical Center Utrecht, Utrecht, the Netherlands. Electronic address: l.hondebrink@umcutrecht.nl.
• Ann Emerg Med. 2018 Mar 1; 71 (3): 294-305.

Study ObjectiveWe study adverse health effects after use of the new psychoactive substance 4-fluoroamphetamine.MethodsAll patients who reported 4-fluoroamphetamine exposure and for whom the Dutch Poisons Information Center was consulted by their physician in 2016 were included in a prospective cohort study. The clinical course was investigated through telephone interviews with the physician and/or patient, using standardized questionnaires. 4-Fluoroamphetamine was analyzed in remaining drug material and biological samples with liquid and gas chromatography-mass spectrometry techniques.ResultsWe included 45 patients, and follow-up with the physician and/or patient was performed in 33 cases. All patients experienced adverse effects after 4-fluoroamphetamine use. Severe toxicity was reported in 8 patients. In 5 of these patients, 4-fluoroamphetamine exposure was confirmed in biological specimens. Severe toxicity that was reported included 2 fatalities, 4 patients with cerebral hemorrhage (1 fatal), 2 patients with inverted Takotsubo's cardiomyopathy, 1 patient with myocardial infarction, 1 patient with acute heart failure, and an overall high prevalence of pronounced hypertension and tachycardia.ConclusionSince the introduction of 4-fluoroamphetamine to the Dutch drug market in 2007, its use continues to increase, possibly because users perceive it as "ecstasy light" and thus relatively safe. However, the proportion of patients with severe toxicity after 4-fluoroamphetamine use is relatively large in our study population. Therefore, users should be warned about the risks of 4-fluoroamphetamine.Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

32 keywords...

hide…