Phendimetrazine is a medication currently being used to help patients with weight loss. It shares a chemical structure with amphetamines. As such, it shares some of the same toxicities, which can include psychosis. Two cases present good examples of phendimetrazine-induced psychotic disorder. A 30-year old female was admitted to emergency room with visual hallucination, auditory hallucination and aberrant behavior. Another 38-year old housewife was accompanied by her family to evaluate mood swing, auditory hallucination and behavioral change to psychiatric clinic. After evaluation in psychiatric ward, they were confirmed to have causal relation with prescription diet pills. These case reports demonstrate the potential dangers of amphetamine based diet pills. There have been several cases of cardiomyopathies and pulmonary hypertension related to phendimetrazine, but psychosis is something that is rarely recognized in an outpatient setting. Two cases showed the importance of obtaining a careful medication history in all patients and specially recognizing diet pills with an amphetamine base causing psychosis.
Amphetamine ; Amphetamines ; Cardiomyopathies ; Diet ; Emergencies ; Female ; Hallucinations ; Humans ; Hypertension, Pulmonary ; Morpholines ; Outpatients ; Prescriptions ; Psychotic Disorders ; Weight Loss

Ecstasy has been registered in 1914 as an anti-tired medicament for military use. From the year 1980, Ecstasy becomes an excitant using in amusing with the name of “shaking drug”, “Rabid drug”. After consumption, users become cheery, infatuated, vigilant, untiring, loosing of the feel of hunger, fond of groping for and embracing, drinking alcohol and beer, dancing in all night. In the state of passionately fond the user can kill and rape. After a stage of exciting, the user can get severe and long weakening, get psychologic disturbance, get acute hepatitis. The harmfulness of ecstasy can be continuously listed
N-Methyl-3,4-methylenedioxyamphetamine ; Military Personnel ; Pharmaceutical Preparations

OBJECTIVES: A retrospective case series study was conducted to investigate the clinical characteristics of psychotic disorders induced by appetite suppressants, phentermine and phendimetrazine. METHODS: A retrospective electronic medical record review identified 5 admitted patients who had psychotic symptoms after taking phentermine or phendimetrazine. Clinical information was reviewed and summarized in each case. RESULTS: Hallucinations were reported in all cases, including auditory, visual, olfactory and somatic hallucinations. After discontinuation of phentermine or phendimetrazine, the symptoms rapidly improved with low dose of antipsychotics. Patients tended to have less prominent negative symptoms and higher insight into illness, and often showed depressive mood. These clinical characteristics were similar to psychosis induced by amphetamines. Two patients developed stimulant use disorder while using phentermine. CONCLUSIONS: These findings call for awareness of the risks associated with use of appetite suppressants. Prescription of phentermine or phendimetrazine should be accompanied by close monitoring of mental status, and suspicion for substance/medication-induced psychotic disorder.
Amphetamines ; Antipsychotic Agents ; Appetite Depressants* ; Appetite* ; Electronic Health Records ; Hallucinations ; Humans ; Phentermine* ; Prescriptions ; Psychotic Disorders* ; Retrospective Studies ; Substance-Related Disorders

<p>OBJECTIVETo investigate whether 3,4-methylenedioxymethamphetamine (MDMA) abuse produces another neurotoxicity which may significantly inhibit the acetylcholinesterase activity and result in severe oxidative damage and liperoxidative damage to MDMA abusers.p><p>METHODS120 MDMA abusers (MA) and 120 healthy volunteers (HV) were enrolled in an independent sample control design, in which the levels of lipoperoxide (LPO) in plasma and erythrocytes as well as the activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPX) and acetylcholinesterase (AChE) in erythrocytes were determined by spectrophotometric methods.p><p>RESULTSCompared with the average values of biochemical parameters in the HV group, those of LPO in plasma and erythrocytes in the MA group were significantly increased (P < 0.0001), while those of SOD, CAT, GPX and AChE in erythrocytes in the MA group were significantly decreased (P < 0.0001). The Pearson product-moment correlation analysis between the values of AChE and biochemical parameters in 120 MDMA abusers showed that significant linear negative correlation was present between the activity of AChE and the levels of LPO in plasma and erythrocytes (P < 0.0005-0.0001), while significant linear positive correlation was observed between the activity of AchE and the activities of SOD, CAT and GPX (P < 0.0001). The reliability analysis for the above biochemical parameters reflecting oxidative and lipoperoxidative damages in MDMA abusers suggested that the reliability coefficient (alpha) was 0.8124, and that the standardized item alpha was 0.9453.p><p>CONCLUSIONThe findings in the present study suggest that MDMA abuse can induce another neurotoxicity that significantly inhibits acetylcholinesterase activity and aggravates a series of free radical chain reactions and oxidative stress in the bodies of MDMA abusers, thereby resulting in severe neural, oxidative and lipoperoxidative damages in MDMA abusers.p>
Acetylcholinesterase ; metabolism ; Adolescent ; Adult ; Amphetamine-Related Disorders ; blood ; enzymology ; metabolism ; Catalase ; blood ; Cholinesterase Inhibitors ; adverse effects ; urine ; Erythrocytes ; enzymology ; Female ; Humans ; Lipid Peroxidation ; drug effects ; Lipid Peroxides ; blood ; Male ; N-Methyl-3,4-methylenedioxyamphetamine ; adverse effects ; urine ; Oxidative Stress ; drug effects ; Superoxide Dismutase ; blood

Objective To establish a method to identify unknown samples based on combined use of gas chromatography-mass spectrometry （GC-MS）, high resolution mass spectrometry （HRMS） and nuclear magnetic resonance spectrum （NMR） technique. Methods The unknown samples were dissolved in methanol solution containing internal standard SKF525A and detected by GC-MS and HRMS. The mixed samples were separated and purified by silica gel column chromatography, and then dissolved in methanol-d4 solution for structural analysis of ¹H nuclear magnetic resonance spectroscopy （¹H NMR）. Results The characteristic fragment ions （m/z） were 86.1 （base peak）, 71.2, 121.1, and 149.0, and the accurate mass number of molecular ion peak was measured by HRMS to be 236.128 89. By combined use of data analysis and database comparison, a new psychoactive substance of the cathinone class, Dibutylone, was detected in the sample, and the sample also contained a small amount of caffeine. The sample was purified, then identified using ¹H NMR, and was further confirmed to be Dibutylone. In addition, the GC-MS retention time and characteristic fragment ions of the main components of the sample were consistent with those of Dibutylone reference material. Conclusion The method established in this study can be used for the identification of Dibutylone in mixed samples.
Chromatography, Liquid ; Gas Chromatography-Mass Spectrometry ; Magnetic Resonance Spectroscopy ; Mass Spectrometry ; N-Methyl-3,4-methylenedioxyamphetamine/isolation & purification* ; Psychotropic Drugs/chemistry*

Amphetamines are chemical synthetic drugs that are becoming increasingly popular in China. As a common sample in the inspection of poisons, hair has the advantages of easy storage, good stability, and long detection time compared with traditional human body fluid samples （blood, urine）, thus possesses an unique application value in the field of forensic toxicology analysis. By now, methods for detecting amphetamines in human hair have been widely used, and validity of the results has been recognized and adopted by the court. This paper reviews domestic and foreign research progress of the detection of amphetamines in hair samples, including the pretreatment and analytic methods.
Amphetamines/analysis* ; China ; Forensic Toxicology ; Hair/chemistry* ; Humans ; Substance Abuse Detection

<p>OBJECTIVETo explore the changes of methylenedioxyamphetamine (MDA), total antioxidants content (TAC) and sialic acid (SA) from the unilateral epididymis of experimental varicocele in adolescent rats, and to illuminate the effects of varicocele on unilateral epididymis epithelium.p><p>METHODSExperimental left varicocele model of 16 adult male Sprague-Dawley rats were established by partial ligation of left renal vein. The epididymis were collected for detecting the content of MDA, TAC and SA by using spectrophotometry.p><p>RESULTSThere was statistically significant differences in the contents of three substances between experimental varicocele and sham-operated groups.p><p>CONCLUSIONThe content of MDA, TAC and SA will change and the sialic acid-secreting-function of unilateral epididymis will be injured because of varicocele.p>
Animals ; Antioxidants ; metabolism ; Epididymis ; metabolism ; Male ; N-Acetylneuraminic Acid ; metabolism ; N-Methyl-3,4-methylenedioxyamphetamine ; metabolism ; Rats ; Rats, Sprague-Dawley ; Varicocele ; metabolism

The published case series have suggested that appetite suppressants had some association with the development of stroke. Phendimetrazine is an appetite suppressant with sympathomimetic activity and it has a similar chemical structure with amphetamines. We report that a 22-year-old woman who had taken phendimetrazine for one month developed sudden right homonymous hemianopsia. MRI showed acute infarction in the territory of left posterior cerebral artery (PCA). Phendimetrazine should be considered as a cause of ischemic stroke.
Amphetamines ; Appetite Depressants ; Appetite* ; Female ; Hemianopsia ; Humans ; Infarction ; Magnetic Resonance Imaging ; Posterior Cerebral Artery ; Stroke* ; Young Adult

A case of methylenedioxymethamphetamine(MDMA)-dependent patient, who showed brief flashbacks, mild cognitive impairment and depression after the cessation of MDMA, were reported and its' related references were reviewed. The flashbacks were consisted of spontaneous recurrences of somatic symptoms such as tachycardia, palpitation, tremor, sweating, increased blood pressure which reflected sympathetic activation, trismus, headache, insomnia, bruxism and nightmares as well as behavioral symptoms such as aggressiveness, perceptual disturbances, paranoid ideation, feelings of closeness with others and anxiety, etc. Thereafter, mild cognitive impairments including reduced attention, concentration, visuospatial ability, uncued recall and verbal fluency were persisted with mild depression.
Anxiety ; Behavioral Symptoms ; Blood Pressure ; Bruxism ; Depression ; Dreams ; Headache ; Humans ; Mild Cognitive Impairment ; N-Methyl-3,4-methylenedioxyamphetamine* ; Recurrence ; Sleep Initiation and Maintenance Disorders ; Sweat ; Sweating ; Tachycardia ; Tremor ; Trismus

Adult ; Brain ; drug effects ; metabolism ; Female ; Hallucinogens ; adverse effects ; Humans ; Magnetic Resonance Imaging ; Motion Perception ; drug effects ; N-Methyl-3,4-methylenedioxyamphetamine ; adverse effects