ABSTRACT
Methoxydine (4-MeO-PCP) and Methoxetamine (3-MeO-2-Oxo-PCE) are both commercially produced designer drugs with structural and biochemical similarities to phencyclidine (PCP). Although phencyclidine toxicity is well documented, its recreational use in present times is rare. With the advent of new designer drugs being available widely through internet sites, Acute Physicians should be aware of the clinical features and management of these potential toxins. We present a case of methoxydine ingestion (which to our knowledge has not been previously documented in any medical journals) and a case of methoxetamine ingestion, and discuss their history, contrasting clinical features and acute management.
Subject(s)
Cyclohexanones/poisoning , Cyclohexylamines/poisoning , Designer Drugs/poisoning , Illicit Drugs/poisoning , Neurotoxicity Syndromes/etiology , Phencyclidine/analogs & derivatives , Substance-Related Disorders/complications , Adult , Drug Overdose/etiology , Drug Overdose/therapy , Emergency Service, Hospital , Emergency Treatment/methods , Follow-Up Studies , Humans , Incidence , Male , Middle Aged , Neurotoxicity Syndromes/therapy , Phencyclidine/poisoning , Risk Assessment , Substance-Related Disorders/therapy , Treatment OutcomeABSTRACT
Delirium is a common cause for hospital admission among elderly patients. Although infection is the most common explanation, there is a large number of other potential causes. We present a case of acute delirium due to serotonin syndrome, precipitated by concomitant prescription of clarithromycin and fluoxetine. The symptoms improved following treatment with a benzodiazepine and discontinuation of the fluoxetine. The diagnosis and management of serotonin syndrome is discussed.
