Many case reports where mephedrone had a role have been published over the last year.1–3
Most cases involve the abuse of multiple substances and some have resulted in death.2 3
A case of mephedrone toxicity confirmed by toxicological tests was recently reported.4
No case reports linking the serotonin syndrome to mephedrone toxicity have been published to date.
Mephedrone is a white powder most commonly taken in capsule form. It can also be snorted, made into tablets, eaten or injected intravenously. Street names for the drug include Plant Food, Miaow-Miaow, M-Cat, MMC, Bubbles (with ketamine), Diablo or Doves (with β-ketoamphetamines).
Methylone is a metabolite of mephedrone.4
Methylone has been shown to increase serotonin release and to inhibit serotonin and dopamine reuptake in rat brain synaptosomes.5
Little is known about the interaction between mephedrone and other substances or medications.
This patient met the Hunter criteria for the serotonin syndrome.6
Hyperthermia is a significant cause of mortality as high temperatures can lead to metabolic acidosis, rhabdomyolysis, renal failure, disseminated intravascular coagulation, coma and death. Benzodiazepines reduce hyperthermia in patients with the serotonin syndrome as they cause sedation and relax the muscles.7
Many therapeutic drugs can cause the serotonin syndrome including all common antidepressants (SSRIs, MAOIs, SNRIs, TCAs, etc) and some opiods (pethidine, fentanyl and tramadol among others).7
- Mephedrone, a relatively new recreational drug, may cause the serotonin syndrome.
- Hyperthermia is a significant cause of mortality in patients with the serotonin syndrome.