Toxicities Associated With NBOMe Ingestion-A Novel Class of Potent Hallucinogens: A Review of the Literature

This meta-analysis (2015, n=20) examined the toxicity of the synthetic serotonergic hallucinogen NBOMe reported in publications that described adverse effects in response to analytically confirmed human ingestion. Severe adverse effects included agitation (85.0%), tachycardia (85.0%), and hypertension (65.0%), and seizures (40.0%) among patients.

Authors

Suzuki, J.
Dekker, M. A.
Valenti, E. S.

Published

November 6, 2014

Psychosomatics

meta Study

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Abstract

Objective

A new class of synthetic hallucinogens called NBOMe has emerged as drugs of abuse. Our aim was to conduct a systematic review of published reports of toxicities associated with NBOMe ingestion.

Methods

We searched the PubMed for relevant English language citations that described adverse effects from analytically confirmed human NBOMe ingestion. Demographic and clinical data were extracted.

Results

Ten citations met criteria for inclusion, representing 20 individual patients. 25I-NBOMe was the most common analog identified, followed by 25B-NBOMe and 25C-NBOMe. Fatalities were reported in 3 (15%) cases. Seven (35%) were discharged after a period of observation, while 8 (40.0%) required admission to an intensive care unit. The most common adverse effects were agitation (85.0%), tachycardia (85.0%), and hypertension (65.0%). Seizures were reported in 8 (40.0%) patients. The most common laboratory abnormalities were elevated creatine kinase (45.0%), leukocytosis (25.0%), and hyperglycemia (20.0%).

Conclusion

NBOMe ingestion is associated with severe adverse effects. Clinicians need to have a high index of suspicion for NBOMe ingestion in patients reporting the recent use of hallucinogens.

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Research Summary of 'Toxicities Associated With NBOMe Ingestion-A Novel Class of Potent Hallucinogens: A Review of the Literature'

Introduction

NBOMes are a recently emerged class of synthetic hallucinogens derived from the 2C family of phenethylamines. Structurally related to mescaline, these N‑benzylmethoxy derivatives were developed as potent agonists at the 5‑HT2A serotonin receptor and have substantially higher affinity at that receptor than earlier 2C compounds. Their potency is notable: sublingual doses as low as 50 μg may produce psychoactive effects. NBOMes circulate in the recreational market under names such as “Smiles,” “N‑bombs,” or shortened chemical identifiers (25I, 25B, 25C) and are commonly sold on blotter paper, sometimes masquerading as LSD. Suzuki and colleagues set out to systematically review published, analytically confirmed human cases of NBOMe ingestion in order to characterise the clinical toxicities, routes of administration, laboratory findings, management, and outcomes. The study focuses on reports that provided laboratory confirmation of NBOMe exposure, aiming to clarify the spectrum and severity of adverse effects associated with this novel class of hallucinogens.

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Study Details

Study Type
meta
Journal
Psychosomatics
APA Citation
Suzuki, J., Dekker, M. A., Valenti, E. S., Arbelo Cruz, F. A., Correa, A. M., Poklis, J. L., & Poklis, A. (2015). Toxicities Associated With NBOMe Ingestion-A Novel Class of Potent Hallucinogens: A Review of the Literature. Psychosomatics, 56(2), 129-139. https://doi.org/10.1016/j.psym.2014.11.002