Unexpected Serotonin Syndrome, Epileptic Seizures, and Cerebral Edema Following 2,5-dimethoxy-4-bromophenethylamine Ingestion

J Forensic Sci. 2019 Nov;64(6):1950-1952. doi: 10.1111/1556-4029.14214. Epub 2019 Oct 23.

Abstract

4-bromo-2,5-dimethoxyphenethylamine (2C-B) is a designer drug. In Europe, 2C-B is easily obtained and used for recreational purposes. It is known for its stimulating effects similar to those of 3,4-methylenedioxymethamphetamine, although in higher doses it has more hallucinogenic effects. Here, we report a case of 2C-B ingestion, confirmed by liquid chromatography-tandem mass spectrometry, in an 18-year-old man. The neurological consequences were severe, including the development of serotonin syndrome and severe brain edema. Supportive therapy resulted in a stable condition, although, after several months, the patient still suffered from severe neurological impairment due to the drug-induced toxicity. This case showed that 2C-B could not be identified with the drugs of abuse screening routinely used in Dutch hospitals. The use of 2C-B carries many risks, with potentially profound neurological damage, that both consumers and healthcare physicians are unaware of.

Keywords: 2C-B; designer drugs; forensic science; intoxication; phenethylamine; serotonin syndrome.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Brain Edema / chemically induced*
  • Chromatography, Liquid
  • Designer Drugs / adverse effects*
  • Dimethoxyphenylethylamine / adverse effects*
  • Humans
  • Male
  • Seizures / chemically induced*
  • Serotonin Syndrome / chemically induced*
  • Substance-Related Disorders / complications
  • Tandem Mass Spectrometry

Substances

  • Designer Drugs
  • Dimethoxyphenylethylamine