Toxicology Letters 208 (2012) 12–15

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Toxicology Letters
journal homepage: www.elsevier.com/locate/toxlet

Mini review

3,4-Methylenedioxypyrovalerone (MDPV): Chemistry, pharmacology and

toxicology of a new designer drug of abuse marketed online
M. Coppola a,∗ , R. Mondola b
a
Department of Addiction, ASL CN2, Viale Coppino 46, 12051, Alba (CN), Italy
b
Department of Mental Health, ASL CN1, Via Torino 70/B, 12037 Saluzzo (CN), Italy

a r t i c l e i n f o a b s t r a c t

Article history: The illicit marketplace of substances of abuse continually offers for sale legal alternatives to controlled
Received 19 August 2011 drugs to a large public. In recent years, a new group of designer drugs, the synthetic cathinones,
Received in revised form 2 October 2011 has emerged as a new trend, particularly among young people. The 3,4-methylenedioxypyrovalerone
Accepted 3 October 2011
(MDPV), one of this synthetic compounds, caused an international alert for its cardiovascular and neuro-
Available online 8 October 2011
logical toxicity. This substance, sold as bath salts, has caused many serious intoxications and some deaths
in several countries. The aim of this paper is summarise the clinical, pharmacological and toxicological
Keywords:
information about this new designer drug.
3,4-Methylenedioxypyrovalerone (MDPV)
Synthetic cathinone © 2011 Elsevier Ireland Ltd. All rights reserved.
Designer drug
Bath salts

Contents

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12
2. Synthetic cathinones, Catha edulis (khat) and natural cathinones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.1. Synthetic cathinones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.2. Chata edulis (khat) and natural cathinones . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3. 3,4-Methylenedioxypyrovalerone (MDPV) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.1. Chemistry . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.2. Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
3.3. Toxicology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
4. Internet information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
5. Legal status . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
6. Discussion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
7. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
Conflict of interest statement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

1. Introduction of these products and its monitoring is an important instrument

to identify new trends of drugs of abuse (Schifano et al., 2010).
The illicit marketplace of substances of abuse continually offers Recent information have shown that the online market is able to
for sale legal alternatives to controlled drugs to a large public. respond rapidly to changes in the legal status of the psychoac-
These psychoactive substances are both synthetic derivatives and tive drugs offering for sale new legal alternatives (Walsh, 2011).
vegetable compounds that can produce important public health After the development of synthetic derivatives based on fentanyl
consequences and policy implications (Collins, 2011). Furthermore, in the 1980s, ring-substituted phenethylamines in the late 1980s,
the internet has emerged as a new marketplace for the spread tryptamines in 1990s and piperazines in the 2000s, in recent
years, a new group of designer drugs, the synthetic cathinones,
has emerged as a new trend, particularly among young people
∗ Corresponding author. Tel.: +39 0173316210; fax: +39 0173420344. (Brandt et al., 2010). Synthetic cathinones are a group of syn-
E-mail address: coppolamail@alice.it (M. Coppola). thetic derivatives of the vegetable cathinone, a phenylalkylamine

0378-4274/$ – see front matter © 2011 Elsevier Ireland Ltd. All rights reserved.
doi:10.1016/j.toxlet.2011.10.002
 M. Coppola, R. Mondola / Toxicology Letters 208 (2012) 12–15
alkaloid naturally present in the Catha edulis (khat) (Hassan et al.,
2007). The first synthetic cathinone which has had a large diffusion
in the population was the maphedrone, a psychoactive substance
that has produced many serious intoxication and some deaths
in various countries (Hadlock et al., 2011). When the legal sta-
tus of this compound changed, another synthetic cathinone, the
3,4-methylenedioxypyrovalerone (MDPV), received a large diffu-
sion among young people causing a new international alert (ISS,
2011). The aim of this paper is summarise the clinical, pharma-
cological and toxicological information about this new designer
drug.
2. Synthetic cathinones, Catha edulis (khat) and natural
cathinones
2.1. Synthetic cathinones
Synthetic cathinones are the beta-keto analogues of the natural
cathinone, one of the psychoactive compounds present in khat, in
particular, most of the synthetic cathinones appeared in the recre-
ational drug market since the mid-2000s are a ring-substituted
cathinone closely related to the phenethylamine family, differing
only by a keto functional group at the beta carbon (namsdl, 2011).
Like the related phenethylamines, synthetic cathinones can exist
in two stereoisomeric forms that may have different potency and
it is likely that some ring-substituted derivatives could be racemic
mixtures (Gibbons and Zloh, 2010). Synthetic cathinones produce
amphetamine-like effects because they inhibit the reuptake of and
stimulate the release of norepinephrine, serotonin and dopamine
(Cozzi et al., 1999; Kehr et al., 2011). These molecules are used as
substitute for other stimulants such as amphetamines, cocaine or
ecstasy because, although they are generally less lipophilic and less
able to cross the blood–brain barrier (pyrrolidine derivatives such
as pyrovalerone or MDPV are more lipophilic and more able to cross
the blood–brain barrier than other synthetic cathinones), they can
produce the same effects on the Central Nervous System (Dargan
et al., 2011). The studies on the metabolism of cathinone deriva-
tives in rats and humans have shown that they are N-demethylated,
the keto group is reduced to hydroxyl and ring alkyl groups are
oxidised (Meyer and Maurer, 2010). The users can snort or ingest
these white or brown amorphous or crystalline powders, but since
they are soluble in water, these substances can also be injected
(Winstock et al., 2011; Schifano et al., 2011). In recent years,
the assumption of synthetic cathinones has been associated with
several cases of toxicity and deaths (James et al., 2010). Clinical fea-
tures include neurological, cardiovascular and psychopathological
symptoms such as: psychomotor agitation, delusions, hallucina-
tions, psychosis, hypertension, palpitation, chest pain, seizures,
headaches (Wood et al., 2010). Synthetic cathinones include sev-
eral substances that have been used as research chemical, but only
three compounds are used as medicinal products: amfepramone
(obesity), pyrovalerone (obesity and chronic fatigue) and bupro-
pion (depression and tobacco dependence), the others are used
only for recreational scope (pharmacycode-amphepramone, 2011;
pharmacycode-bupropion, 2011; Gordons and Cole, 1971).
2.2. Chata edulis (khat) and natural cathinones
Chata edulis, simply called khat, is an evergreen slow-growing
shrub or tree native to Ethiopia and cultivated in East Africa
and South West Arabian Peninsula that in recent years has been
widespread in Europe too (emcdda, 2011). The people living in khat
geographical areas use the fresh vegetable material (leaves, stems,
flower buds) of this plant for its stimulant effects (Kalix, 1992). The
fresh khat leaves contain 62 alkaloids and for two of these, cathine
13
and cathinone, have been demonstrated amphetamine-like effects,
particularly, these phenylalkylamine alkaloids cause the release of
catecholamines from pre-synaptic storage sites in the central and
peripheral nervous system (Kalix, 1986). In addition, these alka-
loids may also have monoamine oxidase inhibition effects (Nencini
et al., 1984). Cathine and cathinone determine in humans increased
in blood pressure and in heart rate, euphoria and psychomotor
hyperactivity (Brenneisen et al., 1990). Several studies have shown
the harmful effects of this plant such as: increased incidence of
acute coronary vasospasm and myocardial infarction, oesophagi-
tis, gastritis, oral keratotic lesions and liver toxicity (Al-Habori,
2005). Furthermore, insomnia, depression, anorexia, psychosis and
impaired working memory have been reported after occasional or
chronic use of khat (Balint et al., 2009; Colzato et al., 2011).
3. 3,4-Methylenedioxypyrovalerone (MDPV)
3.1. Chemistry
The MDPV is a pyrrolidine derivative of the synthetic cathinone
pyrovalerone differing for the presence of a 3,4-methylenedioxy
group linked to the aromatic ring in substitution of a 4-methyle
group (Yohannan and Bozenko, 2010) that was synthesized by
Boehringer Ingelheim and patented in 1969 and first seized in Ger-
man in the year 2007 (Westphal et al., 2009). This compound, IUPAC
name 1-(1,3-benzodioxol-5-yl)-2-pyrrolidin-1-ylpentan-1-one, is
a white (HCL salt form), brown or yellow-green (free base form)
or gray (european form) amorphous or crystalline powder with a
molecular weight of 275.34284 g/mol classified as a research chem-
ical (pubchem, 2011). The MDPV includes in its chemical structure a
nitrogen atom attached to three carbon atoms composing a tertiary
amino group that is responsible of the high solubility of this com-
pound in organic solvents, in particular the free base (caymanchem,
2011).
3.2. Pharmacology
Like pyrovalerone, MDPV is a monoamine uptake inhibitor
more lipophilic and more potent than other cathinone derivatives
(Meltzer et al., 2006). The high lipophilicity of this substance is
caused by the pyrrolidine ring and the tertiary amino group cre-
ating a less polar molecule more able to cross the blood–brain
barrier (emcdda, 2010). The metabolism of MDPV was evaluated
in vitro using human liver microsomes and S9 cellular fractions for
CYP450 phase I and uridine 5-diphosphoglucuronosyltransferase
and sulfotransferase for the phase II metabolism. This study has
demonstrated that the main metabolites of MDPV are catechol and
methyl-catechol pyrovalerone which are in turn sulfated and glu-
curonated (Strano-rossi et al., 2011).
3.3. Toxicology
There are limited information about the short and long-term
toxicological effects of this designer drug of abuse. The action of
MDPV on monoamine reuptake may produce stimulant effects
like cocaine, amphetamines or ecstasy, particularly, the stimulant
effect has been compared to methylphenidate, at low doses, and
cocaine or amphetamines, at high doses (scribd, 2011). In literature
have been reported acute toxicity episodes and deaths related to
MDPV assumption in several countries (acep, 2011). Acute toxicity
mainly includes neurological, cardiovascular and psychopatho-
logical symptoms such as: tachycardia, chest pain, S-T segment
changes, hypertension, hyperthermia, mydriasis, dizzines, tremors,
psychomotor agitation, motor automatisms, parkinsonism, delu-
sions, hallucinations, paranoid psychosis, depression, panic attacks,
14 M. Coppola, R. Mondola / Toxicology Letters 208 (2012) 12–15
long term changes in cognition and emotional stability, rhabdomy-
olysis, abdominal pain, vomiting, kidney damage (Durham, 2011;
CDC, 2011; Penders and Gestring, 2011). The treatment generally
includes low or moderate doses of a benzodiazepine to control
the signs of toxicity and antipsychotics or propofol when this
medicament is ineffective (Spiller et al., 2011). Furthermore, it was
reported the development of craving, tolerance, dependence and
withdrawal syndrome after the frequent consumption of high doses
of MDPV (CDC, 2011). The MDPV is not detected via standard drug
tests but it is required the gas chromatography/mass spectrometry
(GS/MS) (Ojanpera et al., 2011).
4. Internet information
The online discussion about MDPV seems begun around 2004,
but the popularity of this substance increased in late 2008
(drugguide, 2011; drugs-forum, 2011). Users reported soft Central
Nervous System stimulant effects of MDPV at low doses, but very
strong stimulant effects at high doses, more potent than cocaine
or amphetamines (drugs-forum, 2011; erowid, 2011). There were
many reports of people that have used low doses of MDPV to
increase the concentration, capacity to work or study, sexual
performance (drugs-forum, 2011; erowid, 2011). Other desired
psychoactive effects include: increased sociability, energy, lim-
ited euphoria, mild empathogenic effects (drugrecognitionexpert,
2011). Users also reported untoward effects such as: prolonged
panic attack, tremor, agitation, insomnia, nausea, headache, tin-
nitus, dizziness, increased heart rate, altered vision, confusion,
suicidal thoughts, anhedonia, depression, psychosis, risk of toler-
ance and dependence (drugs-forum, 2011; erowid, 2011; zoklet,
2011). Internet information also reported some discussion about
the combination of MDPV with other drugs in order to reduce
the harmful effects or enhance the desired effects. In particular,
the most discussed combination are between MDPV and alco-
hol, propanolol or other beta blocker (to counteract tachycardia)
GHB, 5-Meo-MIPT (as an aphrodisiac), GBL, zopiclone (to produce
visual hallucinations), kratom, hallucinogenes, amphetamines (to
enhance stimulant and entactogen effects), pregabalin, famotidine,
omeprazole, domperidone (to counteract stomach pain), opiates
(speedball like-effects), cannabis, benzodiazepines (to counter-
act anxiety) and other synthetic compounds (e.g. maphedrone,
methylone) (drugs-forum, 2011). The modalities of administra-
tion include: oral ingestion, sublingual, intravenous, intramuscular,
smoking, insufflation (snorting), inhalation and it has been reported
the rectal administration (drugs-forum, 2011; erowid, 2011). Inde-
pendently of the modalities of intake, the psychoactive effects may
be the same, but non-oral assumption could produce shorter dura-
tion of action (drugs-forum, 2011). Some users suggest that 1 mg
or 2 mg of MDPV are able to produce psychoactive effects (sublin-
gual, rectal or inhalation assumption), but the typical doses range
appear to be between 5 and 30 mg in a single ingestion. Redosing in
a single session is very common because MDPV have a short dura-
tion of action (doses higher to 200 mg in a single session have been
reported) (drugs-forum, 2011; bluelight, 2011; erowid, 2011).
5. Legal status
The MDPV in not approved as therapeutic drug and it is a
controlled substance in Sweden (2010), Denmark (2009), Ireland
(2010), United Kingdom (2010), Germany (2010), Australia (2010),
Finland (2010), Israel and Italy. In addition this substance is con-
trolled in some States of United States of America such as: Alabama,
Florida, Idaho, Louisiana, Michigan, Mississippi, New Jersey, North
Carolina, North Dakota and Utah (2011) (sostanze.info, 2011;
drugs-forum, 2011).
6. Discussion
The MDPV is a cathecholamines reuptake inhibitor derived by
pyrovalerone with strong stimulant effects. This compound, classi-
fied as research chemical, can be considered a new designer drug
of abuse. Little is known about the clinical, pharmacological and
toxicological effects of MDPV, but some reports and the informa-
tion on drugs forum suggest that its stimulant action could be more
potent than cocaine or amphetamines. These psychoactive effects
may justify the widespread of this compound as recreational drug,
particularly among young people. Furthermore, the legal status of
MDPV in several countries, the wide availability on the online mar-
ket and the difficulty of identification in biological materials have
favored the use of this synthetic cathinone as alternative to other
illicit stimulants. Finally, the marketing of MDPV as bath salts or
plants fertilizer provided false assurances on the safety of this sub-
stance as drug of abuse. The literature data and internet information
have shown the high Cardiovascular and Central Nervous Systems
acute toxicity of MDPV related to the powerful stimulation of the
catecholaminergic system (Meltzer et al., 2006; Durham, 2011).
Furthermore, the dopaminergic stimulation in the reward system
could explain the development of tolerance, abuse, dependence
and withdrawal syndrome reported by users (Ross and Peselow,
2009). Thus, considering the limited information about the clini-
cal, pharmacological and toxicological effects of this substance in
combination with the potential health risks, the alertness of scien-
tific community is of great importance in order to monitoring and
prevent the spread of MDPV.
7. Conclusion
In this paper we reviewed literature data and internet informa-
tion about the clinical, pharmacological and toxicological effects
of MDPV. Although this substance is marketed as bath salts or
plants fertilizer, the drug users utilize the MDPV for its cocaine
and amphetamine-like effects. Furthermore, in several countries
MDPV is a legal alternative to illicit stimulants used by peo-
ple that are afraid of the judicial consequences of the controlled
substances assumption. Clinical reports and internet information
clearly demonstrate the acute Cardiovascular and Central Nervous
Systems toxicity of MDPV in combination with the high risk of death
drug-related, abuse, tolerance and dependence. Scientific commu-
nity must monitorate the diffusion of MDPV and it should use the
information on drugs forum to identify new trends of substances of
abuse early. In conclusion, the data currently available suggest that
the recreational use of MDPV must be considered highly dangerous
to public health.
Conflict of interest statement
The authors declare that there are no conflicts of interest.
References
Al-Habori, M., 2005. The potential adverse effects of habitual use of Catha edulis
(khat). Expert Opin. Drug. Saf. 4, 1145–1154.
Balint, E.E., Falkay, G., Balint, G.A., 2009. Khat—a controversal plant. Wien. Klin.
Wochenschr. 121, 604–614.
Brenneisen, R., Fisch, H.V., Koelbing, V., Geisshusler, S., Kalix, P., 1990. Amphetamine-
like effect in humans of the khat alkaloid cathinone. Br. J. Clin. Pharmacol. 30,
825–828.
Brandt, S.D., Freeman, S., Summale, H.R., Measham, F., Cole, J., 2010. Analysis of NRG
“Legal highs” in the UK: identification and formation of novel cathinones. Drug
Test. Anal. 2, 377–382.
Centers For Disease Control and Prevention (CDC), 2011. Emergency department vis-
its after use of a drug sold as “bath salts”—Michigan, November 13, 2010–March
31, 2011. MMWR Morb. Mortal. Wkly. Rep. 60, 624–627.
Collins, M., 2011. Some new psychoactive substances: precursor chemicals and
synthesis-driven and -products. Drug Test. Anal. 3, 404–416.
 M. Coppola, R. Mondola / Toxicology Letters 208 (2012) 12–15
Colzato, L.S., Ruiz, M.J., Van den Wildenberg, W.P.M., Hommel, B., 2011. Khat use is
associated with impaired working memory and cognitive flexibility. PLoS One
6, e20602.
Cozzi, N.V., Sievert, M.K., Shulgin, A.T., Jacob III, P., Ruoho, A.E., 1999. Inhibition
plasma membrane monoamine transporters by beta-ketoamphetamines. Eur.
J. Pharmacol. 381, 63–69.
Dargan, P.I., Sedefov, R., Gallegos, A., Wood, D.M., 2011. The pharmacology and toxi-
cology of the synthetic cathinone mephedrone (4-methylmethcathinone). Drug
Test. Anal. 3, 454–463.
Durham, M., 2011. Ivory wave: the next mephedrone? Emerg. Med. J.,
doi:10.1136/emj.2011.1129.20.
Gibbons, S., Zloh, M., 2010. An analysis of ‘legal high’ mephedrone. Bioorg. Med.
Chem. Lett. 20, 4135–4139.
Gordons, G., Cole, J.O., 1971. Evaluation of pyrovalerone in chronically fatigued vol-
unteers. Curr. Ther. Res.-Clin. Exp. 13, 631–635.
Hadlock, G.C., Webb, K.M., McFadden, L.M., Chu, P.W., Ellison, J.D., Allen,
S.C., et al., 2011. 4-Methylmethcathinone (mephedrone): neuropharmaco-
logical effects of a designer stimulant of abuse. J. Pharmacol. Exp. Ther.,
doi:10.1124/jpet.111.184119.
Hassan, N.A., Gunaid, A.A., Murray-Lyon, I.M., 2007. Khat (Catha edulis): health
aspects of khat chewing. East Mediterr. Health J. 13, 706–718.
http://www.acep.org/Content.aspx?id=77160 (visited August 14, 2011).
http://www.bluelight.ru (visited August 17, 2011).
http://www.caymanchem.com/pdfs/10624.pdf (visited September 29, 2011).
http://www.drugguide.us/mdpv/encyclopedia.htm#effects (visited August 15,
2011).
http://www.drugrecognitionexpert.us/2011/02/bath-salts-mdpv/ (visited
September 29, 2011).
http://www.drugs-forum.com (visited August 17, 2011).
http://www.emcdda.europa.eu/publications/drug-profiles/khat (visited August 11,
2011).
http://www.emcdda.europa.eu/publication/drug-profiles/syntetic-cathinones (vis-
ited August 11, 2011).
http://www.erowid.org (visited August 17, 2011).
http://www.iss.it/ssps/rili/cont.php?id=2056&lang=1&tipo=2 (visited August 14,
2011).
http://www.namsdl.org/documents/ACMDCathinonesReport.pdf (visited August
14, 2011).
http://pharmacycode.com/amphepramone.html (visited August 13, 2011).
http://pharmacycode.com/bupropion.html (visited August 14, 2011).
http://www.pubchem.ncbi.nlm.nih.gov/summary/summary.cgi?cid=20111961
(visited August 14, 2011).
http://www.scribd.com/doc/57078733/Bath-Salt (visited August 14, 2011).
http://www.sostanze.info/sites/default/files/documenti/Scheda tecnica MDPV.pdf
(visited August 16, 2011).
http://www.zoklet.net (visited August 17, 2011).
James, D., Adams, R.D., Spears, R., Cooper, G., Lupton, D.J., Thompson, J.P., et al.,
2010. Clinical characteristics of mephedrone toxicity reported to the UK National
Poison Information Service. Emerg. Med. J. 28, 686–689.
15
Kalix, P., 1986. The releasing effect of the alkaloid cathinone at centre and peripheral
catecholamine storage sites. Neuropharmacology 25, 499–501.
Kalix, P., 1992. Chatinone, a natural amphetamine. Pharmacol. Toxicol. 70, 77–86.
Kehr, J., Ichinose, F., Yoshitake, S., Goiny, M., Silvertsson, T., Nyberg, F., et al., 2011.
Mephedrone compared to MDMA (ecstasy) and amphetamine rapidly increases
both dopamine and serotonin levels in nucleus accumbens of awake rats. Br. J.
Pharmacol., doi:10.111/j.1476-5381.2011.01499.x.
Meltzer, P.C., Butler, D., Deschamps, R., Madras, B.K., 2006. 1-(4-Methylphenyl)-2-
pyrrolidin-1-yl-pentan-1-one (pyrovalerone) analogues: a promising class of
monoamine uptake inhibitors. J. Med. Chem. 49, 1420–1432.
Meyer, M.R., Maurer, H.H., 2010. Metabolism of designer drugs of abuse: an updated
review. Curr. Drug Metab. 11, 468–482.
Nencini, P., Amiconi, G., Befani, O., Abdullahi, M.A., Anania, M.C., 1984. Possible
involvement of amine oxidase inhibition in the sympathetic activation by khat
(Catha edulis) chewing in humans. J. Ethnopharmacol. 11, 78–86.
Ojanpera, I.A., Heikman, P.K., Rasanen, I.J., 2011. Urine analysis of
3,4-methylenedioxypyrovalerone in opioid-dependent patients by
gas chromatography–mass spectrometry. Ther. Drug. Monit. 33,
257–263.
Penders, T.M., Gestring, R., 2011. Hallucinatory delirium following use of MDPV:
“Bath Salts”. Gen. Hosp. Psychiatry, doi:10.1016/j.genhosppsych.2011.05.014.
Ross, S., Peselow, E., 2009. The neurobiology of addictive disorders. Clin. Neurophar-
macol. 32, 269–276.
Schifano, F., Ricciardi, A., Corazza, O., Deluca, P., Davey, Z., Raffaelli, C., et al., 2010.
New drugs of abuse on the web: the role of the Psychonaut Web Mapping Project.
Riv. Psichiatr. 45, 88–93.
Schifano, F., Albanese, A., Fergus, S., Stair, J.L., Deluca, P., Corazza, O., et al., 2011.
Mephedrone (4-methylmethcathinone; ‘meow meow’): chemical, pharmaco-
logical and clinical issues. Psychopharmacology 214, 593–602.
Spiller, H.A., Ryan, M.L., Weston, R.G., Jansen, J., 2011. Clinical experience with ana-
lytical confirmation “bath salts” and “legal highs” (synthetic cathinones) in the
United States. Clin. Toxicol. 49, 499–505.
Strano-rossi, S., Cadwallader, A.B., de la Torre, X., Botrè, F., 2011. Toxicological
determination and in vitro metabolism of the designer drug methylenedioxypy-
rovalerone (MDPV) by gas chromatography/mass spectrometry and liquid
chromatography/quadrupole time-of-flight mass spectrometry. Rapid Com-
mun. Mass Spectrom. 24, 2706–2714.
Walsh, C., 2011. Drugs, the internet and change. J. Psychoactive Drugs 43, 55–63.
Westphal, F., Junge, T., Rosner, P., Sonnichsen, F., Schuster, F., 2009. Mass and
NMR spectroscopic characterization of 3,4-methylenedioxypyrovalerone: a
designer drug with alpha-pyrrolidinophenone structure. Forensic Sci. Int. 190,
1–8.
Winstock, A.R., Mitcheson, L.R., Davey, Z., Corazza, O., Schifano, F., 2011.
Mephedrone, new kid for the chop? Addiction 106, 154–161.
Wood, D.M., Davies, S., Greene, S.L., Button, J., Holt, D.W., Ramsey, J., et al., 2010. Case
series of individuals with analytically confirmed acute mephedrone toxicity.
Clin. Toxicol. 48, 924–927.
Yohannan, J.C., Bozenko, J.S., 2010. The characterisation of 3,4-
methylendioxypyrovalerone. Microgram J. 7, 12–15.