Qua-alluding to the Past: A Case of Methaqualone Analog Ingestion

Abstract Methaqualone, known previously under the brand name Quaalude, is a Schedule I sedative hypnotic drug that may cause neurotoxicity in overdose, characterized by somnolence, hyperreflexia and muscular hyperactivity. We present a case of a 21-year-old male who reportedly ingested methaqualone...

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Published inJournal of analytical toxicology Vol. 46; no. 2; pp. e82 - e87
Main Authors Lund, Kyle, Srihari, Priya, Suhandynata, Raymond T, Schwartz, Kristy, Fitzgerald, Robert L, Kreshak, Allyson A
Format Journal Article
LanguageEnglish
Published US Oxford University Press 21.09.2021
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Summary:Abstract Methaqualone, known previously under the brand name Quaalude, is a Schedule I sedative hypnotic drug that may cause neurotoxicity in overdose, characterized by somnolence, hyperreflexia and muscular hyperactivity. We present a case of a 21-year-old male who reportedly ingested methaqualone in addition to insufflation of street cocaine. He subsequently developed hypoxia, hyperreflexia, myoclonus and altered mental status. His laboratory results were notable for the presence of methemoglobinemia, which was most likely due to a cocaine contaminant. Laboratory analysis of the alleged methaqualone pills identified the substance as SL-164, a dichlorinated methaqualone analog. Urine toxicology results were positive for SL-164 (and presumed metabolites) as well as for cocaine and tetrahydrocannabinol metabolites. The patient was treated with supplemental oxygen and a benzodiazepine (lorazepam) and observed in the Emergency Department until his symptoms resolved. This case highlights current community access to methaqualone analogs. The case also focuses on laboratory techniques used to identify the methaqualone analog.
ISSN:0146-4760
1945-2403
DOI:10.1093/jat/bkab103