4‐Fluoroamphetamine (4‐FA) intoxication results in exaggerated blood pressure effects compared to MDMA and amphetamine: A retrospective analysis
Objective 4‐Fluoroamphetamine (4‐FA) is an amphetamine‐type stimulant, with effects comparable to amphetamine and 3,4‐methylenedioxymethamphetamine (MDMA). Severe 4‐FA‐related complications, such as cardiomyopathy, myocardial infarction, and cerebral hemorrhage, have been described. The aim of this...
Saved in:
Published in | Journal of the American College of Emergency Physicians Open Vol. 3; no. 5; pp. e12813 - n/a |
---|---|
Main Authors | , , , , , |
Format | Journal Article |
Language | English |
Published |
United States
John Wiley & Sons, Inc
01.10.2022
Wiley |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Objective
4‐Fluoroamphetamine (4‐FA) is an amphetamine‐type stimulant, with effects comparable to amphetamine and 3,4‐methylenedioxymethamphetamine (MDMA). Severe 4‐FA‐related complications, such as cardiomyopathy, myocardial infarction, and cerebral hemorrhage, have been described. The aim of this study was to explore the cardiovascular symptoms and complications in 4‐FA and compare them to MDMA and amphetamine in intoxicated patients who presented to the emergency department (ED).
Methods
Between November 2015 and March 2020, all self‐reported 4‐FA, MDMA, and amphetamine‐intoxicated adult patients that presented at the ED of an inner‐city hospital in Amsterdam, were retrospectively analyzed for cardiovascular symptoms, vital parameters, cardiovascular complications, interventions, admission rate, and Poisoning Severity Score (PSS).
Results
A total of 582 patients were included, of which 31 (5.3%) with 4‐FA intoxication (10/31 mono‐intoxications, 32.3%), 406 (69.8%) with MDMA (59/406 mono‐intoxications, 14.5%), 100 (17.2%) with amphetamine (10/100 mono‐intoxications, 10.0%), and 45 (7.7%) with a cross intoxication of these drugs. 4‐FA mono‐intoxicated patients experienced more headache (n = 8; 80.0%) compared to MDMA (n = 2; 3.3%; P < 0.001) and amphetamine mono‐intoxicated patients (n = 0; 0.0%; P < 0.001) and their systolic blood pressure was higher (164 mm Hg ± 31 vs 139 mm Hg ± 19; P = 0.031 vs 135 mm Hg ± 22; P = 0.033, respectively). Severe 4‐FA‐related cardiovascular complications included Takotsubo cardiomyopathy (n = 1; 3.2%), subarachnoid hemorrhage (n = 1; 3.2%), and hypertensive urgency (n = 2; 6.5%).
Conclusions
4‐FA intoxication‐related ED symptoms resemble MDMA and amphetamine complications, although patients presented more often with headache and hypertension. Severe 4‐FA‐related cardiovascular complications occurred in 40% of mono‐intoxications. |
---|---|
Bibliography: | The authors have stated that no such relationships exist. Funding and Support JACEP By Supervising Editor: Karl Sporer, MD. Open policy, all authors are required to disclose any and all commercial, financial, and other relationships in any way related to the subject of this article as per ICMJE conflict of interest guidelines (see www.castoredc.com ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 |
ISSN: | 2688-1152 2688-1152 |
DOI: | 10.1002/emp2.12813 |