Synthetic cathinones, more commonly known as "bath salts", are synthetic drugs chemically related to cathinone, a psychostimulant found in the khat plant. They are the first most consumed products among new psychoactive substances, which cause psychostimulant and hallucinogenic effects determining a number of fatalities worldwide. In this paper, we have systematically reviewed cases of synthetic cathinones-related fatalities analytically confirmed, which have occurred in the last few years.OBJECTIVE: Synthetic cathinones,
more commonly known as “bath salts”, are synthetic
drugs chemically related to cathinone, a
psychostimulant found in the khat plant. They are
the first most consumed products among new
psychoactive substances, which cause psychostimulant
and hallucinogenic effects determining
a number of fatalities worldwide. In this paper, we
have systematically reviewed cases of synthetic
cathinones-related fatalities analytically confirmed,
which have occurred in the last few years.
MATERIALS AND METHODS: Relevant scientific
articles were identified in Medline, Cochrane
Central, Scopus, Web of Science and Institutional/
government websites up to November 2017
using the following keywords: synthetic cathinones,
mephedrone, methylenedioxypyrovalerone,
MDPV, methylone, ethylone, buthylone, fatal
intoxication, fatalities and death.
RESULTS: In total, 20 citations met the criteria
for inclusion, representing several fatal cases
with analytically confirmed synthetic cathinones
in biological sample/s of the deceased. The
death was attributed to hyperthermia, hypertension,
cardiac arrest and more in general to the
classic serotonin syndrome. Only rarely did the
concentration of the parent drug causing fatality
overcome the value of 1 mg/L in post-mortem
biological fluids.
CONCLUSIONS: Abuse of synthetic cathinones
still represents a serious public health issue.
Systematic clinical studies on both the animal
and human model are lacking; therefore, the
only available data are from the users who experience
the possible hazardous consequences.
Analytical methodologies for the identification
of parent compounds and eventual metabolites
both in ante-mortem and post-mortem cases
need to be developed and validated. Analytical
data should be shared through different communication
platforms with the aim of stopping this
serious health threat for drug users