Abstract
This chapter addresses drugs that have the basic phenethylamine structure with various substitutions (Fig. 1). Amphetamine and methamphetamine, substituted amphetamines (3,4-methylenedioxymethamphetamine [MDMA; “Ecstasy”] and related compounds), related anorexigens, and new psychoactive substances (novel drugs of abuse) are discussed.
This chapter is a revision of the chapter by Patrick E. McKinney and Robert D. Palmer in the first edition of this book.
Similar content being viewed by others
References
Monroe RR, Drell HJ. Oral use of stimulants obtained from inhalers. J Am Med Assoc. 1947;135(14):909–15.
Smith DE, et al. An epidemiological and clinical analysis of propylhexedrine abuse in the United States. J Psychoactive Drugs. 1988;20(4):441–2.
Bett WR. Benzedrine sulphate in clinical medicine; A survey of the literature. Postgrad Med J. 1946;22:205–18.
Rasmussen N. America’s first amphetamine epidemic 1929–1971: a quantitative and qualitative retrospective with implications for the present. Am J Public Health. 2008;98(6):974–85.
Substance Abuse and Mental Health Services Administration. Results from the 2013 National Survey on Drug Use and Health: Summary of National Findings, NSDUH Series H-48, HHS Publication No. (SMA) 14–4863. Rockville: Substance Abuse and Mental Health Services Administration; 2014.
Mowry JB, et al. 2014 annual report of the American Association of Poison Control Centers’ National Poison Data System (Npds): 32nd annual report. Clin Toxicol (Phila). 2015;53(10):962–1147.
Substance Abuse and Mental Health Services Administration, Drug Abuse Warning Network, 2011. National estimates of drug-related emergency department visits. HHS Publication No. (SMA) 13-4760, DAWNSeries D-39. Rockville: Substance Abuse and Mental Health Services Administration; 2013.
Christophersen AS. Amphetamine designer drugs – an overview and epidemiology. Toxicol Lett. 2000;112–113:127–31.
United Nations Office on Drugs and Crime, W.D.R.U.N.p., Sales No. E.15.XI.6.
European Monitoring Centre for Drugs and Drug Addiction. Exploring methamphetamine trends in Europe, EMCDDA papers. Luxembourg: Publications Office of the European Union; 2014.
Cho AK. Ice: a new dosage form of an old drug. Science. 1990;249(4969):631–4.
Henderson GL. Designer drugs: past history and future prospects. J Forensic Sci. 1988;33(2):569–75.
Shulgin A. Profiles of psychedelic drugs: 10. DOB. J Psychoactive Drugs. 1981;13(1):99.
Vogels N, et al. Content of Ecstasy in the Netherlands: 1993–2008. Addiction. 2009;104(12):2057–66.
Steele TD, McCann UD, Ricaurte GA. 3,4-Methylenedioxymethamphetamine (MDMA, “Ecstasy”): pharmacology and toxicology in animals and humans. Addiction. 1994;89(5):539–51.
White JM, Bochner F, Irvine RJ. The agony of “ecstasy”. Med J Aust. 1997;166(3):117–8.
Bronstein AC, et al. 2010 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 28th annual report. Clin Toxicol (Phila). 2011;49(10):910–41.
Bronstein AC, et al. 2011 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 29th annual report. Clin Toxicol (Phila). 2012;50(10):911–1164.
Mowry JB, et al. 2013 annual report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 31st annual report. Clin Toxicol (Phila). 2014;52(10):1032–283.
European Monitoring Centre for Drugs and Drug Addiction. European drug report 2015 trends and developments. Luxembourg: Publications Office of the European Union, 2015.
Backberg M, et al. Characteristics of analytically confirmed 3-MMC-related intoxications from the Swedish STRIDA project. Clin Toxicol (Phila). 2015;53(1):46–53.
Commission AC. Illicit drug data report 2013–14.
Felgate HE, et al. Recent paramethoxyamphetamine deaths. J Anal Toxicol. 1998;22(2):169–72.
Nicol JJ, et al. Deaths from exposure to paramethoxymethamphetamine in Alberta and British Columbia, Canada: a case series. CMAJ Open. 2015;3(1):E83–90.
Laskowski LK, et al. Evolution of the NBOMes: 25C- and 25B- Sold as 25I-NBOMe. J Med Toxicol. 2015;11(2):237–41.
United States of America, Plaintiff v Damon S. Forbes, et al. Defendants. 1992, United States District Court for the District of Colorado.
McFadden v. United States Certiorari to the United States Court of Appeals for the Fourth Circuit 2015, Supreme Court of the United States.
Addiction, E.M.C.f.D.a.D. Legal approaches to controlling new psychoactive substances. Cited 26 Feb 2016; Available from: http://www.emcdda.europa.eu/topics/pods/controlling-new-psychoactive-substances
Nichols DE. Differences between the mechanism of action of MDMA, MBDB, and the classic hallucinogens. Identification of a new therapeutic class: entactogens. J Psychoactive Drugs. 1986;18(4):305–13.
Jacob 3rd P, Shulgin AT. Structure-activity relationships of the classic hallucinogens and their analogs. NIDA Res Monogr. 1994;146:74–91.
Biel JH, Bopp B. Amphetamines: structure-activity relationships. In: Iversen S, Iversen LL, Snyder SH, editors. Handbook of psychopharmacology. New York: Plenum Press; 1978.
PALMER R. Illicit drug manufacture (with an emphasis on clandestine methamphetamine production): synthetic methods and law enforcement concerns. In: Smith FP, editor. Handbook of forensic drug analysis. Amsterdam/Boston: Elsevier Academic; 2005.
Isaacson EI. Central nervous system stimulants. In: Delgado JN, editor. R.W.e.W.a.G.s.T.o.O.M.a.P.C. 10th ed. Philadelphia: Lippincott-Raven; 1998. p. 463–77.
Heinonen EH, Anttila MI, Lammintausta RA. Pharmacokinetic aspects of l-deprenyl (selegiline) and its metabolites. Clin Pharmacol Ther. 1994;56(6 Pt 2):742–9.
Cody JT, Valtier S. Detection of amphetamine and methamphetamine following administration of benzphetamine. J Anal Toxicol. 1998;22(4):299–309.
Cody JT. Enantiomeric composition of amphetamine and methamphetamine derived from the precursor compound famprofazone. Forensic Sci Int. 1996;80(3):189–99.
Shukla RK, Crump JL, Chrisco ES. An evolving problem: methamphetamine production and trafficking in the United States. Int J Drug Policy. 2012;23(6):426–35.
Melnikova N, et al. Injuries from Methamphetamine-related chemical incidents – Five states, 2001–2012. MMWR Morb Mortal Wkly Rep. 2015;64(33):909–12.
Soine WH. Clandestine drug synthesis. Med Res Rev. 1986;6(1):41–74.
Tanaka K, Ohmori T, Inoue T. Analysis of impurities in illicit methamphetamine. Forensic Science International. 1992;56:157–165.
Lead poisoning associated with intravenous-methamphetamine use – Oregon, 1988. MMWR Morb Mortal Wkly Rep. 1989;38(48):830–1.
Seiden LS, Sabol KE, Ricaurte GA. Amphetamine: effects on catecholamine systems and behavior. Annu Rev Pharmacol Toxicol. 1993;33:639–77.
Banerjee SP, et al. Amphetamine induces beta-adrenergic receptor supersensitivity. Nature. 1978;271(5643):380–1.
Fleckenstein AE, et al. New insights into the mechanism of action of amphetamines. Annu Rev Pharmacol Toxicol. 2007;47:681–98.
Kennedy LT, Hanbauer I. Sodium-sensitive cocaine binding to rat striatal membrane: possible relationship to dopamine uptake sites. J Neurochem. 1983;41(1):172–8.
Fischer JF, Cho AK. Chemical release of dopamine from striatal homogenates: evidence for an exchange diffusion model. J Pharmacol Exp Ther. 1979;208(2):203–9.
Parker EM, Cubeddu LX. Comparative effects of amphetamine, phenylethylamine and related drugs on dopamine efflux, dopamine uptake and mazindol binding. J Pharmacol Exp Ther. 1988;245(1):199–210.
Miller HH, Shore PA, Clarke DE. In vivo monoamine oxidase inhibition by d-amphetamine. Biochem Pharmacol. 1980;29(10):1347–54.
Mantle TJ, Tipton KF, Garrett NJ. Inhibition of monoamine oxidase by amphetamine and related compounds. Biochem Pharmacol. 1976;25(18):2073–7.
Spengler J, Waser P. The influence of various pharmacological agents on the food intake of albino rats in acute experiment. Naunyn Schmiedebergs Arch Exp Pathol Pharmakol. 1959;237:171–85.
Sugrue MF. Neuropharmacology of drugs affecting food intake. Pharmacol Ther. 1987;32(2):145–82.
Morland J. Toxicity of drug abuse – amphetamine designer drugs (ecstasy): mental effects and consequences of single dose use. Toxicol Lett. 2000;112–113:147–52.
Berger UV, Gu XF, Azmitia EC. The substituted amphetamines 3,4-methylenedioxymethamphetamine, methamphetamine, p-chloroamphetamine and fenfluramine induce 5-hydroxytryptamine release via a common mechanism blocked by fluoxetine and cocaine. Eur J Pharmacol. 1992;215(2–3):153–60.
Hekmatpanah CR, Peroutka SJ. 5-hydroxytryptamine uptake blockers attenuate the 5-hydroxytryptamine-releasing effect of 3,4-methylenedioxymethamphetamine and related agents. Eur J Pharmacol. 1990;177(1–2):95–8.
Ricaurte GA, et al. (+/−)3,4-Methylenedioxymethamphetamine selectively damages central serotonergic neurons in nonhuman primates. JAMA. 1988;260(1):51–5.
Ricaurte GA, et al. Lasting effects of (+−)-3,4-methylenedioxymethamphetamine (MDMA) on central serotonergic neurons in nonhuman primates: neurochemical observations. J Pharmacol Exp Ther. 1992;261(2):616–22.
Hatzidimitriou G, McCann UD, Ricaurte GA. Altered serotonin innervation patterns in the forebrain of monkeys treated with (+/−)3,4-methylenedioxymethamphetamine seven years previously: factors influencing abnormal recovery. J Neurosci. 1999;19(12):5096–107.
McCann UD, et al. Altered neuroendocrine and behavioral responses to m-chlorophenylpiperazine in 3,4-methylenedioxymethamphetamine (MDMA) users. Psychopharmacology (Berl). 1999;147(1):56–65.
McCann UD, et al. Positron emission tomographic evidence of toxic effect of MDMA (“Ecstasy”) on brain serotonin neurons in human beings. Lancet. 1998;352(9138):1433–7.
Reneman L, et al. Memory disturbances in “Ecstasy” users are correlated with an altered brain serotonin neurotransmission. Psychopharmacology (Berl). 2000;148(3):322–4.
McGuire P. Long term psychiatric and cognitive effects of MDMA use. Toxicol Lett. 2000;112–113:153–6.
McGuire PK, Cope H, Fahy TA. Diversity of psychopathology associated with use of 3,4-methylenedioxymethamphetamine (‘Ecstasy’). Br J Psychiatry. 1994;165(3):391–5.
O’Shea E, et al. The relationship between the degree of neurodegeneration of rat brain 5-HT nerve terminals and the dose and frequency of administration of MDMA (‘ecstasy’). Neuropharmacology. 1998;37(7):919–26.
Gibb JW, Johnson M, Elayan I, et al. Neurotoxicity of amphetamines and their metabolites. In: Rapaka RS, Chiang N, Martin BR, editors. Pharmacokinetics, metabolism and pharmaceutics of drugs of abuse. Rockville: National Institute on Drug Abuse; 1997. p. 128–45.
Henry JA, Jeffreys KJ, Dawling S. Toxicity and deaths from 3,4-methylenedioxymethamphetamine (“ecstasy”). Lancet. 1992;340(8816):384–7.
Ginsberg MD, Hertzman M, Schmidt-Nowara WW. Amphetamine intoxication with coagulopathy, hyperthermia, and reversible renal failure. A syndrome resembling heatstroke. Ann Intern Med. 1970;73(1):81–5.
Byard RW, et al. Amphetamine derivative fatalities in South Australia – is “Ecstasy” the culprit? Am J Forensic Med Pathol. 1998;19(3):261–5.
Weiss SR, et al. Intracerebral and subarachnoid hemorrhage following use of methamphetamine (“speed”). Int Surg. 1970;53(2):123–7.
Zalis EG, et al. Acute lethality of the amphetamines in dogs and its antagonism by curare. Proc Soc Exp Biol Med. 1965;118:557–61.
Yamawaki S, Lai H, Horita A. Dopaminergic and serotonergic mechanisms of thermoregulation: mediation of thermal effects of apomorphine and dopamine. J Pharmacol Exp Ther. 1983;227(2):383–8.
Callaway CW, Clark RF. Hyperthermia in psychostimulant overdose. Ann Emerg Med. 1994;24(1):68–76.
Office of Applied Statistics, S.A.a.M.H.S.A.D.A.W.N.A.M.E.D.W., DC, Department of Health and Human Services, 1999.
Kataoka Y, et al. Effects of aggregation on methamphetamine toxicity in mice. Acta Med Okayama. 1986;40(3):121–6.
Shintomi K. Effects of psychotropic drugs on methamphetamine-induced behavioral excitation in grouped mice. Eur J Pharmacol. 1975;31(2):195–206.
Citron BP, et al. Necrotizing angiitis associated with drug abuse. N Engl J Med. 1970;283(19):1003–11.
Koff RS, Widrich WC, Robbins AH. Necrotizing angiitis in a methamphetamine user with hepatitis B – angiographic diagnosis, five-month follow-up results and localization of bleeding site. N Engl J Med. 1973;288(18):946–7.
McCann UD, Slate SO, Ricaurte GA. Adverse reactions with 3,4-methylenedioxymethamphetamine (MDMA; ‘ecstasy’). Drug Saf. 1996;15(2):107–15.
Furst SR, et al. Myocardial infarction after inhalation of methamphetamine. N Engl J Med. 1990;323(16):1147–8.
Herr RD, Caravati EM. Acute transient ischemic colitis after oral methamphetamine ingestion. Am J Emerg Med. 1991;9(4):406–9.
Hong R, Matsuyama E, Nur K. Cardiomyopathy associated with the smoking of crystal methamphetamine. JAMA. 1991;265(9):1152–4.
McCann UD, et al. Brain serotonin neurotoxicity and primary pulmonary hypertension from fenfluramine and dexfenfluramine. A systematic review of the evidence. JAMA. 1997;278(8):666–72.
Andreu V, et al. Ecstasy: a common cause of severe acute hepatotoxicity. J Hepatol. 1998;29(3):394–7.
Jones AL, Simpson KJ. Review article: mechanisms and management of hepatotoxicity in ecstasy (MDMA) and amphetamine intoxications. Aliment Pharmacol Ther. 1999;13(2):129–33.
Dykhuizen RS, et al. Ecstasy induced hepatitis mimicking viral hepatitis. Gut. 1995;36(6):939–41.
Eskandari MR, et al. A new approach on methamphetamine-induced hepatotoxicity: involvement of mitochondrial dysfunction. Xenobiotica. 2014;44(1):70–6.
Derlet RW, et al. Amphetamine toxicity: experience with 127 cases. J Emerg Med. 1989;7(2):157–61.
Richards JR, et al. Methamphetamine abuse and rhabdomyolysis in the ED: a 5-year study. Am J Emerg Med. 1999;17(7):681–5.
Eckert J, et al. Hair loss in women. Br J Dermatol. 1967;79(10):543–8.
Buscarino M, Saal J, Young JL. Delusional parasitosis in a female treated with mixed amphetamine salts: a case report and literature review. Case Rep Psychiatry. 2012;2012:624235.
Schaiberger PH, et al. Pulmonary hypertension associated with long-term inhalation of “crank” methamphetamine. Chest. 1993;104(2):614–6.
Bryden AA, Rothwell PJ, O’Reilly PH. Urinary retention with misuse of “ecstasy”. BMJ. 1995;310(6978):504.
McGuire P, Fahy T. Chronic paranoid psychosis after misuse of MDMA (“ecstasy”). BMJ. 1991;302(6778):697.
De-Carolis C, et al. Methamphetamine abuse and “meth mouth” in Europe. Med Oral Patol Oral Cir Bucal. 2015;20(2):e205–10.
Meyer JS. 3,4-methylenedioxymethamphetamine (MDMA): current perspectives. Subst Abuse Rehabil. 2013;4:83–99.
Hayner GN, McKinney H. MDMA. The dark side of ecstasy. J Psychoactive Drugs. 1986;18(4):341–7.
Greer G, Tolbert R. Subjective reports of the effects of MDMA in a clinical setting. J Psychoactive Drugs. 1986;18(4):319–27.
Buffum J, Moser C. MDMA and human sexual function. J Psychoactive Drugs. 1986;18(4):355–9.
Downing J. The psychological and physiological effects of MDMA on normal volunteers. J Psychoactive Drugs. 1986;18(4):335–40.
Brown C, Osterloh J. Multiple severe complications from recreational ingestion of MDMA (‘Ecstasy’). JAMA. 1987;258(6):780–1.
Henry JA, et al. Low-dose MDMA (“ecstasy”) induces vasopressin secretion. Lancet. 1998;351(9118):1784.
Wu D, et al. Interactions of amphetamine analogs with human liver CYP2D6. Biochem Pharmacol. 1997;53(11):1605–12.
Haufroid V, Hantson P. CYP2D6 genetic polymorphisms and their relevance for poisoning due to amfetamines, opioid analgesics and antidepressants. Clin Toxicol (Phila). 2015;53(6):501–10.
Ridpath A, et al. Illnesses and deaths among persons attending an electronic dance-music festival – New York City, 2013. MMWR Morb Mortal Wkly Rep. 2014;63(50):1195–8.
Schwartz RH, Miller NS. MDMA (ecstasy) and the rave: a review. Pediatrics. 1997;100(4):705–8.
Holden R, Jackson MA. Near-fatal hyponatraemic coma due to vasopressin over-secretion after “ecstasy” (3,4-MDMA). Lancet. 1996;347(9007):1052.
Parr MJ, Low HM, Botterill P. Hyponatraemia and death after “ecstasy” ingestion. Med J Aust. 1997;166(3):136–7.
Matthai SM, et al. Cerebral oedema after ingestion of MDMA (“ecstasy”) and unrestricted intake of water. BMJ. 1996;312(7042):1359.
Clark AD, Butt N. Ecstasy-induced very severe aplastic anaemia complicated by invasive pulmonary mucormycosis treated with allogeneic peripheral blood progenitor cell transplant. Clin Lab Haematol. 1997;19(4):279–81.
Marsh JC, et al. Aplastic anaemia following exposure to 3,4-methylenedioxymethamphetamine (‘Ecstasy’). Br J Haematol. 1994;88(2):281–5.
House RV, Thomas PT, Bhargava HN. Selective modulation of immune function resulting from in vitro exposure to methylenedioxymethamphetamine (Ecstasy). Toxicology. 1995;96(1):59–69.
Creighton FJ, Black DL, Hyde CE. ‘Ecstasy’ psychosis and flashbacks. Br J Psychiatry. 1991;159:713–5.
McCann UD, Ricaurte GA. Lasting neuropsychiatric sequelae of (+−)methylenedioxymethamphetamine (‘ecstasy’) in recreational users. J Clin Psychopharmacol. 1991;11(5):302–5.
McCann UD, et al. Cognitive performance in (+/−) 3,4-methylenedioxymethamphetamine (MDMA, “ecstasy”) users: a controlled study. Psychopharmacology (Berl). 1999;143(4):417–25.
Morley JE, et al. Amphetamine-induced hyperthyroxinemia. Ann Intern Med. 1980;93(5):707–9.
Register/, M.G.f.F.W.D.T.P.F. and N. Volume 69, Effective November 1, 2004. p. 19644–73.
Beckman Coulter: EMIT-II monoclonal amphetamine/methamphetamine assay. Product Insert.
Nakanishi K, et al. Cross-reactivities of various phenethylamine-type designer drugs to immunoassays for amphetamines, with special attention to the evaluation of the one-step urine drug test Instant-View, and the Emit(R) assays for use in drug enforcement. (1872–6283 (Electronic)).
Logan BK, Fligner CL, Haddix T. Cause and manner of death in fatalities involving methamphetamine. J Forensic Sci. 1998;43(1):28–34.
Solursh LP, Clement WR. Use of diazepam in hallucinogenic drug crises. JAMA. 1968;205(9):644–5.
Derlet RW, Albertson TE, Rice P. Antagonism of cocaine, amphetamine, and methamphetamine toxicity. Pharmacol Biochem Behav. 1990;36(4):745–9.
Derlet RW, Albertson TE, Rice P. The effect of haloperidol in cocaine and amphetamine intoxication. J Emerg Med. 1989;7(6):633–7.
Derlet RW, Albertson TE, Rice P. Protection against d-amphetamine toxicity. Am J Emerg Med. 1990;8(2):105–8.
Richards JR, Derlet RW, Duncan DR. Methamphetamine toxicity: treatment with a benzodiazepine versus a butyrophenone. Eur J Emerg Med. 1997;4(3):130–5.
Srisuma S, Bronstein AC, Hoyte CO. NBOMe and 2C substitute phenylethylamine exposures reported to the National Poison Data System. Clin Toxicol (Phila). 2015;53(7):624–8.
Ruha AM, Yarema MC. Pharmacologic treatment of acute pediatric methamphetamine toxicity. Pediatr Emerg Care. 2006;22(12):782–5.
WU CS, TSAI YT, TSAI HJ. Antipsychotic drugs and the risk of ventricular arrhythmia and/or sudden cardiac death: a nation-wide case-crossover study. J AM HEART ASSOC. 2015;4(2):e001568.
Bloechliger M, et al. Antipsychotic drug use and the risk of seizures: follow-up study with a nested case–control analysis. CNS Drugs. 2015;29(7):591–603.
Muench J, Hamer AM. Adverse effects of antipsychotic medications. Am Fam Physician. 2010;81(5):617–22.
Jenner L, et al. Management of patients with psychostimulant toxicity : guidelines for emergency departments. Canberra: Australian Govt Dept of Health and Ageing; 2006.
Laskowski LK, et al. Ice water submersion for rapid cooling in severe drug-induced hyperthermia. Clin Toxicol (Phila). 2015;53(3):181–4.
Shioda K, et al. Effect of risperidone on acute methamphetamine-induced hyperthermia in rats. Drug Alcohol Depend. 2010;111(3):241–9.
Shioda K, et al. Risperidone attenuates and reverses hyperthermia induced by 3,4-methylenedioxymethamphetamine (MDMA) in rats. Neurotoxicology. 2008;29(6):1030–6.
Denborough MA, Hopkinson KC. Dantrolene and “ecstasy”. Med J Aust. 1997;166(3):165–6.
McKinney PE, et al. Methamphetamine toxicity prevented by activated charcoal in a mouse model. Ann Emerg Med. 1994;24(2):220–3.
Li J, et al. Methamphetamine use associated with monomorphic ventricular tachycardia. J Addict Med. 2014;8(6):470–3.
Jacobs W. Fatal amphetamine-associated cardiotoxicity and its medicolegal implications. Am J Forensic Med Pathol. 2006;27(2):156–60.
Bowen JS, et al. Diffuse vascular spasm associated with 4-bromo-2,5-dimethoxyamphetamine ingestion. JAMA. 1983;249(11):1477–9.
Bosch X, Poch E, Grau JM. Rhabdomyolysis and acute kidney injury. N Engl J Med. 2009;361(1):62–72.
Davis JM, et al. Effects of urinary pH on amphetamine metabolism. Ann N Y Acad Sci. 1971;179:493–501.
Plessinger MA. Prenatal exposure to amphetamines. Risks and adverse outcomes in pregnancy. Obstet Gynecol Clin North Am. 1998;25(1):119–38.
Kolecki P. Inadvertent methamphetamine poisoning in pediatric patients. Pediatr Emerg Care. 1998;14(6):385–7.
Burchfield DJ, et al. Disposition and pharmacodynamics of methamphetamine in pregnant sheep. JAMA. 1991;265(15):1968–73.
McElhatton PR, et al. Congenital anomalies after prenatal ecstasy exposure. Lancet. 1999;354(9188):1441–2.
Zhang L, et al. Effect of R(−)2,5-dimethoxy-4-methylamphetamine on uterine and umbilical blood flow in conscious pregnant sheep. Eur J Pharmacol. 1991;199(2):179–84.
Smilkstein MJ, Smolinske SC, Rumack BH. A case of MAO inhibitor/MDMA interaction: agony after ecstasy. J Toxicol Clin Toxicol. 1987;25(1–2):149–59.
Henry JA, Hill IR. Fatal interaction between ritonavir and MDMA. Lancet. 1998;352(9142):1751–2.
Author information
Authors and Affiliations
Corresponding authors
Editor information
Editors and Affiliations
Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition
Grading System for Levels of Evidence Supporting Recommendations in Critical Care Toxicology, 2nd Edition
-
I
Evidence obtained from at least one properly randomized controlled trial.
-
II-1
Evidence obtained from well-designed controlled trials without randomization.
-
II-2
Evidence obtained from well-designed cohort or case–control analytic studies, preferably from more than one center or research group.
-
II-3
Evidence obtained from multiple time series with or without the intervention. Dramatic results in uncontrolled experiments (such as the results of the introduction of penicillin treatment in the 1940s) could also be regarded as this type of evidence.
-
III
Opinions of respected authorities, based on clinical experience, descriptive studies and case reports, or reports of expert committees.
Rights and permissions
Copyright information
© 2016 Springer International Publishing AG
About this entry
Cite this entry
Connors, N.J., Hoffman, R.S. (2016). Amphetamines and Derivatives. In: Brent, J., Burkhart, K., Dargan, P., Hatten, B., Megarbane, B., Palmer, R. (eds) Critical Care Toxicology. Springer, Cham. https://doi.org/10.1007/978-3-319-20790-2_4-1
Download citation
DOI: https://doi.org/10.1007/978-3-319-20790-2_4-1
Received:
Accepted:
Published:
Publisher Name: Springer, Cham
Online ISBN: 978-3-319-20790-2
eBook Packages: Springer Reference Biomedicine and Life SciencesReference Module Biomedical and Life Sciences