Health - A Parkinsonian Syndrome in Methcathinone Users and the Role of Manganese (2008)

[Jatelka]

A new entry has been added to Drugs Archive

Description:
New England Journal of Medicine Volume 358:1009-1017 March 6, 2008 Number 10

Ainars Stepens, M.D., Inara Logina, Ph.D., Viesturs Liguts, Ph.D., Pauls Aldin, M.D., Ilze Eksteina, M.D., Ardis Platkajis, Ph.D., Inese Martinsone, M.Sci., Elmars Terauds, M.D., Baiba Rozentale, Ph.D., and Michael Donaghy, F.R.C.P.


Background A distinctive extrapyramidal syndrome has been observed in intravenous methcathinone (ephedrone) users in Eastern Europe and Russia.
Methods We studied 23 adults in Latvia who had extrapyramidal symptoms and who had injected methcathinone for a mean (±SD) of 6.7±5.1 years. The methcathinone was manufactured under home conditions by potassium permanganate oxidation of ephedrine or pseudoephedrine. All patients were positive for hepatitis C virus, and 20 were also positive for the human immunodeficiency virus (HIV).
Results The patients reported that the onset of their first neurologic symptoms (gait disturbance in 20 and hypophonia in 3) occurred after a mean of 5.8±4.5 years of methcathinone use. At the time of neurologic evaluation, all 23 patients had gait disturbance and difficulty walking backward; 11 patients were falling daily, and 1 of these patients used a wheelchair. Twenty-one patients had hypophonic speech in addition to gait disturbance, and one of these patients was mute. No patient reported decline in cognitive function. T1-weighted magnetic resonance imaging (MRI) showed symmetric hyperintensity in the globus pallidus and in the substantia nigra and innominata in all 10 active methcathinone users. Among the 13 former users (2 to 6 years had passed since the last use), lesser degrees of change in the MRI signal were noted. Whole-blood manganese levels (normal level, <209 nmol per liter) averaged 831 nmol per liter (range, 201 to 2102) in the active methcathinone users and 346 nmol per liter (range, 114 to 727) in former users. The neurologic deficits did not resolve after patients discontinued methcathinone use. Conclusions Our observation of a distinctive extrapyramidal syndrome, changes in the MRI signal in the basal ganglia, and elevated blood manganese levels in methcathinone users suggests that manganese in the methcathinone solution causes a persistent neurologic disorder.


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The comments you make there will appear in the posts below.

[nomud]

Thumbs up post,Kudos.There is no doubt method of manufacture and impurities will have an effect on the consumer.That is why swim deletes heavy metels,and other toxic materials from manf. techniques in posts.

[Mona Lisa]

SWIM wonders if this could mainly be due to dopamine depletion, like in Parkinson's. Reminds one of that article about MPTP, the synthetic heroin that caused serious Parkinsonian symptoms in many users back in the 80s

[buzzman]

Can someone convert this to stupid language?

[jungle]

Originally Posted by Mona Lisa

SWIM wonders if this could mainly be due to dopamine depletion, like in Parkinson's.

"Conclusions Our observation of a distinctive extrapyramidal syndrome, changes in the MRI signal in the basal ganglia, and elevated blood manganese levels in methcathinone users suggests that manganese in the methcathinone solution causes a persistent neurologic disorder."

so it seems that it's the injected manganese is responsible for parkinson like symptoms rather than dopamin depletion by methcat itself.

[holdout]

SWIM thinks this report is not so credible. all had hep C virus and almost all had HIV? please find healthier subjects lol

[terrapinzflyer]

Originally Posted by holdout

SWIM thinks this report is not so credible. all had hep C virus and almost all had HIV? please find healthier subjects lol

not a LOL situation.

Study stated that the avg user in the study had been injecting this for 6.7 years, which also implies many had probably been IV users even longer. Both hep c and hiv are sadly somewhat common in long term iv users. flipside is finding perfectly healthy long term iv users is not so easy.

So saying this study is in anyway less then valid on those grounds is unjust.

Reputation Comments on this post:

valid points about long term IV users being common to have hiv / hep

[Alfa]

Originally Posted by buzzman

Can someone convert this to stupid language?

The study is stating that the users of a stimulant called methcathinone, developed parkingson, because the drug was produced wrong.

They analysed the blood of the methcathinone users and found high levels of a metal called manganese in their blood. Even after they quit using methcathinone they stayed ill.

Basically this shows what can happen if a drug is produced wrong. In relation to research chemicals, it clearly shows that one should always ask for a CoA from research chemical vendors, before purchasing.

A CoA is a Certificate of Analysis, which is basically a statement of how pure a drug is.

Reputation Comments on this post:

very understandable summary

[holdout]

Originally Posted by Alfa

A CoA is a Certificate of Analysis, which is basically a statement of how pure a drug is.

good luck getting one (albeit an honest one) from a synth lab in.... *gasp* CHINA!!!!!!


in middle class societies, local community health centers offer a free needle exchange program. find healthy subjects from there!

[Alfa]

Originally Posted by holdout

good luck getting one (albeit an honest one) from a synth lab in.... *gasp* CHINA!!!!!!

That is easily done. If it is honest is indeed the question with some sources.

[terrapinzflyer]

Originally Posted by holdout

in middle class societies, local community health centers offer a free needle exchange program. find healthy subjects from there!

sadly this is not the case in much of the world. Just look at swiy's neighbor to the south- while needle exchanges DO exist in some spots in America- they are highly controversial and tend to exist only in the most liberal cities. This is sadly true of many spots in the world.