Adulterant – Contaminant in MT-45 or Coingestion?

Abstract

We thank Helander et al for sharing their fascinating MT-45 (1-cyclohexyl-4-(1,2-diphenylethyl)piperazine) cases (Br J Dermatol 2016 Dec 14. http://ift.tt/2pQgG1C. [Epub ahead of print]). MT-45 is a piperazine derivative and was investigated as an opioid analgesic in the 1970s. Laboratory studies suggest its pharmacology is complex and involves opioid receptors and non-opioid targets. MT-45 has emerged on the new psychoactive substances market where it is mostly sold on the Internet. The majority of reported clinical features of MT-45 are that associated with traditional opioids (e.g., reduced level of consciousness or coma, reduced respiratory effort, oxygen saturation or cyanosis, miosis, and hearing loss) and patients often present with decreased level of consciousness and respiratory depression that responded well to naloxone treatment.

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