Phenmetrazine abuse

Martin WR, Sloan JW, Sapira JD, et al Physiologic, subjective, and behavioral effects of amphetamine, methamphetamine, ephedrine, phenmetrazine, and methylphenidate in man. Clin Pharmacol Ther 12 245-258, 1971 McCormick TC Jr, McNeil TW Acute psychosis and Ritalin abuse. Tex State J Med... 

In a summary of the human abuse literature on anorectic phenylethylamines, Griffiths et al. (1979) found there was a good correlation between the results of self-administration studies in animals and information about the subjective effects and abuse in man. Specifically, amphetamine, diethyl-propion, and phenmetrazine have been associated with numerous clinical case reports involving abuse, and these three compounds as well as benz-phetamine and /-ephedrine have shown similar subjective effects in drug abuser populations (Griffiths et al. 1979). In addition, fenfluramine was associated with low incidence of abuse in humans and did not maintain self-injection responding in animals. Chlorphentermine was similarly associated with low incidence of abuse in man, but did not maintain selfinjection uniformly in animals (Griffiths et al. 1979). 

The morpholine derivatives phenmetrazine (173 R = H) and phendimetrazine (173 R = Me) have stimulant properties like those of amphetamine. They have been used as anorectics, but they are liable to abuse. Another CNS stimulant used as an anorectic is mazindol (174), which bears some resemblance to certain benzhydrols with antidepressant activity. 

The relative reinforcing effects or abuse potential of these drugs is thought to be related to their potency in releasing dopamine from nerve terminals, compared with serotonin release. Amfetamine, metamfetamine, and phenmetrazine are potent dopamine releasers with high... 

There are many reports of abuse of phenmetrazine. Nervousness, hyperexcitability, euphoria, and insomnia,... 

In Sweden, phenmetrazine has been extensively abused and misused, sometimes with intravenous use. Addicts who had previously been taking morphine stated that phenmetrazine gave them a sense of well-being and overconfidence. There was a high incidence of criminal activity in phenmetrazine users whose primary objective was obtaining money for the drug. Their average doses were 3060 tablets at a time, repeated 4—5 times a day (SED-9,15). 

Amphetamines have also been associated with a syndrome of acute kidney injury and rhabdomyolysis. Several series have described patients following intravenous injection of methamphetamine or phenmetrazine who presented with hyperactivity, fever, chills, sweats, abdominal cramps, diarrhea, and hypotension [177,178]. The patients have developed acute kidney injury which is usually oliguric and associated with classic rhabdomyolysis, similar to cases of cocaine-induced rhabdomyolysis. Several patients have had disseminated intravascular coagulation and liver function abnormalities as well. Methamphetamine abuse has also been associated with accelerated hypertension, unexplained chronic renal failure, acute lead poisoning (a common reagent used in its production utilizes lead acetate) and at least one case of biopsy proven interstitial nephritis the latter patient responded to intravenous corticosteroids but whether the nephritis was truly due to amphetamines remains unproven [179]. 

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