Acute chlorophenylpiperazine overdose: A case report and review of the literature

Therapeutic Drug Monitoring

Volumn 30, Issue 3, 2008, Pages 394-398

  Kovaleva, Julia ^a   Ir, Elke Devuyst ^a   Paepe, Peter De ^c   Verstraete, Alain ^a,b  

^a GHENT UNIVERSITY   (Belgium)

^b GHENT UNIVERSITY HOSPITAL   (Belgium)

^c GHENT UNIVERSITY   (Belgium)

Author keywords

Liquid chromatography tandem mass spectrometry; M chlorophenylpiperazine; Overdose; Serotonin

Indexed keywords

(3 CHLOROPHENYL)PIPERAZINE; ALCOHOL; AMPHETAMINE; BENZOYLECGONINE; PLACEBO; TRAZODONE; 1-(3-CHLOROPHENYL)PIPERAZINE; CENTRAL DEPRESSANT AGENT; CENTRAL STIMULANT AGENT; COCAINE; PIPERAZINE DERIVATIVE; SEROTONIN AGONIST;

ADULT; AGITATION; ANXIETY; ARTICLE; BLOOD LEVEL; BODY TEMPERATURE; CASE REPORT; CLINICAL TRIAL; DROWSINESS; DRUG CLEARANCE; DRUG DISTRIBUTION; DRUG ELIMINATION; DRUG HALF LIFE; DRUG OVERDOSE; DRUG USE; FEMALE; FLUSHING; HOSPITAL; HUMAN; LABORATORY TEST; LIQUID CHROMATOGRAPHY; MASS FRAGMENTOGRAPHY; MASS SPECTROMETRY; MEDICAL LITERATURE; PRIORITY JOURNAL; PUPIL; SYMPTOM; TABLET; TACHYCARDIA; URINE LEVEL; VISUAL DISORDER; ACUTE DISEASE; BLOOD; HIGH PERFORMANCE LIQUID CHROMATOGRAPHY; INTOXICATION; TANDEM MASS SPECTROMETRY;

ACUTE DISEASE; ADULT; AMPHETAMINE; CENTRAL NERVOUS SYSTEM DEPRESSANTS; CENTRAL NERVOUS SYSTEM STIMULANTS; CHROMATOGRAPHY, HIGH PRESSURE LIQUID; COCAINE; ETHANOL; FEMALE; HUMANS; OVERDOSE; PIPERAZINES; SEROTONIN AGONISTS; TANDEM MASS SPECTROMETRY;

EID: 47249096553     PISSN: 01634356     EISSN: 15363694     Source Type: Journal    
DOI: 10.1097/FTD.0b013e318170a879     Document Type: Article

References (33)

1. Europol-EMCDDA Joint Report on a new psychoactive substance: 1-(3-chlorophenyl)piperazine (mCPP). [European Monitoring Centre for Drugs and Drug Addiction web site]. March 23, 2007. Available at: http://www.emcdda. europa.eu/?nnodeid=16775. Accessed April 17, 2007.
2. Avertissement de la Santé publique: CPP en circulation in Belgique. [Scientific Institute of Public Health web site]. July 19, 2005. Available at: http://www.iph.fgov.be/reitox/Warnings/2005-07-19-CPP.pdf
3. m-chlorophénylpipérazine nouvelle identification. [Observatoire Français des Drogues et des Toxicomanies web site]. March 14, 2006. Available at: http://www.drogues.gouv.fr/IMG/pdf/note-mCPP.pdf
4. Ellenhorn MJ, Schonwald S, Ordog J, et al. Ellenhorn's Medical Toxicology: Diagnosis and Treatment of Human Poisoning. 8th ed. Baltimore, MD: Williams and Wilkins; 2006.
5. Hamik A, Peroutka SJ.1-(m-Chlorophenyl)piperazine (mCPP) interactions with neurotransmitter receptors in the human brain. Biol Psychiatry. 1989;25:569-575.
6. Thomas DR, Gager TL, Holland V, et al. m-Chlorophenylpiperazine (mCPP) is an antagonist at the cloned human 5-HT2B receptor. Neuroreport. 1996;7:1457-1460.
7. McCann UD, Eligulashvili V, Mertl M. Altered neuroendocrine and behavioral responses to m-chlorophenylpiperazine in 3,4- methylenedioxymethamphetamine (MDMA) users. Psychopharmacology. 1999;147:56-65.
8. Kahn RS, Wetzler S. m-Chlorophenylpiperazine as a probe of serotonin function. Biol Psychiatry. 1991;30:1139-1166.
9. Broocks A, Pigott TA, Hill JL, et al. Acute intravenous administration of ondansetron and mCPP, alone and in combination, in patients with obsessive-compulsive disorder (OCD): behavioral and biological results. Psychiatry Res. 1998;79:11-20.
10. Krystal JH, Seibyl JP, Price LH, et al. m-Chlorophenylpiperazine effects in neuroleptic-free schizophrenic patients. Arch Gen Psychiatry. 1993;50: 624-635.
11. Germine M, Goddard AW, Sholomskas DE, et al. Response to meta-chlorophenylpiperazine in panic disorder patients and healthy subjects: influence of reduction in intravenous dosage. Psychiatry Res. 1994;54: 115-133.
12. Maes M, Westenberg H, Vandoolaeghe E, et al. Effects of trazodone and fluoxetine in the treatment of major depression: therapeutic pharmacokinetic and pharmacodynamic interactions through formation of meta-chlorophenylpiperazine. J Clin Psychopharmacol. 1997;17:358-364.
13. HAZARDOUS SUBSTANCES DATA BANK [database online]. Bethesda, MD: National Library of Medicine; 2003. Updated September 9, 2003.
14. Mayol RF, Cole CA, Colson KE, et al. Isolation and identification of the major urinary metabolite of m-chlorophenylpiperazine in the rat. Drug Metab Dispos. 1994;22:171-174.
15. Bertilsson L, Dahl ML, Dalen P, et al. Molecular genetics of CYP2D6: clinical relevance with focus on psychotropic drugs. Br J Clin Pharmacol. 2002;53:111-122.
16. Feuchtl A, Bagli M, Stephan R, et al. Pharmacokinetic meta-chlorophenylpiperazine after intravenous and oral administration in healthy male volunteers: implication for the pharmacodynamic profile. Psychopharmacology. 2004;37:180-188.
17. Gijsman HJ, van Gerven JM, Tieleman MC, et al. Pharmacokinetic and pharmacodynamic profile of oral and intravenous meta-chlorophenylpiperazine in healthy volunteers. J Clin Psychopharmacol. 1998;18:289-295.
18. Goeringer KE, Raymon L, Logan BK. Postmortem forensic toxicology of trazodone. J Forensic Sci. 2000;45:850-856.
19. Martínez MA, Ballesteros S, Sánchez de la Torre C, et al. Investigation of a fatality due to trazodone poisoning: case report and literature review. J Anal Toxicol. 2005;29:262-268.
20. Wood DM, Dargan PI, Button J, et al. Pills, collapse and a negative drug screen. Lancet. 2007;369:1490.
21. Silverstone PH, Rue JE, Franklin M, et al. The effects of administration of mCPP on psychological, cognitive, cardiovascular, hormonal and MHPG measurements in human volunteers. Int Clin Psychopharmacol. 1994;3: 173-178.
22. Sabbe M, Hulstijn W, Maes M, et al. Psychomotor slowing, neuroendocrine responses, and behavioral changes after oral administration of meta-chlorophenylpiperazine in normal volunteers. Psychiatry Res. 2001;105:151-163.
23. Ghaziuddin N, Welch K, Greden J. Central serotonergic effects of m-chlorophenylpiperazine (mCPP) among normal control adolescents. Neuropsychopharmacology. 2003;28:133-139.
24. Goodman WK, McDougle CJ, Price LH, et al. m-Chlorophenylpiperazine in patients with obsessive-compulsive disorder: absence of symptom exacerbation. Biol psychiatry. 1995;38:138-149.
25. Khanna S, John JP, Lakshmi PR. Neuroendocrine and behavioral responses to mCPP in obsessive-compulsive disorder. Psychoneuroendocrinology. 2001;26:209-223.
26. Erzegovesi S, Martucci L. Low versus standard dose mCPP challenge in obsessive-compulsive patients. Neuropsychopharmacology. 2001;24:31-36.
27. Asnis GM, Harkavy Friedman JM, Iqbal N, et al. The drug-free period: a methodological issue comment. Biol Psychiatry. 1990;27:657-660.
28. Klaassen T, Pian KL, Westenberg HG, et al. Serotonin syndrome after challenge with the 5-HT agonist meta-chlorophenylpiperazine. Psychiatry Res. 1998;79:207-212.
29. Maurer HH, Sauer C, Theobald DS. Toxicokinetics of drugs of abuse: current knowledge of the isoenzymes involved in the human metabolism of tetrahydrocannabinol, cocaine, heroin, morphine, and codeine. Ther Drug Monit. 2006;3:447-453.
30. Tancer ME, Johanson CE. The subjective effects of MDMA and mCPP in moderate MDMA users. Drug Alcohol Depend. 2001;65:97-101.
31. Tancer ME, Johanson CE. Reinforcing, subjective and physiological effects of MDMA in humans: an comparison with d-amphetamine and mCPP. Drug Alcohol Depend. 2003;72:33-44.
32. Buydens-Branchey L, Branchey M, Fergeson P, et al. The meta-chlorophenylpiperazine challenge test in cocaine addicts: hormonal and physiological responses. Biol Psychiatry. 1997;41:1071-1086.
33. Benkelfat C, Murphy DL, Hill JL, et al. Ethanol-like properties of the serotoninergic partial agonist m-chlorophenylpiperazine in chronic alcohol patients. Arch Gen Psychiatry. 1991;48:383.