Toxicological findings in fatal intoxications from synthetic cathinones: a narrative review

Since description of autopsy findings and an indication of fatal concentrations related to overdoses from synthetic cathinones are rare, we reviewed the literature using three different search engines including articles from 2010 to 2019. Fifty-two resulted in line with our inclusion criteria providing information about 142 subjects, treated as individual cases. From our analysis most cathinones related deaths derived from polydrug abuse. In very few cases, death could be ascribed exclusively to the use of synthetic cathinones, namely mephedrone (4-MMC), butylone (Bk-MBDB), methylone, alpha-pyrrolidinopentiophenone (alpha-PVP), 3,4-dimethylmethcathinone (3,4-DMMC), 3',4'-Methylenedioxy-alpha-pyrrolidinobutiophenone (MDPBP), alpha-propyloaminopentiophenone (N-PP), 4-methylethcathinone (4-MEC) and 4'-methyl-alpha-pyrrolidinohexiophenone (MPHP), with blood concentrations generally higher than 0.5 mg/l in blood. Toxicological knowledge of these substances remains scarce and any contribution would prove fundamental in reconstructing their toxicity profile.