Unexpected Serotonin Syndrome, Epileptic Seizures, and Cerebral Edema Following 2,5-dimethoxy-4-bromophenethylamine Ingestion.

Ingestion of the designer drug 2C-B by an 18-year-old man led to severe neurological consequences, including serotonin syndrome and severe brain edema. Although supportive therapy stabilized his condition, the patient suffered lasting severe neurological impairment months later. Routine drug screening in Dutch hospitals failed to detect 2C-B, highlighting a gap in identification. The case demonstrates that 2C-B carries risks of profound neurological damage that both users and healthcare providers may not recognize.

Study at a glance

Abstract

4-bromo-2,5-dimethoxyphenethylamine (2C-B) is a designer drug. In Europe, 2C-B is easily obtained and used for recreational purposes. It is known for its stimulating effects similar to those of 3,4-methylenedioxymethamphetamine, although in higher doses it has more hallucinogenic effects. Here, we report a case of 2C-B ingestion, confirmed by liquid chromatography-tandem mass spectrometry, in an 18-year-old man. The neurological consequences were severe, including the development of serotonin syndrome and severe brain edema. Supportive therapy resulted in a stable condition, although, after several months, the patient still suffered from severe neurological impairment due to the drug-induced toxicity. This case showed that 2C-B could not be identified with the drugs of abuse screening routinely used in Dutch hospitals. The use of 2C-B carries many risks, with potentially profound neurological damage, that both consumers and healthcare physicians are unaware of.