I enjoyed reading “New ‘legal’ highs: Kratom and methoxetamine” (Current Psychiatry, Pearls, August 2013, p.54-55; http://bit.ly/1gmPVFB), which discussed legal substances of abuse with adverse effects. I appreciate Dr. Julianna Troy’s recommendation to be familiar with “legal” drugs given their prevalence and potential for adverse effects when taken alone or with psychotropics.
Another legal substance, Bromo-DragonFLY—so named for the resemblance of its chemical structure to the insect—is illegal in many European countries and is being abused in the United States, notably in New Orleans, Louisiana.1 Available as a white or off-white powder, or as paper “blotters,” the drug exerts serotonergic and noradrenergic receptor agonism.1 It is characterized by slow onset but long duration of action.
Intoxication with Bromo-Dragon-FLY beyond the usual dose of 800 to 1,300 µg can result in dystonia, tachycardia, hypertension, psychosis, tachypnea, vasoconstriction with necrosis, seizures, hepatic or renal dysfunction, and death.1-5 Treatment comprises hydration, respiratory support, and benzodiazepines, muscle relaxants, or antipsychotics.1-4
Jonathan R. Scarff, MD
VA Outpatient Clinic
Spartanburg, South Carolina