Review: the newly emerged designer psychostimulant 3,4-dimethylmethcathinone (3,4-DMMC)

3,4-Dimethylmetcatinone (3,4-DMMC) is a synthetic cathinone that was detected via the EU Early Warning System in 2010, and sold under the alias “Ocean” and “M2”. Its recreational use and trade in retail outlets have been prohibited in several countries, but this drug remains readily available for purchase through the internet. Along with the increasing number of anecdotal reports on its abuse published in drug forums and blogs, the number of poisonings described in scientific literature sharply increased, including one fatality, thus evidencing the health threats associated with 3,4-DMMC. The present work reviews the available data on 3,4-DMMC pharmacodynamics, pharmacokinetics, and clinical effects. Euphoria, empathy, and insomnia accompanied by severe headache, hypertension, tachycardia, dehydration, seizures, and psychomotor agitation were among the most frequent effects noted for 3,4-DMMC. Nasal intake is associated to severely burned nostrils, nose bleeding and intense rhinorrhoea, throat corrosion and tear over-secretion. 3,4-DMMC is a potent releaser of dopamine and noradrenaline, and preferentially inhibits noradrenaline and serotonin uptake transporters, leading to sympathomimetic stimulation. The drug has also high affinity to adrenergic and 5-HT2A/2C receptors. N-Demethylation, ß-ketoreduction, hydroxylation, and oxidation are the major reactions involved in the production of 3,4-DMMC metabolites, with higher relevance for toxicological analysis in urine, along with the parent compound. In what concerns the toxic effects at target organs, the underlying mechanisms and the relevance of metabolism for these effects, there is an immense scope to be explored. Information on this matter will certainly help finding possible therapeutic solutions for the drug intoxications.