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Intravenous Abuse of Propylhexedrine (Benzedrex®) and the Risk of Brainstem Dysfunction in Young Adults

Published online by Cambridge University Press:  18 September 2015

Luis Fornazzari ,
Peter L. Carlen  and
Bhushan M. Kapur
Luis Fornazzari*
Affiliation:
Addiction Research Foundation, Clinical Institute and Departments of Medicine (Neurology), Physiology and Clinical Biochemistry, University of Toronto
Peter L. Carlen
Affiliation:
Addiction Research Foundation, Clinical Institute and Departments of Medicine (Neurology), Physiology and Clinical Biochemistry, University of Toronto
Bhushan M. Kapur
Affiliation:
Addiction Research Foundation, Clinical Institute and Departments of Medicine (Neurology), Physiology and Clinical Biochemistry, University of Toronto
*
Neurology Program, Department of Medicine (Neurology), University of Toronto, Addiction Research Foundation, Clinical Institute, 33 Russell Street, Toronto, Ontario, Canada M5S 2S1
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Abstract:

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In 1949, amphetamine sulfate was replaced by propylhexedrine in the nasal decongestant agentBenzedrex® because of psychosis, sudden death, and widespread abuse. Propylhexedrine is not without risks, and reported cases of psychosis, myocardial infarction, pulmonary vascular disease and pulmonary hypertension, and sudden death are well documented in the medical literature. We are reporting 2 cases of definite brainstem dysfunction and 5 cases of transient diplopia secondary to IV abuse of Benzedrex®. This widely abused drug is prepared by heating Benzedrex® and hydrochloric acid, and the resulting crystals are dissolved in water for injection. This agent is called “stove-top speed”. All 7 patients had transient diplopia, within seconds after injection. One patient had evidence of a right-internuclear opthalmoplegia, and another had a depressed right gag reflex and paralysis of the right half of the tongue. The deficits in these two patients, persisted for many months. In young adults with history of drug abuse, the IV use of Benzedrex® should be considered in the differential diagnosis of transient or permanent focal brainstem deficits.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 13 , Issue 4 , November 1986 , pp. 337 - 339
Copyright
Copyright © Canadian Neurological Sciences Federation 1986

References

1.Monroe, R, Drell, HJ.Oral use of stimulants obtained from inhalers. JAMA 1947; 135(14): 909–915.CrossRefGoogle ScholarPubMed
2.Norman, J, Shea, JT.Acute hallucinosis as a complication of addiction to amphetamine sulfate. N Engl J Med 1945; 233: 270–271.CrossRefGoogle Scholar
3.Smith, LC.Collapse with death following the use of amphetamine sulfate. JAMA 1939; 113: 1022–1023.CrossRefGoogle Scholar
4.Gyorgy, H.Benzedrine intoxication. Bull US Army M Dept. 1946; 6: 204–205.Google Scholar
5.Mclntyre, D.Psychosis due to nasal decongestant abuse. British Journal of Psychiatry 1976; 12: 93–94.CrossRefGoogle Scholar
6.Pallis, DJ, Barraclough, BM, Tsiantis, J.Psychosis and nasal decongestants. The Practitioner 1972; 209: 676–678.Google ScholarPubMed
7.Anderson, ED.Propylhexedrine (Benzedrex) psychosis. New Zealand Medical Journal 1972; 1: 302.Google Scholar
8.Marsden, P, Sheldon, J.Acute poisoning by propylhexedrine. British Medical Journal 1972; 1: 730.CrossRefGoogle ScholarPubMed
9.Anderson, RJ, Reed, WG, Hills, LD.History, epidemiology and medical complications of nasal inhaler abuse. J Toxicol Clin Toxicol 1982; 19(1): 95–107.CrossRefGoogle ScholarPubMed
10.White, L, DiMaio, VJM.Intravenous propylhexedrine and sudden death. N Engl J Med 1977: 297(19): 1071.Google ScholarPubMed
11.Riddick, LR, Reisch, R.Oral overdose of propylhexedrine. J Foren Sci 1981; 26: 834–839.CrossRefGoogle ScholarPubMed
12.Anderson, R, Garza, H, Garriot, JC, MiMaio, V.Intravenous propylhexedrine (Benzedrex®) abuse and sudden death. Amer J Med 1979; 67: 15–20.CrossRefGoogle ScholarPubMed
13.Fornazzari, L, Wilkinson, DA, Kapur, BM, Carien, PL.Cerebellar cortical and functional impairment in toluene abusers. Acta Neurol Scand 1983; 67: 319–329.CrossRefGoogle ScholarPubMed
14.Beselt, RC.In: Propylhexedrine. Disposition of toxic drugs. In: Davis Biomedical Publishers, California, 1982, pp. 679–681.Google Scholar
15.Harrington, H, Heller, A, Dawson, D.Caplan, L, Crumbagh, C.Intracerebral hemorrhage and oral amphetamine. Arch Neurol 1983; 40: 503–507.CrossRefGoogle ScholarPubMed
16.Rumbagh, CL, Bergeron, RT, Scanlan, RL.Cerebral vascularchanges secondary to amphetamine abuse in the experimental animal. Radiology 1971; 101: 345–351.CrossRefGoogle Scholar
17.Escalante, OD, Ellinwood, EH.Effects of chronic amphetamine intoxication in adrenergic and cholinergic structures in the central nervous system. Histochemical observations in cats and monkeys. In Ellinwood, EH, Cohen, S.(Editors): Current Concepts on Amphetamine abuse. Rockville, Md, MINH, US Dept. of Health Education and Welfare publication (HSM) 72–9085, 1972, pp. 97–106.Google Scholar
18.Citron, BP, Halpern, M, McCarron, M.Nectrotizing angintis associated with drug abuse. N Engl J Med 1970: 283: 1003–1011.CrossRefGoogle Scholar
19.Goldensohn, ES. ed. The non convulsive epilepsies: Clinical manifestations, diagnostic considerations and treatment. Epilepsia 1983; 24 (Suppl) 51–582.Google Scholar