"Bath salts" are a group of synthetic derivatives of cathinone, a naturally occurring psy-chostimulant found in khat plants. The most common active ingredients, mephedrone, methylenedioxypyrovalerone, and methylone, are found to have strong amphetamine-like psychoactive properties. Smoked, inhaled, injected, or ingested, they have a rapid onset of action of 30 to 60 minutes. Reported effects are improved alertness, increased musical sensations, heightened libido/sexuality, euphoria, and relaxation, caused by rapid release and reuptake blockade of primarily dopamine, serotonin, or norepinephrine. We present the case of a 42-year-old woman who developed an acute psychotic reaction and serotonin toxicity after an episode of bath salts intoxication.
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