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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 agent Benzedrex® 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

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