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Bath salts (synthetic cathinones) commonly contain multipe synthetic drugs and can be ingested, smoked, or administered intravenously. The designer stimulant mephedrone (4-methylcathinone) is among the most popular of the derivatives of the naturally occurring psychostimulant cathinone. Bath salt use is on the rise and is responsible for a large number of ED visits.
In spite of their ban, bath salts are still available over the counter in specialty shops and through the Internet with common product names such as: "Ivory Wave," "Cloud 9," "Purple Wars," "Vanilla Sky," "Bliss," etc. They are commonly marketed with the disclaimer, "not for human consumption."
Their presentation mimics other sympathetic drugs through pathways similar to amphetamines. The primary psychological effects have a duration of roughly 3-4 hours, with physiologic effects lasting from 6-8 hours.
| Physical Effects | Behavioral & Mental Status Effects |
| Tachycardia | Agitation |
| Hypertension | Paranoia |
| Dysrhythmias | Hallucinations |
| Hyperthermia | Psychosis |
| Seizures | Violent behavior |
| Sweating | Delusions |
Management is largely supportive and includes IV hydration, benzodiazepines, and close monitoring in the ICU setting.
References
Imam SF, Patel H, Mahmoud M, et.al. Bath salts intoxication: A case series. JEM 2013;45(3):361-365.