Rhabdomyolysis and Acute Kidney Injury after Use of 3-Methyl-PCP: A Case Report

Abstract

Introduction
Dissociative agents, such as phencyclidine (PCP) and ketamine, belong to the arylcyclohexylamine class. During illicit synthesis, numerous analogs of PCP can be produced. To date, over 60 psychoactive “designer” derivatives have been identified, and most are undetectable by standard drug testing. This case describes the first laboratory-confirmed use of 3-methyl-PCP, a novel arylcyclohexylamine dissociative anesthetic.

Case Report
A 29-year-old man presented to the emergency department after a drug overdose experiencing encephalopathy, tachycardia, hypertension, nystagmus and diaphoresis. Diagnostics revealed severe rhabdomyolysis and acute kidney injury. During hospitalization, the patient disclosed the use of 3-methyl-PCP obtained online. The drug product and biological specimens were sent to the Center for Forensic Science Research and Education (CFSRE) for comprehensive drug testing, which confirmed the presence of 3-methyl-PCP using gas chromatography-mass spectrometry and liquid chromatography-quadrupole time-of-flight mass spectrometry.

Discussion
This confirmed case of 3-methyl-PCP intoxication not only demonstrates the potential for severe injury, but also the public health risks of rapidly emerging and unregulated dissociative synthetic anesthetics. Entities such as the CSFRE NPS Discovery Program’s early drug warning system can prove critical for both timely clinical response and public health protection.