Intravenous mephentermine abuse: A case series of psychiatric complications

Abstract:

Mephentermine, a sympathomimetic drug with stimulant properties similar to amphetamines, has emerged as a substance of abuse, particularly in the fitness and bodybuilding communities. Despite its declining medical use globally, it remains available in India, creating unique substance use patterns and psychiatric complications. We describe three cases of IV mephentermine abuse, highlighting vulnerability factors as well as mental health consequences. The first case is that of a young gym trainer who developed psychosis after IV mephentermine use for 8 months. The second case describes a 22-year-old male with premorbid conduct disorder, adult attention-deficit/hyperactivity disorder, and stimulant abuse presenting with IV mephentermine use and anxiety symptoms. The third case demonstrates the case of a professional bodybuilder who presents with polysubstance use (anabolic steroids, benzodiazepines, and mephentermine), depressive symptoms, and attempted self-harm. All three cases showed rapid dose escalation, other comorbid substance use, and clinically significant psychiatric comorbidities. Individualized treatment approaches and challenges in the three cases involving treating dual diagnosis, vulnerabilities, and substance dependence have been discussed. These cases indicate the complex interplay between performance enhancement goals: progression of substance use disorder and evolution of psychiatric comorbidities.