Recent Paramethoxyamphetamine Deaths

Paramethoxyamphetamine (PMA) is a methoxylated phenethylamine derivative that has been used illicitly in Australia since late 1994. It is purportedly sold under the guise of “ecstasy”, which is the colloquial name for methylenedioxymethamphetamine (MDMA). Methods for extraction, identification, and quantitation are presented. Toxicology findings in six fatalities involving the drug are discussed. Femoral blood PMA levels ranged from 0.24 to 4.9 mg/L (mean, 2.3 mg/L). Liver PMA levels ranged from 1.4 to 21 mg/kg (mean, 8.9 mg/kg). Other amphetamines were found in five of the six cases. Blood PMA levels in three nonfatal cases are also presented. PMA appeared to be more toxic than MDMA, and blood levels greater than 0.5 mg/L seemed likely to be associated with toxic effects.