4-Fluoromethcathinone

Substance identification
4-Fluoromethcathinone (flephedrone; 4-FMC) is chemically (R,S)-1-(4-fluoro- phenyl)-2-methylaminopropan-1-one.

Previous review
4-FMC had not been previously pre-reviewed or critically reviewed by the Committee. A direct critical review was proposed based on information brought to WHO’s attention that 4-FMC is clandestinely manufactured, poses an especially serious risk to public health and society, and has no recognized therapeutic use by any party. Preliminary data collected from the literature and from different countries indicated that this substance may cause substantial harm and that it has no medical use.

Similarity to known substances and effects on the central nervous system
4-FMC is a ring-substituted analogue of methcathinone. Key features related to the mechanisms of action are comparable with psychostimulants and medicinal products that target the monoaminergic system. 4-FMC was observed to function as a catecholamine-selective substrate-type releaser of dopamine and norepinephrine. Similarities to psychomotor stimulants such as cocaine, methcathinone and methamphetamine have been shown, although 4-FMC appears to be less potent. Very few non-fatal and fatal intoxications involving 4-FMC have been reported in the literature.

Dependence potential
No detailed clinical studies in humans are available.

Actual abuse and/or evidence of likelihood of abuse
No detailed clinical studies in humans are available. Preclinical data indicate pharmacological overlaps with some classical psychostimulants suggesting the possibility of abuse liability. Fifteen Member States confirmed recreational/ harmful use of 4-FMC.

Therapeutic usefulness
4-FMC has no recorded therapeutic applications or medical use.

Recommendation
Owing to the current insufficiency of data regarding dependence, abuse and risks to public health, the Committee recommended that 4-FMC not be placed under international control at this time but be kept under surveillance.