N-Ethylhexedrone

Substance identification
N-Ethylhexedrone (2-(ethylamino)-1-phenylhexan-1-one) is a synthetic cathinone also known as NEH and hexen. Although originally synthesized and described as a potential anorexigenic agent, N-ethylhexedrone has appeared as a new psychoactive substance on global markets only since 2016.

WHO review history
N-Ethylhexedrone has not been reviewed previously. A critical review was proposed on the basis of information brought to WHO’s attention that N-ethylhexedrone is manufactured clandestinely, poses a risk to public health and society and has no therapeutic use recognized by any Party.

Similarity to known substances and effects on the central nervous system
Similar to other psychostimulants, such as other synthetic cathinones, N-ethylhexedrone increases extracellular concentrations of the neurotransmitters dopamine and noradrenaline. N-Ethylhexedrone is structurally similar to pentedrone, which is listed in Schedule II of the Convention on Psychotropic Substances of 1971.

Human users of N-ethylhexedrone describe psychostimulant effects such as euphoria, empathy, an enhanced sense of well-being, increased talkativeness, sociability, insomnia, increased creativity, increased libido, increased concentration and sensory enhancement. Also, like other psychostimulants, rebound effects such as fatigue, depressive states, anxiety, irritability and insomnia are reported to occur after the initial effects of the drug.

Observation of hospital admissions due to intoxication and users’ reports indicate that the adverse effects of N-ethylhexedrone include hypertension, tremors, convulsions, chest pains, tachycardia, dysrhythmia, limb numbness and elevated temperature. These effects are similar to those of other psychostimulants.

Dependence potential
No controlled experimental studies of the dependence potential of N-ethylhexedrone have been reported in animals or humans. In view of its action on the central nervous system, however, N-ethylhexedrone would be expected to produce a state of dependence similar to amphetamine and other psychostimulants.

Actual abuse and/or evidence of likelihood of abuse
In drug discrimination tests in animals that are predictive of subjective effects in humans, N-ethylhexedrone had methamphetamine- and cocaine-like effects that suggest similar abuse liability.

N-Ethylhexedrone has been detected in biological fluids collected from several cases of non-fatal intoxication as well as one fatality. In some of these cases, N-ethylhexedrone was the only drug detected.

A number of countries in various regions have reported use or detection of the compound in seized materials, including in used syringes.

Therapeutic usefulness
N-Ethylhexedrone is not known to have any therapeutic use.

Recommendation
N-Ethylhexedrone (2-(ethylamino)-1-phenylhexan-1-one) is a synthetic cathinone with effects similar to those of other synthetic cathinones that are listed as Schedule II substances in the Convention on Psychotropic Substances of 1971. Its mode of action and effects are consistent with those of other cathinones, indicating that it has the potential for dependence and likelihood of abuse. There is evidence that use of N-ethylhexedrone in a number of countries in various regions has resulted in cases of fatal and non-fatal intoxication. The substance causes substantial harm and has no therapeutic use.

■ Recommendation: The Committee recommended that N-ethylhexe- drone(2-(ethylamino)-1-phenylhexan-1-one) be added to Schedule II of the 1971 Convention on Psychotropic Substances.