Background
NACD Advisory about DOB.
- White tablets without any logo have appeared in Ireland.
- Taken as Ecstasy, these tablets actually contain DOB - Dimethoxy Bromoamphetamine.
- This was first made in the late 1960's.
- Street name "Snowballs" .
- White tablets, No logo.
- Slightly smaller than MDMA, more rounded at the edges.
Pharmacology & Clinical
- Potent hallucinogenic amphetamine (different to Ecstasy).
- May take up to 3 hours to have an effect (last from 8 to 24 hours) so people take more expecting early effect.
Clinical effects
- Energising effect & very pronounced hallucinations (v different to E).
- Risks of delusional behaviour and psychotic reactions.
- Larger doses - memory loss, irrational violence / self-harm.
- Vascular spasm can result in limb gangrene
Suspect in patient who is agitated or who hallucinates after taking "ecstacy"
Management
- Agitation treated with benzodiazepines
- Heparin ± nitroprusside for spasm