In 1997 three unrelated death because of drugs got reported to the Forensic Science Laboratory of the Netherlands. The substance in question was a new ring-substituted amphetamine derivative.In 1998 two additional cases of this still unknown compound where added to the list, the incidents were reported to the IPSC (Institut de Police Scientifique et de Criminologie, University of Lausanne, Switzerland). In both the Netherlands and Swiss the unknown compound was encountered as in the hydrochloride salt form, and pictures of the different tablets were compared to each other. After an investigation, it appeared that in other European countries such as the United Kingdom and Germany the derivative was also encountered. The new drug even got as far as Australia. After analytical research, the compound was identified as 4-methylthioamphetamine (4-MTA). This was an already known compound originally only intended for pharmacological studies on animals. The studies of 4-MTA by David Nichols were then linked to the tablets found in all the different countries.
4-MTA was developed by the research team led by David E. Nichols but was intended to be used only as an agent for laboratory research into the serotonin transporter protein. Nichols was reportedly sad to see 4-MTA appear as a drug of abuse on the street. He said after finding out his research was used as a dangerous serotonin releasing drugs: ‘’I was stunned. I had published information ultimately led to human death. Nicholas intentions were to discover how MDMA worked in the brain to eventually find a positive use for it in psychotherapy. Nichols studied thereby molecules with similar structure, including 4-MTA. Between 1992 and 1997 they published three papers on the effects of this drug in rats and the idea that it could potentially be used in the treatment of depression and be a potential replacement for Prozac. Without the knowledge of Nichols and his team, others synthesized the drugs into a tablet. These tablets were known by their street name, named ‘flatliners’, Nichols’ laboratory had published that the rats experienced the same euphoric effects as ecstasy, which was probably the motivation for its production and distribution to humans. Nicholas also said: ‘’I have never considered my research to be dangerous, and in fact hoped one day to develop medicines to help people.’’. Because of the 4-MTA relating death, Nicholas laboratory was asked to study the human effects of other materials they have research, to avoid likewise situation as with 4-MTA. Fortunately, most of the molecules the laboratory further had published could not kill in reasonable dosages.
The typical tablets sold on the street contained approximately between 100–140 mg 4-MTA. 4-MTA was briefly sold in smart shops in the Netherlands, though was soon banned by the Dutch government after serious side-effects started to emerge. The Union of Smartshop Owners decided to leave it out of their assortiment after they discovered the drug had only been tested on rats. It was also briefly sold on the black market as MDMA during the late 1990s, mainly in the USA, but proved unpopular due to its high risk of severe side effects (several deaths were reported) and relative lack of positive euphoria.
4-MTA is a strong serotonin releaser similar to paramethoxyamphetamine (PMA), which can cause pronounced hyperthermia potentially resulting in organ failure and death. Therefore, the major neuropharmacological effect is an increased release of serotonin, and the inhibition of serotonin uptake of mono oxidase A (MAO-A). The combination of the releasing of serotonin from neurons, but the prevention of breaking this neurotransmitter down again, leads to dangerous serotonin syndrome. The serotonin syndrome is a hyper serotonergic state, which can be become fatal and is an side effect of serotonergic enhancing drugs. The symptoms of serotonin syndrome are described in the Report on the Risk Assessment of 4-MTA
Symptoms of serotonin syndrome