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Loi B, Zloh M, De Luca MA, Pintori N, Corkery J, Schifano F. 
“4,4'-Dimethylaminorex (4,4'-DMAR; Serotoni) misuse: A Web-based study”. 
Hum Psychopharmacol. 2017 May 28;32(3).

BACKGROUND: 4,4'-DMAR (4,4'-dimethylaminorex; Serotoni) is a potent stimulant drug that has recently been associated with a number of fatalities in Europe. Over the last few years, online communities have emerged as important resources for disseminating levels of technical knowledge on novel psychoactive substances.

Analysing the information provided by the fora communities on 4,4'-DMAR use, additionally critical reviewing the available evidence-based literature on this topic.

METHODS: Different website drug fora were identified. A critical review of the existing evidence-based literature was undertaken. Individuation and analysis of qualitative data from the identified website fora were performed.

RESULTS: The combined search results identified six website fora from which a range of qualitative data on recurring themes was collected. These themes included routes of administration and doses; desired effects; adverse effects; comparison with other drugs; association with other drugs; medications self-administered to reverse 4,4'-DMAR action; overall impression; and provision of harm-reduction advice.

CONCLUSIONS: Although being characterized by a number of methodological limitations, the social networks' Web monitoring approach (netnography) may be helpful to better understand some of the clinical and psychopharmacological issues pertaining to a range of novel psychoactive substances, including 4,4'-DMAR, for which only extremely little, if any, scientific knowledge is available.
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