The abuse potential of oxethazaine: effects of oxethazaine on drug-seeking behavior and analysis of its metabolites in plasma and hair in animal models

Oxethazaine, an over-the-counter (OTC) antacid, is a precursor of phentermine, which is the most abused anorectic by methamphetamine users in Korea. However, no studies have investigated the abuse potential of oxethazaine. Therefore, we examined and compared the consequences of oxethazaine and phentermine treatment on animal models of conditioned place preference (CPP) and self-administration. Furthermore, oxethazaine and its metabolites in rat plasma were monitored using liquid chromatography-tandem mass spectrometry (LC-MS/MS) after oxethazaine administration, and compared with phentermine itself after phentermine administration to clarify the relationship between phentermine production by oxethazaine ingestion and the possible oxethazaine dependence. Oxethazaine metabolites were also determined by LC-MS/MS in rat hair after oxethazaine administration to investigate the possibility of phentermine detection in hair from oxethazaine abusers. In the behavioral experiment, phentermine (3mg/kg) produced CPP in mice while oxethazaine (5, 10, and 15mg/kg) did not. Moreover, phentermine (0.25mg/kg/infusion) was self-administered by rats at 80% of free-feeding weight, whereas oxethazaine was not. In the analytical study, mephentermine and phentermine, both oxethazaine metabolites, were detected below the limit of quantitation or not detected in both plasma and hair from rats that had ingested oxethazaine (10mg/kg, single dose or for 2weeks). On the other hand, phentermine was detected in plasma and hair samples from rats that had ingested phentermine (10mg/kg, single dose or for 2weeks). Consequently, phentermine induced significant rewarding effects, but oxethazaine did not. Presumably, either oxethazaine does not have any abuse potential or oxethazaine metabolism to phentermine does not result in a pharmacologically active level of psychostimulant in the body. Furthermore, phentermine was not a major metabolite in hair obtained from oxethazaine abusers, which should make it possible to differentiate between chronic oxethazaine and phentermine users.