Case Report: An Overdose of Melanotan 2 – the Barbie Drug
Published Date: 04th May 2020
Publication Authors: Gibney E
Background
We present a case of accidental Melanotan 2 overdose. Melanotan 2 is an illegal injectable drug consisting of an Alpha Melanocyte Stimulating Hormone analogue used to increase tanning and sexual performance, and known colloquially as the Barbie Drug. Currently the evidence base for management of Melanotan 2 overdose is limited to several case reports and animal studies.
Case Presentation
This is a case of a 38-year-old woman with a history of Anxiety, PTSD and chronic pain who presented two hours post accidental overdose of Melanotan 2. She had intended to take 0.1 ml of a 10 mg/ml solution, however had given herself 1 ml (10 mg). On admission, she was hypertensive (BP 157/89), vomiting, tachycardic (120bpm), diaphoretic and anxious. She was also experiencing profound muscle spasms which had not responded to initial simple analgesia. After she failed to respond to significant doses of opiate and benzodiazepine we consulted both Toxbase and the National Poisons service and adopted a multimodal approach to management including opiates, high dose benzodiapines and ketamine. This case was complicated by the fact that the patient, diagnosed with chronic back pain, took significant doses of long and short acting opiates daily to manage her pain. The patient was admitted to Intensive Care overnight for observation and discharged home the following day. There is a limited evidence base for managing these cases however case reports suggest sympathomimetic symptoms (1) including those experienced by our patient and priapism (2), with extreme cases developing raised Creatinine Kinase levels and Rhabdomyolysis (2).
Conclusions
In this case we discuss the use of polypharmacy in the approach to managing severe acute pain and muscle spasms, particularly with regard to chronic pain patients. Melanotan 2 is an illegal drug which requires the user to mix, draw and dose themselves correctly, with limited instruction and with increasingly common use it can be expected that more cases of toxicity will be seen. Therefore, understanding different possible approaches to management is required.
Gibney, E; Findlay, E. (2020). Case Report: An Overdose of Melanotan 2 – the Barbie Drug. Journal of the Intensive Care Society. 21 (2), 136