Propylhexedrine: a vintage drug of abuse, rediscovered

In 1949, propylhexedrine replaced amphetamine sulfate as the active ingredient in over the counter Benzedrex due to reports of widespread abuse, psychosis and sudden death. Since its introduction, cases of psychosis, myocardial infarction, pulmonary vascular disease, pulmonary hypertension, and sudden death attributed to propylhexedrine abuse have been well documented, usually in the form of single case reports. Although growing concerns during the 1980's regarding its abuse potential and its use as a precursor in the manufacture of compounds of even higher abuse potential caused propylhexedrine to be reviewed by the WHO Expert Committee on Drug Dependence, no formal studies of the dependence potential of propylhexedrine exists to date. The following is a case of propylhexedrine dependence, with some of its history, revisited.