Self-defenestration associated with 3-MeO-PCE ingestion

New psychoactive substances (NPS) continue to proliferate worldwide, and the pharmacological and toxicological profiles of many remain poorly characterized. Arylcyclohexylamines, derivatives of phencyclidine (PCP) that act as potent N-methyl-D-aspartate (NMDA) receptor antagonists, produce profound dissociative and psychotomimetic effects. 3-Methoxyeticyclidine (3-MeO-PCE), an analog of eticyclidine, has recently appeared on the recreational drug market, yet information on its pharmacology, metabolism, and toxicity are scarce, and only one postmortem blood concentration has been reported to date.

We report the death of a 33-year-old man found beneath his apartment window after a fall of 5.8 m. Autopsy confirmed death from multiple traumatic injuries consistent with a fall from height. Toxicological analysis of peripheral blood identified 3-MeO-PCE (80 µg/L), its metabolite 3-HO-PCE (13 µg/L), tramadol (674 µg/L), and ethanol (0.18 g/L).

Although trauma was the immediate cause of death, the behavioral effects of 3-MeO-PCE-possibly potentiated by tramadol and alcohol-may have contributed to the manner of death. The disordered state of the apartment, together with the absence of any psychiatric history or suicidal indicators, is compatible with acute agitation or dissociation induced by substance use. This case highlights the potential for serious behavioral disturbances associated with 3-MeO-PCE and adds a new peripheral blood concentration to the limited forensic literature on this compound.