Abuse, Toxicology and the Resurgence of Propylhexedrine: A Case Report and Review of Literature

Propylhexedrine, the active ingredient in over-the-counter nasal decongestants, carries significant abuse potential for users seeking psychostimulant effects. Historically, propylhexedrine was perceived to have a good safety profile resulting in endorsement of it replacing the highly abused amphetamine sulfate as the active ingredient in nasal decongestants in 1949. While much of the published literature concerning its psychoactive potential comes from the 1970s and 1980s, we have encountered several recent cases of toxidrome secondary to its abuse. Awareness of the hazards associated with this pharmaceutical should be of interest to physicians of all specialties who are likely to encounter such cases, as well and legislators interested in exerting regulatory control. Here we review all existing literature concerning this pharmaceutical compound.