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    4-MMC molecular structure

    4-MMC Stats & Data

    Meow Drone M-cat Bubble Meow meow 4-methylmethcathinone 4mmc mephedrone
    NPS DataHub
    MW177.25
    FormulaC11H15NO
    CAS1189805-46-6
    IUPAC(''RS'')-2-Methylamino-1-(4-methylphenyl)propan-1-one
    SMILESCNC(C)C(=O)c1ccc(C)cc1
    InChIKeyYELGFTGWJGBAQU-VIFPVBQESA-N
    Phenethylamines Cathinones
    Chemical Class Substituted cathinone
    Psychoactive Class Stimulant / Entactogen

    Interaction Warnings

    ⚠ mdma

    The neurotoxic effects of MDMA may be increased when combined with other stimulants.

    ⚠ cocaine

    This combination may increase strain on the heart.

    Pharmacology

    DrugBank

    Description

    Mephedrone has been investigated in Alcohol-Related Disorders and Amphetamine-Related Disorders.

    Mechanism of Action

    Mephedrone shares a number of effects with MDMA and methamphetamine on the CNS, interacting with monoamine plasma membrane transporters for serotonin (5-hydroxytryptamine, 5-HT) dopamine (DA) and likely norepinephrine (NE), blocking their reuptake, while stimulating their release. It was originally hypothesized that mephedrone could cause methamphetamine-like neurotoxicity due to the fact that it simultaneously stimulates both DA release and inhibition of its uptake, cause hyperthermia and increase the locomotor activity. Moreover, mechanistic and structural similarities with MDMA and methamphetamine led to the hypothesis that mephedrone could also cause toxic effects to DA nerve terminals. However, this hypothesis was ruled out after a number of studies 12, 38, 40, 46-48. In addition, its effects are evident not only on dopaminergic and -serotoninergic systems, but also on other pathways. As an example, German et al. demonstrated that neuropeptide neurotensin content in the limbic system and basal ganglia was increased after four injections of mephedrone at the dose of 25 mg/kg.

    History & Culture

    1929–present

    Mephedrone was first synthesized in 1929 by Saem de Burnaga Sanchez, who published his work in the Bulletin de la Société Chimique de France under the chemical name "toluyl-alpha-monomethylaminoethylcetone." Following this initial synthesis, the compound remained an obscure product of academic chemistry for over seven decades, attracting no significant attention from researchers or the broader public.

    2003–2007

    The compound was rediscovered in 2003 when an underground chemist operating under the pseudonym "Kinetic" posted a synthesis report on The Hive, a now-defunct online forum for amateur chemistry discussion. Kinetic described synthesizing the substance out of curiosity and reported experiencing effects comparable to MDMA, noting a sense of well-being that he had not encountered from other substances. This post brought mephedrone to the attention of clandestine drug manufacturers. Following this rediscovery, the drug was commercially introduced in Israel by Ezekiel Golan, a mathematician known as "Dr. Z" or "Dr. Zee." A related cathinone product called "hagigat" had been sold legally in Israel since approximately 2004. After Israeli authorities banned hagigat, modified formulations were developed and marketed by the company Neorganics under names such as "Neodoves pills," though this product line was discontinued in January 2008 following regulatory action. By 2007, mephedrone had become available for purchase through international online vendors.

    2007–2010

    Between 2007 and 2010, mephedrone underwent rapid proliferation across Europe, Australia, and New Zealand. Law enforcement agencies first became aware of the compound in 2008, and by 2010 it had been reported in most European countries. The United Kingdom experienced particularly significant uptake, with usage growing substantially between the summer of 2009 and March 2010. During this period, mephedrone became readily available at music festivals, head shops, and through online retailers. A 2009 survey of Mixmag readers found it had become the fourth most popular recreational drug in the UK, trailing only cannabis, cocaine, and MDMA. The drug attracted users from diverse social backgrounds. Researchers, charity workers, teachers, and users themselves all reported observing widespread and increasing use during 2009. Criminologist Fiona Measham of Lancaster University suggested that mephedrone's rapid adoption was partly attributable to the concurrent decline in quality of traditional stimulants. Data indicated that average cocaine purity in the UK had fallen from approximately 60% in 1999 to 22% by 2009, while roughly half of ecstasy tablets seized in 2009 contained no MDMA whatsoever. This decline has been partially attributed to the seizure of 33 tonnes of sassafras oil, a key MDMA precursor, in Cambodia in June 2008. Similar patterns emerged in the Netherlands, where testing found mephedrone present in approximately 20% of ecstasy tablets by mid-2009.

    2009–2010

    The emergence of mephedrone was accompanied by significant media attention, much of which contained inaccuracies or exaggerations. Major news organizations incorrectly reported that the substance was commonly used as a plant fertilizer; in reality, vendors marketed it as "plant food" specifically to circumvent laws prohibiting the sale of compounds intended for human consumption. In late 2009, UK newspapers began referring to the drug as "meow" or "miaow," sometimes doubled as "meow meow," despite these terms being largely unknown among actual users at the time. In November 2009, The Sun published a sensationalized story claiming a user had severely injured himself while under the influence of mephedrone. This account was later traced to an obvious joke posted on an internet forum, which had been uncritically incorporated into a police report and subsequently treated as factual by journalists. The period was characterized by considerable media hysteria, including deaths being falsely attributed to the substance.

    Subjective Effects

    Physical

    The physical effects of mephedrone can be broken down into several components which progressively intensify proportional to dosage.

    • Spontaneous tactile sensations: The body high of mephedrone can be described as a moderate to extreme euphoric tingling sensation that encompasses the entire body. It is capable of becoming overwhelmingly pleasurable at higher dosages. This sensation maintains a consistent presence that steadily rises with the onset and hits its limit once the peak has been reached.
    • Stimulation: In terms of its effects on the user's physical energy levels, mephedrone is commonly considered to be extremely stimulating and energetic. This encourages activities such as running, climbing and dancing in a way that makes mephedrone a popular choice for musical events such as festivals and raves. The particular style of stimulation which mephedrone presents can be described as forced. This means that at higher dosages it becomes difficult or impossible to keep still, as jaw clenching, involuntarily bodily shakes and vibrations become present, resulting in an extreme unsteadiness of the hands and a general lack of motor control.
    • Vibrating vision: A person's eyeballs may begin to spontaneously wiggle back and forth in a rapid motion, causing vision to become blurry and temporarily out of focus-- a condition known as nystagmus.
    • Dehydration: Dry mouth and dehydration are a universal experience with mephedrone and are a product of an increased heart rate and extreme motivation to engage in strenuous physical activities. While it is important to avoid becoming dehydrated, especially when out dancing in a hot environment, there is a potential possibility of suffering from water intoxication through over-drinking so it is advised that users simply sip at water and never over drink.
    • Difficulty urinating: Higher doses of mephedrone result in an overall difficulty when it comes to urination, an effect that is completely temporary and harmless.
    • Vasoconstriction: A survey conducted by the UK's National Addiction Centre reported that 15% of mephedrone users experienced cold or blue fingers and lips indicative of vasoconstriction occurring.
    • Tactile enhancement
    • Increased heart rate
    • Increased perspiration
    • Increased blood pressure
    Cognitive

    The cognitive effects of mephedrone can be broken down into several components which progressively intensify proportional to dosage. The general head space of mephedrone is described by many as one of extreme mental stimulation and powerful euphoria. It contains a large number of typical stimulant cognitive effects.

    • Euphoria: Strong emotional euphoria and feelings of happiness are present within mephedrone and are likely a direct result of serotonin and dopamine release.
    • Thought acceleration
    • Analysis enhancement
    • Empathy, love and sociability enhancement: This particular effect, although distinct, is far less prominent than the same effect found within traditional entactogens such as MDMA or 2C-B
    • Time distortion: Strong feelings of time compression are common within mephedrone and speed up the experience of time quite noticeable.
    • Ego inflation
    • Disinhibition
    • Motivation enhancement
    • Anxiety
    • Compulsive redosing
    • Cognitive fatigue: This component can occur during the offset of this compound as a rebound effect which is usually equal in its intensity to the enhancements which occurred before it.

    Forked from Subjective Effect Documentation by Josie Kins, September 2015. Via dose.wiki (CC0).

    Toxicity

    PsychonautWiki DrugBank

    Almost nothing is known about the long-term effects of mephedrone due to its short history of its use. Along side of this, the exact toxic dosage is unknown. In 2010, unconfirmed reports speculated about the role mephedrone has played in the deaths of several young people in the UK. By July 2010, mephedrone had been alleged to be involved in 52 fatalities in the UK, but detected in only 38 of these cases. Of the nine that coroners had finished investigating, two were caused directly by mephedrone.

    Toxicity (DrugBank)

    Mephedrone ... does not cause neurotoxicity to dopamine nerve endings of the striatum.

    Effect Profile

    Curated + 97 Reports
    Empathogen 6.7

    Strong euphoria and stimulation with moderate empathy, mild sensory enhancement

    Empathy / Social Openness×3
    67.4 2/20
    Euphoria / Mood Elevation×2
    810 2/20
    Stimulation×1
    88.7 3/20
    Sensory Enhancement×1
    510 3/20
    Catalog Erowid

    User Experiences

    Euphoria "------------------------------------------------------------------------------------------ Update: well hell, those were a wild and wonderful few years." — Bluelight ↗
    Stimulation "There is no coke in coke anymore and if there is it's overwhelmed by the jittery shittiness of being cut hard with ephedrine, at least that's what my test results have come up with." — Bluelight ↗
    Empathy "Spent a while puking about then about 8 hours of intense tripping, way beyond the point where 2c-b is a fun enjoyable sociable fun drug." — Bluelight ↗
    Stimulant 6.0

    Strong euphoria with moderate stimulation, mild anxiety/jitters, low focus

    Stimulation / Energy×3
    78.9 2/20
    Euphoria / Mood Lift×2
    99.9 4/20
    Focus / Productivity×2
    21.6 2/20
    Anxiety / Jitters×1
    510 3/20
    Catalog Erowid

    User Experiences

    Euphoria "It’s a bit rushy too." — Bluelight ↗
    Stimulation "I had 3-mmc with a few drinks recently and it was quite pleasant like diet mepth....kept me awake..did some creative stuff." — Bluelight ↗
    Anxiety/jitters "In my experience, meph and MD have very different comedown effects during the week after use Meph is more of a jittery, anxiety filled affair where MD just makes me feel genuinely depressed for 2/3..." — Bluelight ↗

    Empirical Duration

    Erowid Reports

    Median times after the dose that Erowid reports state. A curve is drawn only when reports state all four points (onset, peak begins, comedown begins, back to baseline) and the medians fall in that order. No point is estimated from another.

    Oral (20 reports)
    Onset T+30min11 reports Peak begins T+1h7 reports Comedown begins T+1h 9m8 reports Back to baseline not stated

    No curve: fewer than 5 reports state the return to baseline, and no point is estimated from another.

    Tolerance & Pharmacokinetics

    drugs.wiki
    Half-Life
    ~2.1–2.2 h (human PK); MDMA ~7.9–8 h for comparison
    Addiction Potential
    High: short half-life with rapid onset encourages frequent redosing; many users report binge patterns of 0.5–2 g per session. Compulsive redosing increases cardiovascular/overheating risks and worsens the comedown.

    Tolerance Decay

    Full tolerance 1d Half tolerance 7d Baseline ~10d

    Tolerance builds rapidly within and across sessions for monoamine‑releasing stimulants; user reports suggest partial cross‑tolerance with MDMA, amphetamines, and other cathinones. Data are anecdotal; schedule extended breaks (≥2 weeks) to reduce comedown and restore baseline.

    Cross-Tolerances

    MDMA
    Amphetamines
    Other synthetic cathinones

    Experience Report Analysis

    Erowid
    148 Reports
    97 Single-substance
    2006–2025 Date Range
    116 With Age Data
    32 Effects Detected

    Demographics

    Gender Distribution

    Age Distribution

    Reports Over Time

    Effect Analysis

    Erowid

    Effects aggregated from 97 experience reports (97 single-substance Erowid)

    97 Reports
    32 Effects Detected
    10 Positive
    13 Adverse
    9 Neutral

    Effect Sentiment Distribution

    Confidence Distribution

    Each bar is the share of reports mentioning the effect; its whisker, and the band on the rows below, is the 95% interval: where the share could plausibly be with other reports of the same kind.

    Positive Effects 10

    Euphoria 66.0% (95% interval 56 to 75 percent) 70%
    Stimulation 49.5% (95% interval 40 to 59 percent) 70%
    Music Enhancement 42.3% (95% interval 33 to 52 percent) 70%
    Empathy 37.1% (95% interval 28 to 47 percent) 70%
    Tactile Enhancement 19.6% (95% interval 13 to 29 percent) 70%
    Color Enhancement 14.4% (95% interval 9 to 23 percent) 70%
    Body High 11.3% (95% interval 6 to 19 percent) 70%
    Introspection 9.3% (95% interval 5 to 17 percent) 70%
    Focus Enhancement 8.2% (95% interval 4 to 15 percent) 70%
    Pain Relief 3.1% (95% interval 1 to 9 percent) 70%

    Adverse Effects 13

    Anxiety 34.0% (95% interval 25 to 44 percent) 70%
    Jaw Clenching 28.9% (95% interval 21 to 39 percent) 70%
    Confusion 20.6% (95% interval 14 to 30 percent) 70%
    Increased Heart Rate 16.5% (95% interval 10 to 25 percent) 70%
    Pupil Dilation 15.5% (95% interval 10 to 24 percent) 70%
    Headache 14.4% (95% interval 9 to 23 percent) 70%
    Nausea 12.4% (95% interval 7 to 20 percent) 70%
    Memory Suppression 10.3% (95% interval 6 to 18 percent) 70%
    Muscle Tension 6.2% (95% interval 3 to 13 percent) 70%
    Sweating 6.2% (95% interval 3 to 13 percent) 70%
    ⚠ Psychosis 3.1% (95% interval 1 to 9 percent) 70%
    Motor Impairment 3.1% (95% interval 1 to 9 percent) 70%
    Appetite Suppression 3.1% (95% interval 1 to 9 percent) 70%
    Show 9 neutral or unclassified mentions
    Sedation 19.6% (95% interval 13 to 29 percent)
    Auditory Effects 16.5% (95% interval 10 to 25 percent)
    Visual Distortions 14.4% (95% interval 9 to 23 percent)
    Open-Eye Visuals 8.2% (95% interval 4 to 15 percent)
    Dissociation 7.2% (95% interval 4 to 14 percent)
    Hospital 6.2% (95% interval 3 to 13 percent)
    Ego Dissolution 6.2% (95% interval 3 to 13 percent)
    Time Distortion 5.2% (95% interval 2 to 12 percent)
    Closed-Eye Visuals 4.1% (95% interval 2 to 10 percent)

    Also reported in combinations. In the 51 4-MMC reports where another drug was taken too, 4 (7.8%) mention hospital, emergency services or an overdose, 1 (2.0%) a seizure and 2 (3.9%) psychosis. In the 97 single-substance reports: 6.2%, 1.0% and 3.1%. These are not in the figures above: they cannot be put down to 4-MMC alone, and a mention is not always something that happened to the writer.

    Subjective Effect Ontology

    Experience Reports

    Structured effect tags extracted from 148 experience reports using a controlled vocabulary of 220+ canonical effects across 15 domains.

    Emotional

    euphoria 101 68.2% (95% interval 60 to 75 percent)

    1 unique effects extracted · Derived from experience reports

    Dosage Distribution

    Dose distribution from experience reports, one dose per report (the first listed). Doses above Q3 + 3×IQR, far above what people typically take, are left out of the median and range and listed under each route: most are real heavy doses or overdoses, not mistakes.

    Insufflated

    Median: 100.0 mg IQR: 50.0–145.2 mg n=26

    4 reports gave a dose above the typical range (750–1,700 mg), so they are not in the figures above. Listing a dose here does not mean it is safe.

    Show the reports

    Oral

    Median: 200.0 mg IQR: 106.2–250.0 mg n=34

    1 report gave a dose above the typical range (700 mg), so it is not in the figures above. Listing a dose here does not mean it is safe.

    Show the report

    Real-World Dose Distribution

    Erowid

    From 190 of 228 recorded dose entries: those that state a weight (mg, g or µg), in routes with at least five of them. Values above Q3 + 3×IQR, far above what people typically take, are left out; they can include real heavy doses and overdoses, not only mistakes.

    Insufflated (n=103)

    Median: 100.0mg 25th: 50.0mg 75th: 125.0mg 90th: 190.0mg

    Oral (n=74)

    Median: 167.5mg 25th: 100.0mg 75th: 250.0mg 90th: 300.0mg

    Smoked (n=6)

    Median: 30.0mg 25th: 30.0mg 75th: 30.0mg 90th: 90.0mg

    Common Combinations

    Most co-occurring substances, as a share of all 148 reports filed under 4-MMC; whiskers are 95% intervals

    Form / Preparation

    Most common forms and preparations, as a share of the 125 reports that give one; whiskers are 95% intervals

    Body-Weight Dosing

    Dose per kg of body weight, one dose per report (the first listed), from reports giving a weight of 30–250 kg. Doses above Q3 + 3×IQR, far above what people typically take, are left out of the median and range and listed under each route.

    Insufflated

    Median: 1.634 mg/kg IQR: 0.674–2.0 mg/kg n=25

    3 reports gave a dose above the typical range (9.375–18.743 mg/kg), so they are not in the figures above. Listing a dose here does not mean it is safe.

    Show the reports

    Oral

    Median: 2.578 mg/kg IQR: 1.486–3.493 mg/kg n=34

    1 report gave a dose above the typical range (12.868 mg/kg), so it is not in the figures above. Listing a dose here does not mean it is safe.

    Show the report

    Redose Patterns

    Redosing behavior across 129 reports

    43.4% (95% interval 35 to 52 percent) Redosed
    2.1 Avg Doses
    50m Median Interval

    Legal Status

    European Council Decision (December 2010) requiring EU Member States to subject mephedrone to control measures and criminal penalties
    Country Status Notes
    Australia Schedule 9 Classified as a prohibited substance under the Poisons Standard. Manufacture, possession, sale, or use is prohibited except for approved medical or scientific research purposes with Commonwealth and/or State or Territory Health Authorities approval.
    Austria SMG controlled Illegal to possess, produce, and sell under the Suchtmittelgesetz (Narcotics Act) as of August 21, 2010.
    Belgium Regulated drug Banned on April 29, 2010. Requires approval from the Ministry of Human Health to import, sell, or possess.
    Brazil Class F2 Added to the list of scheduled drugs as of August 2011. Illegal to possess, sell, or manufacture without a license.
    China Category I psychotropic substance Controlled as of September 1, 2010. Illegal to sell, buy, import, export, and manufacture.
    Croatia Controlled substance Classified as a controlled substance as of January 12, 2010.
    Czech Republic Controlled substance Added to controlled lists in early 2011 alongside other cathinone derivatives. The Czech Republic has decriminalized possession of small amounts of most recreational drugs, so penalties for personal possession are relatively low.
    Denmark Illegal Banned by the Minister for Health and Prevention on December 18, 2008. Denmark also implemented an analogue law effective July 1, 2012 that covers cathinone derivatives including mephedrone.
    Estonia Controlled substance Classified as a controlled substance as of November 2009.
    Finland Medicinal product Classified as a medicinal product under the Medicines Act. Illegal to manufacture, import, possess, sell, or transfer without a prescription.
    France Illicit substance Added to the list of illicit substances by the Ministry of Health in early June 2010, published in the Journal Officiel du 11 juin 2010.
    Germany Anlage I BtMG Controlled under Anlage I of the Betäubungsmittelgesetz (Narcotics Act, Schedule I) as of January 22, 2010. Illegal to manufacture, possess, import, export, buy, sell, procure, or dispense without a license.
    Guernsey Class B Classified as a Class B controlled substance as of April 16, 2010.
    Hungary List 1 Classified as a List 1 controlled substance as of January 1, 2011.
    India Controlled psychotropic substance Added to the list of controlled psychotropic substances, reportedly in 2014 or early 2015.
    Ireland Controlled substance Controlled under the Misuse of Drugs Act 1977 as of May 11, 2010.
    Isle of Man Illegal Illegal to import or sell since February 2010.
    Israel Controlled substance First country to ban mephedrone by name in December 2007. Added to the list of controlled substances, making it illegal to buy, sell, or possess. Israel subsequently banned four families of substances including cathinones and methcathinones in July 2010.
    Italy Tabella I Listed in Tabella I of the controlled substances tables, making it illegal to possess, purchase, or sell.
    Jersey Class C Classified as a Class C controlled substance since December 2010.
    Lithuania Controlled substance Classified as a controlled substance as of June 20, 2010.
    Mexico Schedule I Classified as a Schedule I controlled substance as of January 7, 2014.
    Netherlands Unregulated medicine In March 2010, the Dutch Ministry of Health and the Medicines Authority IGZ classified mephedrone as an unregulated medicine, prohibiting sales and distribution.
    Norway Controlled (Derivatbestemmelsen) Controlled under the Derivatbestemmelsen, an analogue act-type law that covers mephedrone alongside other substances.
    Poland I-P group psychotropic drug Added to the list of controlled psychotropic drugs in the I-P group on August 25, 2010.
    Romania Controlled substance Added to the list of controlled substances in February 2010.
    Russia List 1 Classified as List 1 in the Russian Federation as of August 2010. Illegal to manufacture, buy, possess, or distribute.
    Singapore Banned substance Classified as a banned substance as of November 15, 2010.
    Slovak Republic Controlled substance Controlled as of March 1, 2011.
    Spain Schedule I Classified as a Schedule I controlled substance as of February 10, 2011.
    Sweden Hälsofarlig vara (health hazard) Classified as a health hazard substance with a ban on sale effective December 15, 2008. Personal use is not explicitly illegal under this regulation, but commercial sale is prohibited.
    Switzerland Verzeichnis D Specifically named as a controlled substance under Verzeichnis D of the Swiss controlled substances regulations.
    Turkey Illegal Classified as a drug with prohibition on possession, production, supply, and import.
    United Kingdom Class B Controlled as a Class B drug as of April 16, 2010 through the cathinone catch-all clause under the Misuse of Drugs Act 1971.
    United States Schedule I Federally scheduled in July 2012 under the Controlled Substances Act. Illegal to manufacture, buy, possess, or distribute without a DEA license. Prior to federal scheduling, numerous states enacted emergency bans starting in 2010-2011 including Alabama, Florida, Indiana, Louisiana, Michigan, Minnesota, New Jersey, New York, Ohio, Pennsylvania, Texas, and others.

    Harm Reduction

    drugs.wiki

    - Potency and identity are highly variable in 2024–2025 street markets. Drug‑checking services report many samples sold as “3/4‑MMC” actually contain other cathinones (NEP, a‑PVP, 2‑MMC), which can be several‑fold more potent or longer‑lasting. Multi‑reagent testing helps but may not distinguish specific cathinones; FT‑IR/GC‑MS is preferable.

    - Oral and intranasal onsets/durations match community datasets: oral 15–45 min onset with 2–5 h total; sniffed 5–15 min onset with 1–3 h total. These short, punchy effects promote redosing within 45–120 min, increasing acute risks.

    - Human PK shows a short elimination half‑life around 2.1–2.2 h, much shorter than MDMA (~7.9–8 h). The brief half‑life explains more compulsive dosing and higher cardiovascular/overheating load within a session.

    - Significant peripheral vasoconstriction has been documented after prolonged/repeated dosing (e.g., blue/cold extremities), sometimes at cumulative doses in the 0.6–1.8 g range over hours. Cease use if these signs appear and warm/rest; seek care if pain, pallor, or numbness persists.

    - Intranasal use commonly causes marked burning, nosebleeds, and sinus issues; harm reduction includes finely crushing, using small lines, alternating nostrils, and gentle saline rinses post‑session. Many switch to oral due to nasal injury.

    - Injection is associated with higher risk of severe local and systemic harm (vasoconstriction, tissue injury, infections). Use of synthetic cathinones by injection is reported but uncommon; if it occurs, sterile supplies and very dilute test doses are essential. Strongly discouraged.

    - Hydration: as with other serotonergic stimulants (e.g., MDMA), over‑ or under‑hydration can be dangerous. Sip ~250 mL water per hour at rest (up to ~500 mL/h if dancing/very active) with electrolytes; avoid excessive water without salts to reduce hyponatremia risk.

    - Redosing strategy: spacing doses by at least 2–3 h and capping total session amounts reduces cumulative strain and comedown severity. Many reports describe binges of 0.5–2 g when redosing every 30–90 min—avoid this pattern.

    - Bruxism/jaw tension is common with stimulants; gum, conscious jaw relaxation, and adequate magnesium status may help some users, but evidence is largely anecdotal. Lowering dose remains the most reliable mitigation.

    - Sleep, mood, and appetite often deteriorate after sessions; plan recovery time, nutrition, and sleep hygiene. Seek medical care for chest pain, hyperthermia, agitation not relieved by rest, or persistent psychotic symptoms.

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