Alpha-Methyltryptamine

Jasmine Ahn, Student Pharmacist

Fall 2022

History and Background

Alpha-methyltryptamine, also known as AMT, is a tryptamine derivative. AMT was first studied in the 1960s by a couple of pharmaceutical companies as a possible antidepressant due to its MAOI properties. AMT was studied by the Upjohn Company, but it was concluded that AMT was a toxic substance and produces psychosis. AMT was an available prescription in the 1960s in the Soviet Union, under the name of Indopan in 5 mg and 10 mg tablets. As of today, there is not much known due to little to no formal research on the drug. There are no currently accepted medical uses in the United States. Recently, AMT has been emerging in club and rave scenes for recreational use for its hallucinogenic effects and is used as a substitute for MDMA. The abuse of AMT has led to two emergency department admissions and one death.

Slang Terms: Amtrak, Amthrax, Spirals https://www.erowid.org/archive/rhodium/chemistry/it-290.html.

Pharmacology and Drug Effects

AMT’s molecular formula is C11H14N2 and the molecular weight is 174.74 g/mol. The class of the drug is tryptamines and all are composed of a substituted monoamine group. The drug works by inhibiting MAOs which causes an impact on the brain's chemicals. It can be taken in crystal powder, capsule, or tablet form. AMT is usually taken by ingestion, smoking, or insufflation, although oral ingestion is the most common route. Common dosages include 20-40 mg for oral dosage and 6-10 mg for smoked dosage. The duration of action for AMT is 12-16 hours and the stimulant activity is due to the presence of an alpha carbon methyl group. There are many ways of synthesis for AMT from different compounds: indole, tryptophan, indole-3-carboxaldehyde gramine, and 2-nitropropene. The pyrrole of the indole ring appears to be essential for hallucinogenic activity.

AMT is considered a synthetic hallucinogen that can alter the user’s perception, thought, and mood. Effects of this substance include an increase in energy, hallucinogens with both visual and auditory distortions, euphoria, empathy, and emotional distress. Some also report nervous tension, irritability, restlessness, inability to sleep, blurry vision, and dilated pupils.

Drug Interactions and Toxicology

Drug toxicology can be separated into mild to moderate poisoning and severe poisoning. For mild to moderate, tryptamines have the potential to cause pleasant or frightening hallucinations and unpredictable behavior. Some adverse effects include nausea, vomiting, anorexia, dizziness, paresthesias, anxiety, mood alterations, time distortion, and confusion. For severe poisoning, the signs are severe anxiety, possible agitation, hypertension, sinus tachycardia, rhabdomyolysis, and hyperthermia. To show a range of toxicity based on doses; 5-10 mg is reported to be mood-lifting, 20 mg causes euphoria, and 30 mg can induce hallucinations.

Drug interactions can occur with any other MAO inhibitors, SSRIs, cold preparations, cough medications with decongestants, dextromethorphan, Demerol, sinus medications, and nose drops or nasal sprays. AMTs also interact with amphetamines, MDMA, MDA or “MD” compounds, and cocaine.

Laws

AMT is a Schedule I substance under the Controlled Substances Act in the United States. It was regulated on April 4, 2003. In Germany, it is supposedly illegal to sell or possess AMT.

Monitoring and Drug Screens

To monitor patients on AMT, check the core temperature and mental status. Hospitals can monitor serum electrolytes, liver enzymes, renal function, and urinalysis. Check the patient's ECG and conduct continuous cardiac monitoring. If patients have prolonged agitation, monitor creatine kinase. Assess for myoglobinuria and hemoglobinuria following significant exposure.

Recent research has yielded how AMT can be detected but there are no available screens now. AMT is not tested in standard and extended drug tests. The detection period in urine for AMT is unknown.

Professional Opinion

Due to the current potential of psychedelic-assisted therapies like MDMA and psilocybin for PTSD and depression, AMT can be a potential treatment with more research on efficacy and safety.

~ J. Ahn

References

1.Dialtonez. AMT FAQ. Erowid AMT Vault.

https://www.erowid.org/chemicals/amt/amt_faq1.shtml. March 12, 2003.

Accessed October 13, 2022.

2.Rhodium. Synthesis of Alpha-Methyltryptamine (IT-290; AMT).

https://www.erowid.org/archive/rhodium/chemistry/it-290.html. August 2004.

Accessed October 13, 2022.

3.Hallucinogenic Tryptamines. Micromedex (electronic version). IBM Watson Health; 2019.

Accessed October 13, 2022. https://www.micromedexsolution.com

4.Vorce SP, Sklerov JH. A general screening and confirmation approach to the analysis of designer tryptamines and phenethylamines in blood and urine using GC-EI-MS and HPLC-electrospray-MS. J Anal Toxicol. 2004;28(6):407-410. doi:10.1093/jat/28.6.407

5.Drug Enforcement Administration. Alpha-Methyltryptamine. February 2020. Accessed October 13, 2022. https://www.deadiversion.usdoj.gov/drug_chem_info/amt.pdf