By Kevin Shanks, D-ABFT-FT

Stimulants come and go. New ones arrive on the illicit drug market all the time. One of the newest stimulants to be identified is MDPHP, also known as 3′,4′-Methylenedioxy-α-pyrrolidinohexiophenone. It is a substituted cathinone, a class of compounds related to cathinone, a naturally occurring stimulant alkaloid found in the plant Catha edulus (khat). MDPHP belongs to the pyrrolidinophenone subclass and is structurally related to older stimulant compounds, alpha-PVP and MDPV. MDPHP first appeared on world drug markets around 2014-2015, but has recently seen an increase in prevalence. While not explicitly listed as a controlled substance in the United States, it may be considered a positional isomer of the already controlled MDPV and alpha-PVP, and therefore be considered illegal to manufacture, possess, distribute, and consume.  

Chemical Structure of MDPHP drawn by Kevin G. Shanks (2026)

Pharmacologically, the substituted cathinones class primarily acts on monoamine transporters in the body and inhibits the reuptake of dopamine, norepinephrine, and/or serotonin and may act as releasers of any of the three neurotransmitters. MDPHP acts primarily as a dopamine and norepinephrine reuptake inhibitor. The end result of this action is an increased concentration of neurotransmitters in the nerve cell synapse, which leads to stimulant physiological effects on the body. People who use stimulants are typically seeking the desired effects such as euphoria, increased energy, sociability, and alertness. But adverse effects include anxiety, agitation, paranoia, hallucinations, and aggression. When taken in overdose, acute toxicity is demonstrated via hypertension, hyperthermia, tachycardia, severe agitation, hallucinations, seizure, kidney failure, rhabdomyolysis, and death. Chronic use can manifest in cognitive impairment, sleepiness/tiredness, psychosis, physical and psychological dependence and addiction. 

MDPHP has been implicated in fatalities in peer-reviewed published literature. In one case published by Di Candia et al., a 48 year old male with back and leg pain was found semi-unconscious on a public street. Emergency personnel were called and they documented history to include an HIV+ status and amnesia. After arrival at the hospital, his breathing and heart rate increased and he became unconscious before respiratory and cardiac activity stopped and could not be regained. At autopsy, various bone fractures, cerebral and pulmonary congestion and edema, and atrial and ventricular hemorrhages were documented. Toxicological analysis of postmortem femoral blood was positive for MDPHP (399 ng/mL). 

In a second case published by Croce et al. a 30 year old male with a history of drug use and addiction was found deceased in his bedroom. He was last seen alive 24 hours prior to discovery. At autopsy, pleural visceral congestion, pulmonary edema, and moderate hepatic steatosis were observed. Toxicological analysis was completed on postmortem central blood and peripheral blood, among other specimens drawn at autopsy. MDPHP was positive in the central blood (1,639.99 ng/mL) and in the peripheral blood (1,601.90 ng/mL).  

In a third case published by Casati et al. a 58 year old male was found floating in the water. He was last seen alive 7 days prior. Documented medical history included HIV+ status and he regularly used MDPV. At autopsy, rigor was present. Both hands were macerated and the heart was enlarged with mild ventricular hypertrophy. Cerebral and pulmonary congestion were also observed. Toxicological analysis was positive for MDPHP in femoral blood (350 ng/mL) and central blood (110 ng/mL). Other substances present included MDPV, MDPPP, MDPBP, citalopram, clonazepam, and 7-aminoclonazepam. 

As a new stimulant, it is prudent to be aware of MDPHP and its availability on the illicit drug market. Axis monitors MDPHP in the Novel Emerging Compounds (NEC) panel (order code 13710) and Comprehensive Panel, Blood with Analyte Assurance (order code 70510) using liquid chromatography with quadrupole time of flight mass spectrometry (LC-QToF-MS).  

If you have questions about MDPHP and how it may play a role in your medical-legal investigation, please reach out to subject matter experts by email ([email protected]) or phone (317-759-4869, Option 3). 

References 

• Di Candia, D., Boracchi, M., Ciprandi, B. et al. (2022) A unique case of death by MDPHP with no other co-ingestion: a forensic toxicology case. International Journal of Legal Medicine.  DOI: https://doi.org/10.1007/s00414-022-02799-w 
• Croce, E.B., Dimitrova, A., Grazia Di Mili, M. et al. (2025) Postmortem distribution of MDPHP in a fatal intoxication case. Journal of Analytical Toxicology.  DOI: https://doi.org/10.1093/jat/bkae092 
• Casati, S., Ravelli, A., Dei Cas, M. et al. (2025) Polydrug fatal intoxication involving MDPHP: Detection and in silico investigation of multiple 3,4-methylenedioxy-derived designer drugs and their metabolites. Journal of Analytical Toxicology.  DOI: https://doi.org/10.1093/jat/bkaf048