Synthetic Cathinones: Analytical Strategies, Pitfalls and Priorities for Forensic and Clinical Toxicology

Abstract

Synthetic cathinones are β-keto analogues within the broader class of β-phenethylamine amphetamine-type stimulants and represent a persistent analytical challenge due to their structural variability and rapid analogue turnover. Their frequent misrepresentation as other stimulants, together with the limited clinical and toxicological data available for many compounds, complicate both interpretation and risk assessment. This review examines the pharmaco-toxicological context of synthetic cathinones, with a primary focus on analytical strategies for their detection and interpretation in clinical and forensic settings. Methodological considerations are discussed across blood/plasma, urine, oral fluid and hair, highlighting the strengths and limitations of current screening, confirmatory and quantitative approaches. Attention is given to issues affecting analytical reliability, including compound instability, matrix effects, availability of reference materials and the impact of evolving sampling and microsampling formats on specimen handling. Emphasis is also placed on the interpretive integration of analytical data with patterns of use and potential co-exposures. Overall, this paper aims to bridge analytical methodology and translational application, supporting robust and adaptable testing practices in response to changing stimulant profiles.