An oral dose of MDPV is estimated to be around 5-20 milligrams (compared to 100-150 milligrams for MDMA). The main psychoactive effects last two to three hours, and side-effects persist for several additional hours.
Side-effects, particularly at high doses, can include anxiety and paranoia, delusions, muscle spasms, and an elevated heart rate. In extreme cases, MDPV has been linked to rhabdomyolysis (rapid muscle breakdown), brain injury, and death.
Like other cathinones, MDPV is a stimulant and shares some effects with other stimulants such as amphetamine, cocaine and MDMA. MDPV produces its effects by inhibiting the reuptake of two important signalling molecules (neurotransmitters) in the brain; norepinephrine and dopamine.
Norepinephine is generally responsible for preparing the brain and body for action in the so-called “fight or flight response”, while dopamine is involved in more complex functions such as arousal, motivation, reward and motor control.
By blocking the ability of certain brain cells (neurons) to reabsorb these neurotransmitters, MDPV effectively increases the intensity and duration of norepinephrine and dopamine signalling. Cocaine works in a similar way, but in a lab test, MDPV was a much more potent inhibitor than cocaine.
Other norepinephrine-dopamine reuptake inhibitors (NDRIs) include pharmaceuticals such as methylphenidate (known as ritalin and used to treat ADHD) and buproprion (an antidepressant). But the psychoactive and stimulant effects of MDPV are much stronger than pharmaceutical NDRIs.
Pyrovalerone – a hybrid of mephedrone and MDPV – is an approved appetite suppressant used medically for weight loss. However, it’s rarely used due to its potential for abuse.
Studies in laboratory animals highlight the stimulating effects of MDPV, and also its potential for dependence. Mice trained to identify MDPV find it similar to both MDMA and methamphetamine. MDPV stimulates movement in rats approximately ten times more potently than cocaine, and rats will readily self-administer MDPV, suggesting it’s addictive.
But many of these deaths involved extreme doses, repeated dosing (“bingeing”), intravenous use or additional drugs. In fatal cases involving a single synthetic cathinone, death has been attributed to complications arising from extremely high body temperatures or damage to the vessels of the heart. Fortunately, specialised drug testing can detect MDPV and its derivatives.