Last published: June 26, 2019
What is methoxetamine?
Methoxetamine (MXE) is a dissociative drug, which means it causes people to feel separated or detached from their body or physical environment. Dissociatives are a type of hallucinogen, which means that they can cause hallucinations and other changes in thoughts, emotions and consciousness.
MXE may also be known as M-ket, Kmax and Mexxy.4
MXE is also a New Psychoactive Substance (NPS). NPSs are a range of drugs that have been designed to mimic existing illicit drugs. In the case of MXE, it attempts to recreate the effects of ketamine and has been marketed and sold online as a legal alternative.1,5,6 However, in some states and territories, NPSs are illegal.
MXE is mostly sold as a white, off-white, beige or yellow powder but can also be found in capsule or liquid form. It is often labelled as “Not for Human Consumption” to avoid legal restrictions regarding the importation and sale of illicit drugs and NPSs. All drugs sold in powder form may be sold cut (mixed) with other substances, which can reduce the purity of the dose and have unintended effects. This means that the effects can be unpredictable.
How is it used?
MXE is usually snorted, swallowed or injected.7
One of the most significant differences between ketamine and MXE is the length of time before its effects are felt. MXE is said to be slower-acting, but more potent and long-lasting.4,5,7 It can take anywhere from 5- 90 minutes to feel the effects. This has led to people overdosing, as they have taken additional doses while waiting for the effect to be felt.1-4 When taken orally, the effects are usually felt within 15–45 minutes. After snorting, the effects are reported to occur within a few minutes.1
Effects of Methoxetamine (MXE)
There is no safe level of drug use.
Use of any drug always carries some risk. It’s important to be careful when taking any type of drug.
MXE can affect everyone differently, based on:
- the amount taken
- a person’s height, weight and health
- whether the person is used to taking it
- whether other drugs are taken around the same time
- the strength of the drug (which can vary from batch to batch).
In small doses the following effects may occur and may last for up to 7 hours: 1,7
- pleasant sensory experience
- vivid hallucinations
Some adverse effects include: 1,4,7
- rapid heart rate
- slurring or difficulty speaking
- psychomotor agitation e.g. tapping or pacing.
Higher doses or long-term use of MXE can lead to: 1,7,8,9
- cardiovascular problems
- respiratory damage
- increased risk of injury
- speech difficulties
- memory loss
- panic attacks
As with ketamine, long term use of MXE is also associated with kidney damage and cystitis.12
Using methoxetamine with other drugs
The effects of combining drugs – including over-the-counter or prescribed medications – can be unpredictable and dangerous. There is little evidence available on the effects of MXE when combined with other drugs.10 Anecdotal reports suggest that mixing MXE with alcohol, cannabis and antidepressants should be avoided.1
Health and safety
Use of MXE is likely to be more dangerous when:
- taken in combination with alcohol or other drugs, including over-the-counter or prescribed medications
- driving or operating heavy machinery
- judgment or motor coordination is required
- alone (in case medical assistance is required)
- the person has a mental health problem
- the person has an existing heart problem.
Injecting drugs, including MXE, can cause damage to veins and other tissues.
Sharing needles may also transmit:
- Hepatitis B
- Hepatitis C
Dependence and tolerance
There is limited evidence regarding MXE and dependence, however, experts believe that the similarity to ketamine means that it carries a comparable risk of dependency.7,10,11 While the Independent Scientific Committee on Drugs (UK) ranks ketamine as less harmful than other illicit drugs such as methamphetamine, heroin, cocaine or GHB,13 some studies have indicated a high risk for tolerance and dependency.14
In the days after MXE use, the following may be experienced:
- low mood and/or depressive thoughts
- memory loss
- impaired judgement, disorientation
- aches and pains.
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- Corazza O, Schifano F, Simonato P,et al. The phenomenon of new drugs on the Internet: a study on the diffusion of the ketamine derivative methoxetamine (‘MXE’). Hum Psychopharmacol 2012;27:145–9.
- Ward J, Rhyee S, Plansky J, Boyer E. Methoxetamine: a novel ketamine analog and growing health-care concern. Clin Toxicol 2011;49:874–5.
- Wood DM, Davies S, Puchnarewicz M, Johnston A, Dargan PI. Acute toxicity associated with the recreational use of the ketamine derivative methoxetamine. Eur J Clin Pharmacol 2012;68:853–6. doi: 10.1007/s00228-011-1199-9. Epub 2011 Dec 29. (accessed 29 December).
- Hofer KE, Grager B, Muller DM, et al. Ketamine-like effects after recreational use of methoxetamine.
- Winstock AR, Lawn W, Deluca P, Borschmann R. Methoxetamine: An early report on the motivations for use, effect profile and prevalence of use in a UK clubbing sample. Drug and Alcohol Review. 2016 Mar;35(2):212-7.
- Morris, H. Interview with a ketamine chemist: or to be more precise, an arylcyclohexylamine chemist. Vice Magazine, 2011.
- Kjellgren A, Jonsson K. Methoxetamine (MXE)–a phenomenological study of experiences induced by a “legal high” from the Internet. Journal of Psychoactive Drugs. 2013 Jul 1;45(3):276-86.
- Botanas CJ, de la Peña JB, Dela Pena IJ, Tampus R, Yoon R, Kim HJ, Lee YS, Jang CG, Cheong JH. Methoxetamine, a ketamine derivative, produced conditioned place preference and was self-administered by rats: evidence of its abuse potential. Pharmacology Biochemistry and Behavior. 2015 Jun 1;133:31-6.
- Speiser, M. A handful of dangerous new legal drugs has public health experts worried. Australia: Business Insider; 12 August 2015 [cited 2019 March 27].
- European Monitoring Centre for Drugs and Drug Addiction. Report on the risk assessment of 2‐(3‐methoxyphenyl)‐2‐(ethylamino) cyclohexanone (methoxetamine) in the framework of the council decision on new psychoactive substances, risk assessments, Publications Office of the European Union, Luxembourg.
- WHO Secretariat, Essential Medicines and Health Products, Policy Access and Use. Methoxetamine (MXE) Critical Review Report. Geneva: World Health Organization; 2015 November 16 [cited 2019 March 27].
- Emily Guarnotta. The Effects of Methoxetamine Use. United States: Drug Abuse, American Addiction Centres; [Date unknown] [updated 2018 November 25; cited 2019 March 28].
- van Amsterdam J, Nutt D, Phillips L, van den Brink W. European rating of drug harms. Journal of Psychopharmacology. 2015 Jun;29(6):655-60.
- Bhad R, Dayal P, Kumar S, Ambekar A. The drug ketamine: a double edged sword for mental health professionals. Journal of Substance Use. 2016 Jul 3;21(4):341-3.