The Tox Lab

This week on The Tox Lab, we’re exploring early warning systems and their growing role in toxicology and public health. We break down the core principles that underpin early warning systems, before focusing on how these frameworks are applied to drug early warning systems aimed at identifying emerging substances and harms. We then discuss a recent paper examining the value of incorporating experie...

Welcome back to The Tox Lab! We are kicking off 2026 by exploring drugs that disrupt metabolism and the consequences that can follow. In this episode, we focus on compounds that alter glucose metabolism and the interplay between toxicology and biochemistry. We discuss a fatal case of metformin toxicity and the analytical and interpretive challenges involved in recognising this diagnosis. We then t...

This week on The Tox Lab, we’re closing out the year with a festive twist as we explore the link between marzipan, bitter almonds, and cyanide. We take a closer look at the chemistry linking cyanide to almonds and discuss a case of intentional bitter almond ingestion. We then turn to National Poisons Information Service data to examine patterns of cyanide exposure, clinical outcomes, and the antid...

This week on The Tox Lab, we’re taking a closer look at serotonin and its intriguing role in both depression and epilepsy. We review recent data examining the seizure risk associated with different classes of antidepressants and what this means for clinical decision making. We then explore a case report in which sertraline, an SSRI, appeared to have an anti-seizure effect, challenging some long-he...

This week on The Tox Lab, we are examining the growing evidence around cannabis and cardiovascular risk. We start with a recent systematic review and meta-analysis that explores whether cannabis use is linked to higher rates of cardiovascular disease. We break down the strength of the data and discuss what the current evidence can and cannot tell us. We then move onto research investigating how TH...

This week on The Tox Lab, we’re diving into the emerging world of “space oil”, the anesthetic drug etomidate, which has begun appearing in the recreational drug supply across parts of Asia and beyond. We explore several cases involving etomidate vaping, where repeated exposure led to adrenal insufficiency due to its potent inhibition of 11β-hydroxylase. We also discuss a fatal ingestion case, high...

This week on The Tox Lab, we’re taking a closer look at organophosphates, a diverse group of compounds used everywhere from agriculture to chemical warfare. We walk through two real-world poisoning cases: an accidental exposure from a head lice treatment and an intentional ingestion of phorate, illustrating just how wide the spectrum of organophosphate toxicity can be. Along the way, we break down...

This week on The Tox Lab, we’re exploring a series of fascinating and unusual poisoning cases, each with its own toxic twist. From hair straightening treatments and bearded fireworms to midodrine, isotocyanozene, and sodium azide, we discuss the mechanisms, clinical presentations, and toxicological challenges behind each case. Join us as we unpack what these cases reveal about the diverse and some...

This week on The Tox Lab, we’re turning our attention inward to errors in toxicology. From calibration and maintenance mistakes to reporting issues and even instances of fraud, we unpack how things can go wrong in the analytical process and what that means for the credibility of our field. We explore the real-world consequences of these errors and most importantly, what we can learn from them to s...

This week on The Tox Lab, we’re discussing brorphine — a novel synthetic opioid that briefly appeared on the drug market around 2020. We explore its emergence and pharmacology, including data on its activity at the µ-opioid receptor. We also discuss one of the few documented case studies describing an individual presenting for detoxification following brorphine use. Finally, we review recent resea...

This week on The Tox Lab, we’re celebrating our 50th episode — and one whole year of toxicology talk! 🎉 Join us as we look back on some of our most memorable moments from the past year, revisit a few topics with new updates, and share what’s next for The Tox Lab. Whether you’ve been here since episode one or you’re just joining us, thank you for being part of our growing community of toxicologist...

This week on The Tox Lab, we’re revisiting one of history’s most infamous poisons — arsenic. Once dubbed the king of poisons, arsenic still poses real risks today. We discuss recent research on arsenic in the water supply and how prenatal exposure may influence birth outcomes in the United States. We also review two unusual cases of intentional elemental arsenic ingestion, exploring the unexpected...

This week on The Tox Lab, we’re embracing autumn and diving into the fascinating, and sometimes dangerous, world of mushrooms. We explore ten years of mushroom exposure data reported to the UK National Poisons Information Service, examining the species most often involved and the mechanisms behind their toxicity. We also take a look at commercial products containing mushrooms and discuss a paper s...

This week on The Tox Lab, we’re taking a closer look at clozapine, a highly effective antipsychotic with a complex toxicological profile. We review a study from Western Sydney examining cases of self-poisoning and adverse drug reactions, discuss a case of chronic clozapine toxicity, and explore new research into its effects on cardiac mitochondria. From clinical outcomes to cellular mechanisms, we...

This week on The Tox Lab, we’re discussing medetomidine and its unexpected association with hallucinations. We review a recent paper highlighting its emergence in the drug supply and the apparent increase in hallucinatory effects reported with its use. Although medetomidine has been linked to reducing post-operative delirium, we also discuss a case report of dexmedetomidine-induced delirium in a p...

This week on The Tox Lab, we’re taking a closer look at diphenidine and other diarylethylamines — a class of drugs that briefly emerged as alternatives to ketamine. We explore their history, reported effects, and the fatalities linked to their use before they faded from the drug scene. With current discussions around reclassifying ketamine, we ask: could diphenidine — or similar substances — make...

This week on The Tox Lab, we’re diving into the world of GLP-1 receptor agonists, including the well-known weight loss drug Ozempic. We explore how these drugs work and their potential benefits beyond weight loss, including effects on heart health. We then discuss a case of intentional Ozempic overdose, examining the clinical presentation and outcomes. Finally, we turn to the growing problem of co...

This week on The Tox Lab, we’re shaking things up with a case-based mystery episode. We walk through four real-life poisoning cases, starting with how each patient presented and progressed, before revealing the substance behind the toxic effects. Can you solve the puzzle before we uncover the cause? If you like this style of episode, let us know in the comments below! Hope you enjoy! ⚠️ Spoiler al...

This week on The Tox Lab, we’re talking about 2C-B and “Tusi” — two drugs often confused, but very different in composition and effects. We explore Dutch Poison Information Centre data on 2C-B, examining reported exposures and the spectrum of effects across low, moderate, and high doses. We then turn to casework from the Miami-Dade Medical Examiner Toxicology Laboratory to look at “Tusi” (also kno...

This week on The Tox Lab, we’re taking a closer look at ibogaine — a plant-derived alkaloid attracting interest as a potential treatment for addiction. We discuss a study from New Zealand exploring its use in opioid dependence, while also highlighting the serious risks reported in case studies, including severe cardiotoxicity. We then turn to National Poisons Information Service data to examine re...

This week on The Tox Lab, we’re diving into the surprising sides of nicotine. Beyond its well-known risks, we explore how nicotine might have therapeutic potential in conditions like schizophrenia and dementia—where deficits in nicotinic acetylcholine receptors could play a role. We also discuss the MIND study, which is testing whether nicotine can boost memory, attention, and learning in dementia...

This week on The Tox Lab, we’re taking a closer look at BTMPS. A compound used as a light stabiliser in plastics, BTMPS unexpectedly surfaced in the U.S. drug supply in the summer of 2024. We unpack what’s known so far about its emergence, discuss possible reasons for its appearance, and revisit earlier research exploring its activity at nicotinic acetylcholine receptors and signs of cardiotoxicit...

This week on The Tox Lab, we’re taking a closer look at death cap mushrooms following the recent conclusion of the Erin Patterson case. We explore the toxicology of Amanita phalloides, from the mechanism of amatoxins to the clinical course of poisoning and the challenges of treatment. We also look at poison centre data from California to understand how often suspected exposures are reported—and ho...

This week on The Tox Lab, we’re diving into novel nitazene metabolites in post-mortem toxicology. We discuss findings from our own paper identifying metabolites of protonitazene in post-mortem casework, and highlight the variability in metabolites identified and what this might mean for identifying nitazene exposure. We also examine a post-mortem case report on 5-amino and 5-acetamido metonitazene...

In this week's episode, we’re exploring the role of AI in toxicology. From large language models supporting drug identification to machine learning tools navigating the vast datasets produced by high-resolution mass spectrometry, we look at how artificial intelligence could be integrated into toxicological workflows. We also discuss the limitations — including bias in training data, challenges wit...