This is a special area of interest for me, and I volunteer for a harm reduction organisation. If this is what uworld says, I would disagree with them. It very much depends on which synthetic cathinone we’re talking about - if we look at mephedrone for example (probably the most common/well-known/most use data), this actually has a far shorter duration than amphetamine. A better differentiator for that would be the presence of increased euphoria compared to amphetamine (but not as much as say MDMA). 4-CMC is another one (this one more as an adulterant) which has a similar duration to MDMA/amphetamines. It is very hard to give general advice about a very wide class of drugs, but overall I would agree with this card as-is. A better differentiator would be how it was sold - a pill is more likely to be a cathinone than an amphetamine (unless a professional and plain pill, e.g. adderall etc) with the exception of MDMA. Euphoria I would say is the biggest symptom differentiator - but again, that differentiates cathinones vs standard amphetamines, not vs MDMA. I could expand a lot further and give further information on differentiation, but hopefully I’ve made enough of an argument.
Joe, while you make a good point, uworld focuses on the “classical” presentation that shows up on NBME exams. Another key differentiator is that synthetic cathinones will not show up on UDS
I think my concern would be that I don’t think this IS by any means classical. The most commonly encountered cathinone (mephedrone) has an extremely short duration of action, not dissimilar to cocaine. UDS - yes, potentially - I would lean towards ‘may not’ - cathinones have been in common use >10 years now, and as a result many urine screens will pick them up.