4-FA is popular in the Netherlands where it is predominantly used for its specific effects (77% of users) rather than its legal status (18%). 4-FA has become illegal since May 2017.
The subjective effects of 4-fluoroamphetamine include euphoria which some find similar to the effects of MDMA and amphetamine, increased energy (stimulation), mood elevation, feelings of warmth and empathy, excessive talking, bruxism, and suppressed appetite (anorexic). The general course of effects involves primarily empathogenic effects for the first few hours, which fades out as increased stimulation develops over the next several hours.[medical citation needed]
Regarding the metabolic fate of 4-FA, the C-F bond at the 4-position on the phenyl ring likely resists deactivation in the liver by cytochrome P450 oxidase.
4-FA does not cause long-lasting depletion of brain serotonin, unlike its analogs4-CA and 4-BA. This is thought to "reflect the inability of the fluoro-compound to be metabolized in the same way as the other haloamphetamines."
Neurotoxicity does not increase down the series of para-halogenated amphetamine derivatives, even though serotonin releasing potency does follow this trend. For example, 4-iodoamphetamine is less toxic than is 4-chloroamphetamine. Hence, this property is not related to serotonin releasing potency as such, since PAL-287 was reported to be not at all neurotoxic even though it is a powerful 5-HT releasing agent. It is unclear where 4-methylamphetamine fits in on the neurotoxicity scale. The extensive serotonergic neurotoxicity of 4-chloroamphetamine (and its brominated derivative), and the increased serotonergic toxicity of 4-methylamphetamine suggest that para-substitution seems to increase overall serotonergic (neuro)toxicity, compared to amphetamine. Exceptions include 4-MTA, a para-substituted, non-neurotoxic amphetamine.
4-FA has only been involved in one death worldwide, where it was combined with amphetamine, methadone and benzodiazepines.
As of October 2015, 4-FA is a controlled substance in China. 4-FA is banned in the Czech Republic. As of May 25, 2017 4-FA is a controlled substance in the Netherlands. 4-FA is also controlled in Australia, Belgium, UK, Germany, Israel, Slovakia, Bulgaria, Chile, Brazil, Canada, Croatia, Sweden, New Zealand and France.
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