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The authors report a case of atypical intoxication in a 16-year-old female who consumed cannabis in conjunction with an unusual powdered mixture containing psychotropic substances. The intoxication led to confusion, hallucinations, sinus tachycardia, and hospitalization. A comprehensive high-resolution mass spectrometry and liquid-chromatography mass spectrometry analysis of her plasma, her urine and a powder found in her possession revealed the presence of the same five medicines: citalopram\/escitalopram, paroxetine, sertraline, venlafaxine, and trihexyphenidyl. This case underscores the intricate interactions between psychoactive substances that are never prescribed together in clinical settings, along with the issue of diverted prescription drugs like trihexyphenidyl. It also emphasizes the potential circulation and use of crushed mixtures of medication for recreational purpose. Fortunately, powder analysis provided crucial insight to understand the intoxication.<\/jats:p>","DOI":"10.1093\/jat\/bkaf009","type":"journal-article","created":{"date-parts":[[2025,2,15]],"date-time":"2025-02-15T07:51:21Z","timestamp":1739605881000},"page":"369-373","source":"Crossref","is-referenced-by-count":2,"title":["Psychoactive cocktail consumption on Reunion Island: a case report"],"prefix":"10.1093","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6692-2890","authenticated-orcid":false,"given":"Joris","family":"Guyon","sequence":"first","affiliation":[{"name":"CHU de Bordeaux, Service de Pharmacologie M\u00e9dicale, Laboratoire de Pharmacologie et Toxicologie , Bordeaux F-33000,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4430-4615","authenticated-orcid":false,"given":"Adrien","family":"Maillot","sequence":"additional","affiliation":[{"name":"Centre d\u2019Investigation Clinique 1410, Inserm , Saint-Denis F-97400,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sophie","family":"Bastard","sequence":"additional","affiliation":[{"name":"CHU de La R\u00e9union, Laboratoire de Biochimie M\u00e9dicale , Saint-Denis F-97400,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Flore","family":"Weisse","sequence":"additional","affiliation":[{"name":"CHU de La R\u00e9union, Service des Urgences , Saint-Denis F-97400,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Am\u00e9lie","family":"Daveluy","sequence":"additional","affiliation":[{"name":"CHU de Bordeaux, Service de Pharmacologie M\u00e9dicale, Centre d\u2019addictovigilance , Bordeaux F-33000,","place":["France"]},{"name":"Universit\u00e9 de Bordeaux, Inserm UMR 1219, Bordeaux Population Health Research Center, Team, Pharmacoepidemiology , Bordeaux F-33000,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"M\u00e9t\u00e9","sequence":"additional","affiliation":[{"name":"CHU de La R\u00e9union, Service d\u2019Addictologie , Saint-Denis F-97400,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,2,15]]},"reference":[{"key":"2025052712334580200_R1","doi-asserted-by":"publisher","first-page":"126","DOI":"10.1111\/fcp.12233","article-title":"Which psychoactive substances are used by patients seen in the healthcare system in French overseas territories? 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