Electrophysiological Actions of Synthetic Cathinones on Monoamine Transporters

Products containing psychoactive synthetic cathinones, such as mephedrone and 3,4-methylenedioxypyrovalerone (MDPV) are prevalent in our society. Synthetic cathinones are structurally similar to methamphetamine, and numerous synthetics have biological activity at dopamine, serotonin, and norepinephrine transporters. Importantly, monoamine transporters co-transport sodium ions along with their substrate, and movement of substrates and ions through the transporter can generate measurable ionic currents. Here we review how electrophysiological information has enabled us to determine how synthetic cathinones affect transporter-mediated currents in cells that express these transporters. Specifically, drugs that act as transporter substrates induce inward depolarizing currents when cells are held near their resting membrane potential, whereas drugs that act as transporter blockers induce apparent outward currents by blocking an inherent inward leak current. We have employed the two-electrode voltage-clamp technique in Xenopus laevis oocytes overexpressing monoamine transporters to determine whether synthetic cathinones found in the so-called bath salts products behave as blockers or substrates. We also examined the structure-activity relationships for synthetic cathinone analogs related to the widely abused compound MDPV, a common constituent in "bath salts" possessing potent actions at the dopamine transporter.

Studies on photodegradation process of psychotropic drugs: a review

Consumption of psychotropic drugs is still increasing, especially in high-income countries. One of the most crucial consequences of this fact is significant release of them to the environment. Considerable amounts of atypical antipsychotics, benzodiazepines, antidepressants, and their metabolites were detected in river, lake, and sea water, as well as in tissues of aquatic organisms. Their ecotoxicity was proved by numerous studies. It should be noticed that interaction between psychotropic pharmaceuticals and radiation may lead to formation of potentially more toxic intermediates. On the other hand, photo-assisted wastewater treatment methods can be used as an efficient way to eliminate them from the environment. Many methods based on photolysis and photocatalysis were proposed and developed recently; nevertheless, the problem is still unsolved. However, according to recent studies, photocatalysis could be considered as the most promising and far more effective than regular photolysis. An overview on photolytic as well as homogenous and heterogeneous photocatalytic degradation methods with the use of various catalysts is presented. The photostability and phototoxicity of pharmaceuticals were also discussed. Various analytical methods were used for the photodegradation research, and this issue was also compared and summarized. Use of high-resolution multistage mass spectrometry (Q-TOF, ion trap, Orbitrap) was suggested. The combined techniques such as LC-MS, GC-MS, and LC-NMR, which enable qualitative and quantitative analyses in one run, proved to be the most valuable in this case. Assembling of MS/MS spectra libraries of drug molecules and their phototransformation products was identified as the future challenge.

Differential effect of the 17β-aminoestrogens prolame, butolame and pentolame in anxiety and depression models in rats

Estrogens of clinical use produce consistent antidepressant- and anxiolytic-like effects in animal models of menopause. Regulation of the hypothalamic-pituitary-adrenal (HPA) or stress axis, has been proposed as a pathway through which estrogens improve affective-like behaviors. Anticoagulant 17β-aminoestrogens (17β-AEs) butolame and pentolame mimic some effects of estradiol (E2), i.e., on female rodent sexual behavior, with opposite actions on coagulation. However, their psychoactive actions have not been explored. On the basis of similitude with E2's effects, we hypothesized that these 17β-AEs would induce anxiolytic- and antidepressant-like effects, which would be reflected in a reduction of activity in the HPA axis. In ovariectomized female rats, chronic treatment with prolame (60 μg/kg), butolame (65 μg/kg) and pentolame (70 μg/kg) reduced anxiety-like behavior in the elevated plus maze (evidenced by an increase in time in open arms, E2 (40 μg/kg) +176%; prolame +201%; butolame, +237%; and pentolame +295%, in comparison to the control vehicle group 100%). Pentolame also decreased significantly anxiety-like behavior in the burying behavior test. Prolame and E2 produced a significantly antidepressant-like action, which was not induced by butolame and pentolame. Behavioral effects of 17β-AEs (and E2) on anxiety and depression did not follow the same pattern than corticosterone or E2 levels; they also were associated to changes in locomotor activity, evaluated by the open field test. These results constitute the first evidence of specific and selective actions of butolame and pentolame as anxiolytics for females with a hypoestrogenic condition. Results also confirm the potential of prolame as an antidepressant steroid with equivalent actions to E2. Psychoactive properties of 17β-AEs in combinations with reduced adverse effects on coagulation, suggest that 17β-AEs may be a good alternative replacement therapy for women with symptoms associated with menopause.

Occurrence and fate of psychiatric pharmaceuticals in the urban water system of Shanghai, China

Psychiatric pharmaceuticals are the most prescribed active substances throughout the world and their presence in the environment raised concerns. The occurrence and fate of 15 selected psychiatric pharmaceuticals, including eight benzodiazepines, four antidepressants, one antiepileptic and two metabolites of benzodiazepines were investigated in wastewater treatment plant (WWTP) influents and effluents, surface water, and final drinking water in Shanghai. Psychiatric pharmaceuticals were in WWTPs influents ranging from low ng L(-1) to 68.2 ng L(-1), dominated by carbamazepine, doxepin, diazepam and lorazepam. Target analytes were still detected in effluents from low ng L(-1) range to 47.3 ng L(-1), with carbamazepine, diazepam, and oxazepam as most prevalent. WWTPs were low effective (<50%) in removing most of them, excluding amitriptyline (mean 60%), doxepin (mean 70%), temazepam (mean 78%) and lorazepam (mean 93%). In addition, carbamazepine, diazepam, oxazepam and lorazepam were detected in low ng L(-1) to 75.5 ng L(-1) in the surface water of Huang Pu Rive. The pattern of contaminants in surface water is similar to the effluent wastewater, which suggested the main source of organic trace pollutants might be WWTPs. Furthermore, carbamazepine (0.8-2.5 ng L(-1)), diazepam (0.5-3.2 ng L(-1)) and alprazolam (2.3 ng L(-1)) were also detected in drinking water and the concentrations were below the health based precautionary value. The investigation was within the range of those results reported in other countries. Our results indicate ubiquity of the investigated compounds in the aquatic system. These pollutants may potentially reach drinking water via WWTP effluents and/or surface waters and require constant attention.

New psychoactive substances: catalysing a shift in forensic science practice?

The analysis of substances of abuse remains one of the most matured areas in forensic science with a strong scientific basis, namely analytical chemistry. The current evolving drug markets, characterized by the global emergence of new psychoactive substances (NPS) and the need for forensic scientists to identify an unprecedented and ever-increasing number of NPS, presents a unique challenge to this discipline. This article looks at the current situation with NPS at the global level, and the challenges posed to the otherwise technically robust forensic science discipline of analysis of substances of abuse. It discusses the preparedness of forensic science to deal with the current situation and identifies the need for a shift in forensic science practice, especially one which embraces research and looks beyond normal casework in order to provide the much needed data for developing effective policy responses to the NPS problem.

Steric parameters, molecular modeling and hydropathic interaction analysis of the pharmacology of para-substituted methcathinone analogues

BACKGROUND AND PURPOSE

There is growing concern over the abuse of certain psychostimulant methcathinone (MCAT) analogues. This study extends an initial quantitative structure-activity relationship (QSAR) investigation that demonstrated important steric considerations of seven 4- (or para-)substituted analogues of MCAT. Specifically, the steric character (Taft's steric ES ) of the 4-position substituent affected in vitro potency to induce monoamine release via dopamine and 5-HT transporters (DAT and SERT) and in vivo modulation of intracranial self-stimulation (ICSS). Here, we have assessed the effects of other steric properties of the 4-position substituents.

EXPERIMENTAL APPROACH

Definitive steric parameters that more explicitly focus on the volume, width and length of the MCAT 4-position substituents were assessed. In addition, homology models of human DAT and human SERT based upon the crystallized Drosophila DAT were constructed and docking studies were performed, followed by hydropathic interaction (HINT) analysis of the docking results.

KEY RESULTS

The potency of seven MCAT analogues at DAT was negatively correlated with the volume and maximal width of their 4-position substituents, whereas potency at SERT increased as substituent volume and length increased. SERT/DAT selectivity, as well as abuse-related drug effects in the ICSS procedure, also correlated with the same parameters. Docking solutions offered a means of visualizing these findings.

CONCLUSIONS AND IMPLICATIONS

These results suggest that steric aspects of the 4-position substituents of MCAT analogues are key determinants of their action and selectivity, and that the hydrophobic nature of these substituents is involved in their potency at SERT.

MAM-2201, a synthetic cannabinoid drug of abuse, suppresses the synaptic input to cerebellar Purkinje cells via activation of presynaptic CB1 receptors

Herbal products containing synthetic cannabinoids-initially sold as legal alternatives to marijuana-have become major drugs of abuse. Among the synthetic cannabinoids, [1-(5-fluoropentyl)-1H-indol-3-yl](4-methyl-1-naphthalenyl)-methanone (MAM-2201) has been recently detected in herbal products and has psychoactive and intoxicating effects in humans, suggesting that MAM-2201 alters brain function. Nevertheless, the pharmacological actions of MAM-2201 on cannabinoid receptor type 1 (CB1R) and neuronal functions have not been elucidated. We found that MAM-2201 acted as an agonist of human CB1Rs expressed in AtT-20 cells. In whole-cell patch-clamp recordings made from Purkinje cells (PCs) in slice preparations of the mouse cerebellum, we also found that MAM-2201 inhibited glutamate release at parallel fiber-PC synapses via activation of presynaptic CB1Rs. MAM-2201 inhibited neurotransmitter release with an inhibitory concentration 50% of 0.36 μM. MAM-2201 caused greater inhibition of neurotransmitter release than Δ(9)-tetrahydrocannabinol within the range of 0.1-30 μM and JWH-018, one of the most popular and potent synthetic cannabinoids detected in the herbal products, within the range of 0.03-3 μM. MAM-2201 caused a concentration-dependent suppression of GABA release onto PCs. Furthermore, MAM-2201 induced suppression of glutamate release at climbing fiber-PC synapses, leading to reduced dendritic Ca(2+) transients in PCs. These results suggest that MAM-2201 is likely to suppress neurotransmitter release at CB1R-expressing synapses in humans. The reduction of neurotransmitter release from CB1R-containing synapses could contribute to some of the symptoms of synthetic cannabinoid intoxication including impairments in cerebellum-dependent motor coordination and motor learning.

Selective reagent ionisation-time of flight-mass spectrometry: a rapid technology for the novel analysis of blends of new psychoactive substances

In this study we demonstrate the potential of selective reagent ionisation-time of flight-mass spectrometry for the rapid and selective identification of a popular new psychoactive substance blend called 'synthacaine', a mixture that is supposed to imitate the sensory and intoxicating effects of cocaine. Reactions with H3O(+) result in protonated parent molecules which can be tentatively assigned to benzocaine and methiopropamine. However, by comparing the product ion branching ratios obtained at two reduced electric field values (90 and 170 Td) for two reagent ions (H3O(+) and NO(+)) to those of the pure chemicals, we show that identification is possible with a much higher level of confidence then when relying solely on the m/z of protonated parent molecules. A rapid and highly selective analytical identification of the constituents of a recreational drug is particularly crucial to medical personnel for the prompt medical treatment of overdoses, toxic effects or allergic reactions.

Effect of chromatographic conditions on retention behavior and system efficiency for HPTLC of selected psychotropic drugs on chemically bonded stationary phases

Selected psychotropic drug standards have been chromatographed on RP18, CN and diol layers with a variety of aqueous and nonaqueous mobile phases. The effect of buffers at acidic or basic pH, acetic acid, ammonia and diethylamine (DEA) in aqueous mobile phases on retention, efficiency and peak symmetry was examined. Improved peak symmetry and separation selectivity for investigated compounds were observed when ammonia or DEA were used as mobile phase additives. The effect of diethylamine concentration in aqueous eluents on retention, peak symmetry and theoretical plate number obtained on CN plates was also investigated. Because of the strong retention of these basic drugs on stationary phases bonded on silica matrix, nonaqueous eluents containing medium polar diluents, strongly polar modifiers and silanol blockers (ammonia or diethylamine) were applied. Aqueous and nonaqueous eluent systems with the best selectivity and efficiency were used for separate psychotropic drug standards' mixture on CN layer by 2D TLC.

Analysis and characterization of the novel psychoactive drug 4-chloromethcathinone (clephedrone)

Novel psychoactive drugs, such as amphetamine-, cathinone-, benzofury- and tryptamine derivatives, gained high popularity on the global drug market in the last years. These drugs are sold via the Internet as for example "research chemicals", "room odorizers" or "lawn fertilizers" by different online suppliers. They are also known as "Legal Highs", among them, cathinone derivatives play an important role. Well known substituted cathinone derivatives are mephedrone, brephedrone and flephedrone. Since a couple of weeks, a chlorine substituted methcathinone derivative, namely clephedrone (4-chloromethcathinone), is commercially available via the Internet from www.deboralabs.com. The goal of this study was to confirm identity of this substance, which was done successfully by GC-MS and NMR. Since all cathinone derivatives are chiral, it was found out, whether the purchased sample was present as a racemic mixture. For this purpose, methods for enantioseparation by GC and CE were developed and applied successfully. In case of CE a chiral selector was added, whereas chiral separation with GC-MS was done indirectly, after derivatization of clephedrone with trifluoroacetyl-l-prolyl chloride.

Implications of psychoactive 'bath salts' use during pregnancy

Psychoactive bath salts (PABS) comprise a group of highly dangerous designer drugs showing a sharp escalation in reported U.S. exposures from 2010 through 2012, following rapid spread of the drug in Europe. Since a federal ban on the major ingredients in October 2011, numbers have declined. However, evidence from the United Kingdom shows an initial decline after the UK ban in 2010 with a 400 percent increase in reports by 2012. Actual information about the effect of PABS use on pregnant women and fetuses is almost nonexistent. Clinicians should be aware of the potential maternal, fetal and neonatal effects of PABS.

[Role of GABA-A receptors in mechanism of psychotropic action of pyrrol[1,2-a][1,4]diazepines studied using drug discrimination technique in Wistar rats]

The role of GABA-A receptors in psychotropic effects of pyrrolo[1,2-a][1,4]diazepine derivatives GMAL-24 and GMAL-27 has been studied on an operant method with liquid reinforcement of drug discrimination in male Wistar rats. It is established that, in substitution tests, GMAL-24 (2, 5, 10 mg/kg) and GMAL-27 (2, 5, 10 mg/kg) do not produce interoceptive effects of phenazepam (1 mg/kg) and fail to inhibit interoceptive effects of corasol (20 mg/kg). The obtained results indicate that pyrrolo[1,2-a][1,4]diazepine derivatives do not exhibit GABA-A receptor-positive modulator properties in vivo.

Psychoactive pharmaceuticals in sludge and their emission from wastewater treatment facilities in Korea

Concern over the occurrence of pharmaceuticals and their metabolites in the environment is mounting due to the potential adverse effects on nontarget organisms. This study draws upon a nationwide survey of psychoactive pharmaceuticals (i.e., antischizophrenics, anxiolytics, and antidepressants) in sludge from 40 representative wastewater treatment plants (WWTPs) that receive domestic, industrial, or mixed (domestic plus industrial) wastewaters in Korea. A total of 16 psychoactive pharmaceuticals (0.12-460 ng/g dry weight) and nine of their metabolites (0.97-276 ng/g dry weight) were determined in sludge. The median concentrations of psychoactive drugs in sludge from domestic WWTPs were 1.2-3.2 times higher than the concentrations found in WWTPs that receive combined domestic and industrial wastewaters. Among the psychoactive drugs analyzed, the median environmental emission rates of alprazolam (APZ) and carbamazepine (CBZ) through domestic WWTPs (both sludge and effluent discharges combined) were calculated to be ≥ 15.5 μg/capita/day, followed by quetiapine (QTP; 8.51 μg/capita/day), citalopram (CLP; 5.45 μg/capita/day), and venlafaxine (VLF; 3.59 μg/capita/day). The per-capita emission rates of some of the metabolites of psychoactive drugs through WWTP discharges were higher than those calculated for parent compounds. Significant correlations (ρ = 0.432-0.780, p < 0.05) were found between the concentrations of typically coprescribed antischizophrenics and antidepressants in sludge. Multiple linear regression analysis of measured concentrations of drugs in sludge revealed that several WWTP parameters such as treatment capacity, population-served, sludge production rate, composition of wastewater (domestic versus industrial), and hydraulic retention time can affect the concentrations of psychoactive drugs in sludge.

Structural elucidation and identification of a new derivative of phenethylamine using quadrupole time-of-flight mass spectrometry

RATIONALE

In recent years, the phenomenon of uncontrolled distribution of new psychoactive substances that were marketed without prior toxicological studies has been observed. Because many designer drugs are related in chemical structure, the potential for misidentifying them is an important problem. It is therefore essential to develop an analytical procedure for unequivocal elucidation of the structures of these compounds. The issue has been discussed in the context of 25I-NBMD [2-(4-iodo-2,5-dimethoxyphenyl)-N-[(2,3-methylenedioxyphenyl)methyl]ethanamine], a psychoactive substance first discovered on the drug market in 2012.

METHODS

The substance was extracted from blotter papers with methanol. Separation was achieved via liquid chromatography. Analysis was conducted by electrospray ionization quadrupole time-of-flight mass spectrometry (ESI-QTOFMS). Identification of the psychoactive component was supported by electron impact gas chromatography/mass spectrometry (GC/EI-MS).

RESULTS

The high accuracy of the LC/ESI-QTOFMS method allowed the molecular mass of the investigated substance (M(exp) = 441.0438 Da; mass error, ∆m = 0.2 ppm) and the formulae of ions formed during fragmentation to be determined. The main ions were recorded at m/z = 135.0440, 290.9876 and 305.9981. Structures of the obtained ions were elucidated in the tandem mass spectrometry (MS/MS) experiments by comparing them to mass spectra of previously detected derivatives of phenethylamine.

CONCLUSIONS

The performed study indicated the potential for using LC/QTOFMS method to identify new designer drugs. This technique can be used supplementary to standard GC/MS. Prior knowledge of the fragmentation mechanisms of phenethylamines allowed to predict the mass spectra of the novel substance--25I-NBMD.

Distinguishing two isomeric mephedrone substitutes with selective reagent ionisation mass spectrometry (SRI-MS)

The isomers 4-methylethcathinone and N-ethylbuphedrone are substitutes for the recently banned drug mephedrone. We find that with conventional proton transfer reaction mass spectrometry (PTR-MS), it is not possible to distinguish between these two isomers, because essentially for both substances, only the protonated molecules are observed at a mass-to-charge ratio of 192 (C12 H18NO(+)). However, when utilising an advanced PTR-MS instrument that allows us to switch the reagent ions (selective reagent ionisation) from H3O(+) (which is commonly used in PTR-MS) to NO(+), O2(+) and Kr(+), characteristic product (fragment) ions are detected: C4H10N(+) (72 Da) for 4-methylethcathinone and C5 H12N(+) (86 Da) for N-ethylbuphedrone; thus, selective reagent ionisation MS proves to be a powerful tool for fast detection and identification of these compounds.

[Recreational drugs: the complication's pleasure?]

Steadily increasing since 1990, the use of psychoactive substances was expanded to new designer drugs (bath salts, spice) with so original still unknown pharmacological effects. At the beginning, the pleasure, first feeling, turns sometimes, in acute medical emergency and then, in some cases, in chronic diseases. Side expected or not desired effects, seen in emergency departments could be necrotizing gangrene among consumers Krokodil or dystonic reactions in consumers of Spice. Moreover, adulterants could increase the dangerosity of the substances. Searching a toxidrome helps to find the incrimining substance.

Bath salts and synthetic cathinones: an emerging designer drug phenomenon

Synthetic cathinones are an emerging class of designer drugs abused for psychostimulant and hallucinogenic effects similar to cocaine, methylenedioxymethamphetamine (MDMA), or other amphetamines. Abuse of synthetic cathinones, frequently included in products sold as 'bath salts', became prevalent in early 2009, leading to legislative classification throughout Europe in 2010 and schedule I classification within the United States in 2011. Recent pre-clinical and clinical studies indicate that dysregulation of central monoamine systems is a principal mechanism of synthetic cathinone action and presumably underlie the behavioral effects and abuse liability associated with these drugs. This review provides insight into the development of synthetic cathinones as substances of abuse, current patterns of their abuse, known mechanisms of their action and toxicology, and the benefits and drawbacks of their classification.

Argyreia nervosa (Burm. f.): receptor profiling of lysergic acid amide and other potential psychedelic LSD-like compounds by computational and binding assay approaches

ETHNOPHARMACOLOGICAL RELEVANCE

The convolvulacea Argyreia nervosa (Burm. f.) is well known as an important medical plant in the traditional Ayurvedic system of medicine and it is used in numerous diseases (e.g. nervousness, bronchitis, tuberculosis, arthritis, and diabetes). Additionally, in the Indian state of Assam and in other regions Argyreia nervosa is part of the traditional tribal medicine (e.g. the Santali people, the Lodhas, and others). In the western hemisphere, Argyreia nervosa has been brought in attention as so called "legal high". In this context, the seeds are used as source of the psychoactive ergotalkaloid lysergic acid amide (LSA), which is considered as the main active ingredient.

AIM OF THE STUDY

As the chemical structure of LSA is very similar to that of lysergic acid diethylamide (LSD), the seeds of Argyreia nervosa (Burm. f.) are often considered as natural substitute of LSD. In the present study, LSA and LSD have been compared concerning their potential pharmacological profiles based on the receptor binding affinities since our recent human study with four volunteers on p.o. application of Argyreia nervosa seeds has led to some ambiguous effects.

MATERIAL AND METHODS

In an initial step computer-aided in silico prediction models on receptor binding were employed to screen for serotonin, norepinephrine, dopamine, muscarine, and histamine receptor subtypes as potential targets for LSA. In addition, this screening was extended to accompany ergotalkaloids of Argyreia nervosa (Burm. f.). In a verification step, selected LSA screening results were confirmed by in vitro binding assays with some extensions to LSD.

RESULTS

In the in silico model LSA exhibited the highest affinity with a pKi of about 8.0 at α1A, and α1B. Clear affinity with pKi>7 was predicted for 5-HT1A, 5-HT1B, 5-HT1D, 5-HT6, 5-HT7, and D2. From these receptors the 5-HT1D subtype exhibited the highest pKi with 7.98 in the prediction model. From the other ergotalkaloids, agroclavine and festuclavine also seemed to be highly affine to the 5-HT1D-receptor with pKi>8. In general, the ergotalkaloids of Argyreia nervosa seem to prefer serotonin and dopamine receptors (pKi>7). However, with exception of ergometrine/ergometrinine only for 5-HT3A, and histamine H2 and H4 no affinities were predicted. Compared to LSD, LSA exhibited lower binding affinities in the in vitro binding assays for all tested receptor subtypes. However, with a pKi of 7.99, 7.56, and 7.21 a clear affinity for 5-HT1A, 5-HT2, and α2 could be demonstrated. For DA receptor subtypes and the α1-receptor the pKi ranged from 6.05 to 6.85.

CONCLUSION

Since the psychedelic activity of LSA in the recent human study was weak and although LSA from Argyreia nervosa is often considered as natural exchange for LSD, LSA should not be regarded as LSD-like psychedelic drug. However, vegetative side effects and psychotropic effects may be triggered by serotonin or dopamine receptor subtypes.

[Enantiomers: a new problem in pharmacotherapy of depression?]

Enantiomers as a optically active forms of drugs now have a big impact on most areas of pharmacotherapy. They arouse a large interest in the field of psychiatry and especially in the treatment of depression. This is due to the fact that enantiomers (chiral forms) of many drugs may have a different pharmacokinetic, pharmacological or pharmacogenetic profiles. Therefore, in many cases the use of a single enantiomer of the drug may have huge advantages over previously used forms and lead to strong improvement of the current treatments. An example is the stereoselective property of such a psychotropic drug fluoxetine as belonging to a group of selective serotonin reuptake inhibitors (SSRI).

Conformational analysis of flephedrone using quantum mechanical models

Flephedrone is an analogue of cathinone - chemically similar to ephedrine, cathine and other amphetamines. Conformations of all isomers of flephedrone have been studied at the quantum-chemical level. Calculations have been performed using DFT and MP2 methods with two basis sets - 6-31G and 6-31G(d,p). Results show that there are low energy conformers for the ortho, meta, and para isomers that are connected by way of low-barrier transition states. Boltzmann distribution of population predicts the highest population for the 1-meta conformer with a 10% increase in solution. The molecular electrostatic potential surface data for each molecule has been calculated revealing likely reaction sites.

Single chemical entity legal highs: assessing the risk for long term harm

A recent and dramatic increase in the emergence of novel psychoactive substances ('legal highs') has left many governments unable to provide a timely response to an increasing number of potentially harmful drugs now available to the public. In response to this rapid increase in lawful drug use, the UK government intends to implement temporary class drug orders, whereby substances with a potential for misuse and harm can be regulated for a 12 month period. During this period an investigation of the potential for harms induced by these drugs will take place. However, the short time-frame in which information must be gathered, and the paucity of data available on novel psychoactive substances, means that robust pharmacological and toxicological analyses may be replaced by extrapolating data from illegal drugs with similar chemical structures. This review explores the potential pharmacology and toxicology of past and present 'legal highs' and discusses the risks of failing to carry out in-depth scientific research on individual substances.

Pharmacological activity of salvinorin A, the major component of Salvia divinorum

The hallucinogenic plant Salvia divinorum (i.e., "magic mint") is a member of the Sage family that has been historically used for divination and shamanism by the Mazatecs. Today, S. divinorum has become increasingly popular as a recreational drug for its hallucinogenic effects. The non-nitrogenous diterpene, salvinorin A, the major active component of S. divinorum, is responsible for the hallucinogenic effect of this plant. Here, we described the behavioral effects of salvinorin A in animals including the addictive, antinociception and antidepressant properties of the drug. The present paper also demonstrates the not well recognized (or unclear) mechanisms of action of salvinorin A. The last part of the paper presents information about the legal status of S. divinorum and its derivatives. Taking into account the increasing popularity and consumption of salvinorin A and S. divinorum today, it is important to collect all data on the pharmacological profile of this plant and its products.

Psychoactive "bath salts" intoxication with methylenedioxypyrovalerone

Abuse of the psychoactive "designer drug" methylenedioxypyrovalerone (MDPV) has become a serious international public health concern because of the severity of its physical and behavioral toxicities. MDPV is the primary ingredient in so-called "bath salts," labeled as such to avoid criminal prosecution and has only been classified recently as a controlled substance in the United States and some other countries. However, it remains a danger because of illegal sources, including the Internet. MDPV is a synthetic, cathinone-derivative, central nervous system stimulant and is taken to produce a cocaine- or methamphetamine-like high. Administered via oral ingestion, nasal insufflation, smoking, intravenous or intramuscular methods, or the rectum, the intoxication lasts 6 to 8 hours and has high addictive potential. Overdoses are characterized by profound toxicities, causing increased attention by emergency department and law enforcement personnel. Physical manifestations range from tachycardia, hypertension, arrhythmias, hyperthermia, sweating, rhabdomyolysis, and seizures to those as severe as stroke, cerebral edema, cardiorespiratory collapse, myocardial infarction, and death. Behavioral effects include panic attacks, anxiety, agitation, severe paranoia, hallucinations, psychosis, suicidal ideation, self-mutilation, and behavior that is aggressive, violent, and self-destructive. Treatment is principally supportive and focuses on counteracting the sympathetic overstimulation, including sedation with intravenous benzodiazepines, seizure-prevention measures, intravenous fluids, close (eg, intensive care unit) monitoring, and restraints to prevent harm to self or others. Clinical presentation is often complicated by coingestion of other psychoactive substances that may alter the treatment approach. Clinicians need to be especially vigilant in that MDPV is not detected by routine drug screens and overdoses can be life-threatening.