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Csaszar F, B Erdos M, Ellis R, Kelemen G, Javor R. Novel Psychoactive Substance Use and Psychological Trauma: A Multimethodological Analysis. Subst Use Misuse 2024:1-9. [PMID: 38907593 DOI: 10.1080/10826084.2024.2369181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/24/2024]
Abstract
BACKGROUND Authors discuss the connections between novel psychoactive substance (NPS) use and psychological trauma. The transition from classical substances to NPS, a paradigm change, poses a challenge for the treatment systems. Objective: Research evidence suggests difficulties in emotion regulation and trauma-related NPS-use. Authors explore some demographic and psychopathological characteristics related to such findings and examine the connections between emotion regulation deficiency and the choice of substance. METHOD This study uses a methodological triangulation of a biologically identified sample to confirm NPS use, a survey method to describe users' socioeconomic characteristics, and Minnesota Multiphasic Personality Inventory (MMPI-2) subscales to study dysfunctions in emotion regulation. RESULTS Participants (77 patients) were mainly polydrug users. The transgenerational transfer of substance use was a salient feature, but material deprivation was not characteristic of the entire sample. NPS use was not connected to certain psychopathological characteristics the way classical substance use was. More than half of the respondents had elevated scores on MMPI-2 Demoralization (RCd) and Dysfunctional Negative Emotions (RC7) scales. Nearly half of them also scored high on Neuroticism/Negative Emotionality (NEGE). CONCLUSIONS Results suggest that NPS use in the context of polydrug use is connected to psychological trauma and emotion regulation deficiency, but the MMPI-2 scales to assess emotional dysfunctions are not connected to a particular type of NPS.
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Affiliation(s)
- Ferenc Csaszar
- Doctoral School of Clinical Neurosciences, Medical School, University of Pécs & Addiction Rehabilitation Department of Szigetvár Hospital, Szigetvár, Hungary
| | - Marta B Erdos
- Department of Community and Social Studies, Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
- Social Innovation Evaluation Research Centre (SIERC), Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
| | - Roger Ellis
- Social and Health Evaluation Unit - Identity Exploration Ltd., United Kingdom & University of Chester, Chester, UK
| | | | - Rebeka Javor
- Social Innovation Evaluation Research Centre (SIERC), Faculty of Humanities and Social Sciences, University of Pécs, Pécs, Hungary
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Chen S, Zhou W, Lai M. Synthetic Cathinones: Epidemiology, Toxicity, Potential for Abuse, and Current Public Health Perspective. Brain Sci 2024; 14:334. [PMID: 38671986 PMCID: PMC11048581 DOI: 10.3390/brainsci14040334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 03/11/2024] [Accepted: 03/23/2024] [Indexed: 04/28/2024] Open
Abstract
Synthetic cathinones, derived from cathinone found in the plant Catha edulis, represent the second largest and most frequently seized group of new psychoactive substances. They are considered as β-keto analogs of amphetamine, sharing pharmacological effects with amphetamine and cocaine. This review describes the neurotoxic properties of synthetic cathinones, encompassing their capacity to induce neuroinflammation, dysregulate neurotransmitter systems, and alter monoamine transporters and receptors. Additionally, it discusses the rewarding and abuse potential of synthetic cathinones drawing from findings obtained through various preclinical animal models, contextualized with other classical psychostimulants. The review also offers an overview of current abuse trends of synthetic cathinones on the illicit drug market, specifying the aspects covered, and underscores the risks they pose to public health. Finally, the review discusses public health initiatives and efforts to reduce the hazards of synthetic cathinones, including harm reduction methods, education, and current clinical management strategies.
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Affiliation(s)
- Shanshan Chen
- Zhejiang Provincial Key Laboratory of Addiction Research, The Affiliated Kangning Hospital of Ningbo University, Ningbo 315201, China; (S.C.); (W.Z.)
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo 315201, China
| | - Wenhua Zhou
- Zhejiang Provincial Key Laboratory of Addiction Research, The Affiliated Kangning Hospital of Ningbo University, Ningbo 315201, China; (S.C.); (W.Z.)
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo 315201, China
| | - Miaojun Lai
- Zhejiang Provincial Key Laboratory of Addiction Research, The Affiliated Kangning Hospital of Ningbo University, Ningbo 315201, China; (S.C.); (W.Z.)
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo 315201, China
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3
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Li K, Liu X, Zhang M, Su R. Effects of Ketanserin, M100907 and Olanzapine on hallucinogenic like action induced by 2,5-dimethoxy-4-methylamphetamine. Behav Pharmacol 2023; 34:92-100. [PMID: 36752335 DOI: 10.1097/fbp.0000000000000693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
2,5-dimethoxy-4-methylamphetamine (DOM) is a kind of hallucinogen of phenylalkylamine. Psychedelic effects mainly include audiovisual synesthesia, complex imagery, disembodiment etc. that can impair control and cognition leading to adverse consequences such as suicide. By now, there are no specific drugs regarding the management of classic hallucinogen use clinically. We evaluated the effects of three 5-HT 2A receptor antagonists ketanseirn, M100907 and olanzapine on hallucination-like behavior in therapeutic and preventive administration with male C57BL/6J mice. Two models were used to evaluate the therapeutic potential of antagonists, one is head-twitch response (HTR) and the other is locomotion. Effects of ketanserin, M100907 and olanzapine on DOM-induced HTR were studied in preventive and therapeutic administration, respectively. In the preventive administration, the ID 50 values of ketanseirn, M100907 and olanzapine were 0.4 mg/kg, 0.005 mg/kg and 0.25 mg/kg. In the therapeutic administration, the ID 50 values of ketanseirn, M100907 and olanzapine were 0.04 mg/kg, 0.005 mg/kg and 0.03 mg/kg. Secondly, locomotor activity induced by DOM was performed to further evaluate the efficacy of three compounds. In locomotion, M100907(0.005 mg/kg) whenever in preventive or therapeutic administration, reduced the increase of movement distance induced by DOM. Although ketanserin (0.4 mg/kg) in the preventive administration also decreased the movement distance induced by DOM, it was alone administrated to influence the locomotor activity. Through HTR and locomotion, we compared the efficacy and latent side effects of ketanserin, M100907 and olanzapine against hallucinogenic like action induced by DOM. Our study provided additional experimental evidence on specific therapeutic drugs against hallucinogenic behavior induce by representative hallucinogen DOM.
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Affiliation(s)
- Kaixi Li
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing
- Shihezi University College of Pharmacy/Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, Shihezi, Department of Pharmacy, Xinjiang, China
| | - Xiaoyan Liu
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing
| | - Mei Zhang
- Shihezi University College of Pharmacy/Key Laboratory of Xinjiang Phytomedicine Resource and Utilization, Ministry of Education, Shihezi, Department of Pharmacy, Xinjiang, China
| | - Ruibin Su
- State Key Laboratory of Toxicology and Medical Countermeasures, Beijing Key Laboratory of Neuropsychopharmacology, Beijing Institute of Pharmacology and Toxicology, Beijing
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Sarparast A, Thomas K, Malcolm B, Stauffer CS. Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review. Psychopharmacology (Berl) 2022; 239:1945-1976. [PMID: 35253070 PMCID: PMC9177763 DOI: 10.1007/s00213-022-06083-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/03/2022] [Indexed: 12/13/2022]
Abstract
RATIONALE & OBJECTIVES ± 3,4-Methylenedioxymethamphetamine (MDMA) and psilocybin are currently moving through the US Food and Drug Administration's phased drug development process for psychiatric treatment indications: posttraumatic stress disorder and depression, respectively. The current standard of care for these disorders involves treatment with psychiatric medications (e.g., selective serotonin reuptake inhibitors), so it will be important to understand drug-drug interactions between MDMA or psilocybin and psychiatric medications. METHODS In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we queried the MEDLINE database via PubMed for publications of human studies in English spanning between the first synthesis of psilocybin (1958) and December 2020. We used 163 search terms containing 22 psychiatric medication classes, 135 specific psychiatric medications, and 6 terms describing MDMA or psilocybin. RESULTS Forty publications were included in our systematic review: 26 reporting outcomes from randomized controlled studies with healthy adults, 3 epidemiologic studies, and 11 case reports. Publications of studies describe interactions between MDMA (N = 24) or psilocybin (N = 5) and medications from several psychiatric drug classes: adrenergic agents, antipsychotics, anxiolytics, mood stabilizers, NMDA antagonists, psychostimulants, and several classes of antidepressants. We focus our results on pharmacodynamic, physiological, and subjective outcomes of drug-drug interactions. CONCLUSIONS As MDMA and psilocybin continue to move through the FDA drug development process, this systematic review offers a compilation of existing research on psychiatric drug-drug interactions with MDMA or psilocybin.
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Affiliation(s)
- Aryan Sarparast
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA
| | - Kelan Thomas
- College of Pharmacy, Touro University California, Vallejo, CA, 94592, USA
| | | | - Christopher S Stauffer
- Department of Psychiatry, Oregon Health & Science University, Portland, OR, 97239, USA.
- Department of Mental Health, VA Portland Health Care System, Portland, OR, 97239, USA.
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5
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Roy S, Charreteur R, Peries M, Kheloufi F, Eiden C, Nagot N, Donnadieu-Rigole H, Micallef J, Peyrière H. Abuse and misuse of second-generation antipsychotics: an analysis using VigiBase TM , the World Health Organisation pharmacovigilance database. Br J Clin Pharmacol 2022; 88:4646-4653. [PMID: 35633029 DOI: 10.1111/bcp.15420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 05/16/2022] [Accepted: 05/18/2022] [Indexed: 11/30/2022] Open
Abstract
The study aim was to assess the abuse/misuse potential of second-generation antipsychotics (SGAPs) using VigiBaseTM data. We extracted individual case safety reports (ICSRs) of 'Drug abuse, dependence, and withdrawal' involving SGAPs up to June 2018. We assessed disproportionate reporting by calculating the Information Component (IC), considering the lower end of the 95% credibility interval for IC (IC025 ), and the Proportional Reporting Ratio (PRR). We identified 1,683 ICSRs recorded as 'abuse, dependence, and withdrawal' involving SGAPs, mainly quetiapine (n=1,089) and olanzapine (n=209). The disproportional reporting indicators highlighted an association between 'Drug abuse and dependence', and quetiapine, olanzapine, and ziprasidone, as indicated by the IC025 (2.263, 0.259, and 1.051, respectively) and PRR values (3.929, 1.020, and 1.334, respectively). The abuse/misuse potential is confirmed for quetiapine and olanzapine and highlighted for the first time for ziprasidone. Physicians should consider these risks when prescribing these antipsychotics, especially to patients with history of drug abuse.
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Affiliation(s)
- Sophie Roy
- Addictovigilance Centre, Montpellier University Hospital, Montpellier, France
| | - Robin Charreteur
- Addictovigilance Centre, Montpellier University Hospital, Montpellier, France
| | - Marianne Peries
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, Montpellier, France
| | - Farid Kheloufi
- Addictovigilance Centre, Department of Clinical Pharmacology and Pharmacovigilance, University of Aix Marseille, INSERM UMR 1106 Institut de Neurosciences des Systèmes, Marseille, France
| | - Céline Eiden
- Addictovigilance Centre, Montpellier University Hospital, Montpellier, France
| | - Nicolas Nagot
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, Montpellier, France
| | - Hélène Donnadieu-Rigole
- Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, Montpellier, France.,Department of Addictology, Montpellier University Hospital, Montpellier, France
| | - Joëlle Micallef
- Addictovigilance Centre, Department of Clinical Pharmacology and Pharmacovigilance, University of Aix Marseille, INSERM UMR 1106 Institut de Neurosciences des Systèmes, Marseille, France
| | - Hélène Peyrière
- Addictovigilance Centre, Montpellier University Hospital, Montpellier, France.,Pathogenesis and Control of Chronic Infections, University of Montpellier, INSERM, EFS, Montpellier, France
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Pham A, Lee JY, Miller CWT. Acute Extrapyramidal Side Effects from Smoked Haloperidol. Case Rep Psychiatry 2021; 2021:4177263. [PMID: 34635875 PMCID: PMC8502104 DOI: 10.1155/2021/4177263] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/27/2021] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Haloperidol is a dopamine receptor antagonist used to treat patients with psychotic disorders. Especially at high doses, haloperidol carries a higher risk of extrapyramidal symptoms (EPS) compared to second-generation antipsychotics. Few cases of haloperidol misuse are found in the medical literature. Case Presentation. We describe a patient with schizophrenia who smoked marijuana mixed with crushed haloperidol tablets. After the smoking of cannabis and haloperidol, the patient presented to the emergency department (ED) with suicidal ideation, psychosis, and acute dystonia. With the administration of intramuscular diphenhydramine at the ED, the dystonia resolved in less than an hour. To our knowledge, this is the first report on haloperidol misuse by smoking. CONCLUSION Clinicians should be aware that patients might misuse prescribed antipsychotics via unconventional routes, potentially combined with other substances.
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Affiliation(s)
- Angeline Pham
- Department of Psychiatry, University of Maryland Medical Center, USA
| | - Joo-Young Lee
- Department of Psychiatry, University of Maryland Medical Center, USA
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Turoňová D, Kujovská Krčmová L, Švec F. Application of microextraction in pipette tips in clinical and forensic toxicology. Trends Analyt Chem 2021. [DOI: 10.1016/j.trac.2021.116404] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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8
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Smith KE, Rogers JM, Strickland JC, Epstein DH. When an obscurity becomes trend: social-media descriptions of tianeptine use and associated atypical drug use. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2021; 47:455-466. [PMID: 33909525 DOI: 10.1080/00952990.2021.1904408] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Originally believed to be an atypical antidepressant acting at serotonin transporters, tianeptine is now known to also be an atypical agonist at mu-opioid receptors. Its nonmedical use may be increasing amidst the broader context of novel drug and supplement use.Objectives: To analyze social-media text from current, former, and prospective tianeptine users for better understanding of their conceptualizations of tianeptine, motives for and patterns of use, and reported benefits and harms.Methods: Reddit posts were obtained and thematically coded; additional quantitative analyses were conducted.Results: A total of 210 posts mentioning tianeptine were made between 2012 and 2020. Eighteen thematic categories were identified, 10 of which were consistent with expected themes. Two independent raters coded all text, generating 1,382 unique codes, of which 1,090 were concordant (78.9% interrater agreement). Tianeptine use was frequently associated with use of other drugs, particularly kratom, phenibut, and racetams. People conceptualized and variously used tianeptine as an opioid, antidepressant, and "nootropic" (cognitive enhancer). Between 2014 and 2020, mentions of positive effects decreased, while mentions of adverse effects and withdrawal increased. Motivations for use included substitution or withdrawal mitigation for other drugs (especially opioids) and for kratom itself; self-treatment for psychiatric symptoms; and improvement of quality of life, mood, or performance. Descriptions of tolerance, withdrawal, and addiction were evident. Intravenous use was rare and strongly discouraged, with detrimental effects described.Conclusion: Tianeptine is recognized as an opioid (though not only an opioid) in online communities. Posts describe benefits, acute risks, and patterns of co-use that warrant greater clinical attention.
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Affiliation(s)
- Kirsten E Smith
- National Institute on Drug Abuse Intramural Research Program, Translational Addiction Medicine Branch, Baltimore, MD, USA
| | - Jeffery M Rogers
- National Institute on Drug Abuse Intramural Research Program, Translational Addiction Medicine Branch, Baltimore, MD, USA
| | - Justin C Strickland
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - David H Epstein
- National Institute on Drug Abuse Intramural Research Program, Translational Addiction Medicine Branch, Baltimore, MD, USA
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9
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Sutherland R, Jayathilake R, Peacock A, Dietze P, Bruno R, Reddel S, Gisev N. Trends and characteristics of extra-medical use of quetiapine among people who regularly inject drugs in Australia, 2011-2018. Drug Alcohol Depend 2021; 221:108636. [PMID: 33631549 DOI: 10.1016/j.drugalcdep.2021.108636] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 01/31/2021] [Accepted: 02/02/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS There are ongoing concerns regarding the extra-medical use of quetiapine and related harms. We aimed to investigate trends in quetiapine use and extra-medical use among people who regularly inject drugs (PWID) in Australia between 2011-2018, and examine changes in the characteristics associated with extra-medical use of quetiapine, comparing those reporting use in 2011 and 2018. METHODS This study examines eight years of survey data (2011-2018; n = 7,135 PWID) from Australia's Illicit Drug Reporting System. Linear regression was used to analyse trends over time, and multinomial logistic regression used to identify factors associated with extra-medical quetiapine use in 2011 and 2018. FINDINGS The percentage of PWID reporting extra-medical quetiapine use decreased from 14.9 % in 2011 to 12.0 % in 2018; ranging between 10.5 %-15.8 % across years, and reported use was typically infrequent (less than once a month). In both 2011 and 2018, extra-medical quetiapine use was associated with use of benzodiazepines (2011 Adjusted Odds Ratio (AOR) 4.76, 95 % confidence interval (Cl) 2.31-9.82; 2018 AOR 3.10, 95 % Cl 1.84-5.23) and stimulants (2011 AOR 2.81, 95 % Cl 1.51-5.21; 2018 AOR 2.68, 95 % Cl 1.32-5.46) in the past six months. CONCLUSIONS Slightly more than one in ten PWID reported extra-medical quetiapine use between 2011-2018. Overall, the frequency of extra-medical quetiapine use among PWID was low, however, individuals often engaged in polysubstance use that has the potential to cause other drug-related harms. Targeted harm-reduction interventions focused on polysubstance use are therefore warranted to reduce potential risks among this group.
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Affiliation(s)
- Rachel Sutherland
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia.
| | - Rashmi Jayathilake
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Amy Peacock
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia; School of Psychology, School of Medicine, University of Tasmania, Sandy Bay, TAS, 7005, Australia
| | - Paul Dietze
- Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia; School of Psychology, School of Medicine, University of Tasmania, Sandy Bay, TAS, 7005, Australia
| | - Siobhan Reddel
- Victorian Counselling and Psychology Services, 23 Swanston St, Melbourne, VIC, 3000, Australia; La Trobe Community Health Service, 31 Mason St, Warragul, VIC, 3820, Australia; Budja Budja Aboriginal Cooperative Health Service, 20-22 Grampians Rd, Halls Gap, VIC, 3381, Australia
| | - Natasa Gisev
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, 2052, Australia
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10
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The e-psychonaut drugs' psychopharmacology. Curr Opin Pharmacol 2021; 57:165-174. [PMID: 33774473 DOI: 10.1016/j.coph.2021.02.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 02/23/2021] [Accepted: 02/24/2021] [Indexed: 01/31/2023]
Abstract
The focus here was on the pharmacological and clinical pharmacological issues pertaining to the vast range of drugs (e.g. synthetic cannabimimetics, synthetic opioids, novel stimulants, novel psychedelics, PCP/ketamine-like compounds, prescribed medicinal compounds and popular psychotropic herbs/plants) discussed by Internet-based enthusiasts of new/novel psychoactive substances (NPS), 'e-psychonauts'. Currently ongoing related in silico studies, followed by further in vitro and in vivo/preclinical studies, will hopefully provide important findings in terms of which molecules within each given NPS class may present with higher levels of receptor affinities, and hence clinical potency. Understanding the pharmacological characteristics/potency of those novel recreational molecules will hopefully help in predicting related NPS diffusion, morbidity and possible lethality data.
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Abstract
OPINION STATEMENT Olanzapine has become a major drug in the management of chemotherapy-induced nausea and vomiting as a prophylactic agent. In addition, a recent randomized trial has demonstrated its benefits in treating nausea and vomiting associated with advanced cancer. The added benefit to olanzapine is that it also stimulates appetite. As a result, since it treats multiple symptoms associated with advanced cancer, it is likely to become the antiemetic of choice in palliative care at least in the USA. The added benefit of treating insomnia and the avoidance of benzodiazepines should place olanzapine in at the top of the list of drugs to use for patients who do complain of insomnia. There is no good evidence that it potentiates the respiratory depression of opioids unlike benzodiazepines. The evidence is weak that olanzapine in as an adjuvant analgesic. Hopefully, future trials will explore this in greater depth. The benefits of adding olanzapine to potent opioids are that it may reduce craving, drug cues, and opioid misuse. Other symptoms like anxiety and depression may be addressed by the addition of olanzapine to standard antidepressants.
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Affiliation(s)
- Mellar P Davis
- Geisinger Medical Center, 100 N Academy Ave, Danville, PA, 17822, USA.
| | - Gareth J Sanger
- Blizard Institute and National Bowel Research Centre, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, England
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12
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Schifano F. Coming Off Prescribed Psychotropic Medications: Insights from Their Use as Recreational Drugs. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 89:274-282. [PMID: 32615566 DOI: 10.1159/000507897] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 04/15/2020] [Indexed: 11/19/2022]
Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom,
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13
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Natter J, Michel B. Memantine misuse and social networks: A content analysis of Internet self-reports. Pharmacoepidemiol Drug Saf 2020; 29:1189-1193. [PMID: 32602152 DOI: 10.1002/pds.5070] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 05/05/2020] [Accepted: 05/29/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE Memantine is a N-methyl-D-aspartate (NMDA) receptor antagonist currently used for moderate-to-severe Alzheimer's disease. Although the risk of memantine abuse is very low, other NMDA receptor antagonists, such as phencyclidine and ketamine, are well known to drug users. The purpose of this study was to collect data on social networks in order to identify unexpected forms of memantine abuse. METHOD A Google Trends search was used to highlight reddit.com as a major source of social discussions about memantine. Self-reported users experiences posted on reddit.com were recorded and sorted using representative keywords. RESULTS From 2010 to November 2019, 307 topics citing memantine were identified on reddit.com and 136 users experiences extracted from the topics were recorded. The main use identified was "self-medication" based on off-label uses of memantine such as anxiety, depression, attention-deficit hyperactivity disorder, or obsessive-compulsive disorder (n = 87 reports), followed by nootropic (42) and recreational (39) uses. The average reported doses for acute and chronic uses were 156 ± 110 mg and 23 ± 24 mg respectively. For chronic use, the average duration was 15 ± 29 weeks. Most chronic users (77 out of 100) reported at least one side effect. CONCLUSION Memantine misuse seems to be a growing phenomenon. Beyond expected use for recreational purpose; the main uses identified on reddit.com were not reported in the medical literature. Off-label uses and nootropic purposes seemed to be key features of memantine misuse.
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Affiliation(s)
- Johan Natter
- Faculty of Pharmacy, University of Strasbourg, Strasbourg, France.,Department of Pharmacy, University Hospital of Strasbourg, Strasbourg, France
| | - Bruno Michel
- Faculty of Pharmacy, University of Strasbourg, Strasbourg, France.,Department of Pharmacy, University Hospital of Strasbourg, Strasbourg, France.,Laboratory of Neuro-cardiovascular Pharmacology and Toxicology EA7296, University of Strasbourg, Strasbourg, France
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14
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Schifano F, Napoletano F, Arillotta D, Zangani C, Gilgar L, Guirguis A, Corkery JM, Vento A. The clinical challenges of synthetic cathinones. Br J Clin Pharmacol 2020; 86:410-419. [PMID: 31674690 DOI: 10.1111/bcp.14132] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 08/07/2019] [Accepted: 09/05/2019] [Indexed: 12/21/2022] Open
Abstract
AIMS Within the new psychoactive substances (NPS) scenario, several hundred different molecules, mostly including synthetic cannabinoids and cathinones, have been identified so far. The aims of the paper were to: (i) identify the number of synthetic cathinones mentioned in a range of psychonaut, NPS-related, online sources; and (ii) describe the associated acute/long term clinical scenario and the related treatment/management plan. METHODS After about 18 months of operation and exclusion of false positives/duplicates, some 4204 unique NPS molecules were included in the NPSfinder® crawling/navigating software database. Most popular NPS included: 1265 psychedelic phenethylamines (30.1%; confidence interval [CI] 95%: 28.7-31.5%); 1253 synthetic cannabinoids (29.8%; CI 95%: 28.4-31.2%); 429 synthetic opioids (10.2%; CI 95%: 9.3-10.2%); and 171 synthetic cathinones (4.1%; CI 95% 3.5-4.7%). Conversely, the United Nations Office on Drugs and Crime and the European Monitoring Centre for Drugs and Drug Addiction databases respectively included 169 and 140 cathinones. Overall, the 3 databases reported some 222 synthetic cathinones, and 41 were uniquely identified by the NPSfinder®. RESULTS In terms of clinical scenarios, synthetic cathinone ingestion is initially associated with stimulant effects; however, psychopathological disturbances, violence, suicidal behaviour, hyperthermia, coma and death have also been described. CONCLUSION The proportion of cathinones commented on by psychonaut fora appeared to be relatively small, and similar to those reported by both the United Nations Office on Drugs and Crime and European Monitoring Centre for Drugs and Drug Addiction. This may be associated with a recent significant decline in both cathinone-related consumption and acute medical presentation. Due to their complex behavioural and medical toxicity issues, healthcare professionals should be, however, be educated to recognise the signs and symptoms of NPS, including synthetic cathinone, ingestion.
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Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Flavia Napoletano
- East London Foundation Trust (ELFT), Homerton University Hospital, London, UK
| | - Davide Arillotta
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Caroline Zangani
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Department of Health Sciences, University of Milan, Milan, Italy
| | - Liam Gilgar
- Gabalfa Clinic, Cardiff and Vale NHS Health Board, Cardiff, UK
| | - Amira Guirguis
- Swansea University Medical School; Institute of Life Sciences; Swansea, UK
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Alessandro Vento
- Addictions' Observatory (ODDPSS), Rome, Italy.,Guglielmo Marconi University, Rome, Italy.,Department of Mental Health, ASL Roma 2, Rome, Italy
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16
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Chomchai S, Phuditshinnapatra J, Mekavuthikul P, Chomchai C. Effects of unconventional recreational drug use in pregnancy. Semin Fetal Neonatal Med 2019; 24:142-148. [PMID: 30744980 DOI: 10.1016/j.siny.2019.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Recreational drug toxicity is a rapidly evolving aspect in clinical practice. The prevalence of recreational drug abuse in the past decade has achieved an epidemic scale due to invention of new agents and ease of accessibility to the abused drugs. "Unconventional recreational drugs" is the term that includes new psychoactive drugs and medications diverted for recreational goals. Misuse of unconventional recreational drugs during pregnancy can affect both the pregnant woman and the fetus. However, the problems are usually unrecognized and overlooked by healthcare professionals. In this articles, obstetric complications, teratogenicity and neonatal abstinence syndrome from exposure during pregnancy to synthetic cannabinoids, synthetic cathinones, tramadol, kratom, olanzapine, quetiapine, ketamine and ketamine are reviewed. The main purpose is to create awareness about maternal, fetal and neonatal effects of these unconventional recreational drugs, so healthcare professionals will have improved vigilance for these under-recognized issues.
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Affiliation(s)
- Summon Chomchai
- Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | | | - Chulathida Chomchai
- Mahidol University International College, Mahidol University, Nakhon Pathom, Thailand.
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17
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Synthetic Cannabinoid use in a Case Series of Patients with Psychosis Presenting to Acute Psychiatric Settings: Clinical Presentation and Management Issues. Brain Sci 2018; 8:brainsci8070133. [PMID: 30011896 PMCID: PMC6071094 DOI: 10.3390/brainsci8070133] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 06/29/2018] [Accepted: 07/05/2018] [Indexed: 12/16/2022] Open
Abstract
Background: Novel Psychoactive Substances (NPS) are a heterogeneous class of synthetic molecules including synthetic cannabinoid receptor agonists (SCRAs). Psychosis is associated with SCRAs use. There is limited knowledge regarding the structured assessment and psychometric evaluation of clinical presentations, analytical toxicology and clinical management plans of patients presenting with psychosis and SCRAs misuse. Methods: We gathered information regarding the clinical presentations, toxicology and care plans of patients with psychosis and SCRAs misuse admitted to inpatients services. Clinical presentations were assessed using the PANSS scale. Vital signs data were collected using the National Early Warning Signs tool. Analytic chemistry data were collected using urine drug screening tests for traditional psychoactive substances and NPS. Results: We described the clinical presentation and management plan of four patients with psychosis and misuse of SCRAs. Conclusion: The formulation of an informed clinical management plan requires a structured assessment, identification of the index NPS, pharmacological interventions, increases in nursing observations, changes to leave status and monitoring of the vital signs. The objective from using these interventions is to maintain stable physical health whilst rapidly improving the altered mental state.
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18
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Metastasio A, Negri A, Martinotti G, Corazza O. Transitioning Bodies. The Case of Self-Prescribing Sexual Hormones in Gender Affirmation in Individuals Attending Psychiatric Services. Brain Sci 2018; 8:E88. [PMID: 29757929 PMCID: PMC5977079 DOI: 10.3390/brainsci8050088] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 04/24/2018] [Accepted: 05/11/2018] [Indexed: 12/31/2022] Open
Abstract
Self-prescribing of sexual hormones for gender affirmation is a potentially widespread and poorly studied phenomenon that many clinicians are unaware of. The uncontrolled use of hormones poses significant health hazards, which have not been previously reported in the literature. We have collected seven clinical cases in general adult psychiatry settings (both inpatient and outpatients), describing transgender and gender non-conforming individuals' (TGNC) self-prescribing and self-administering hormones bought from the Internet without any medical consultation. Among these cases, two were taking androgens, and the rest were taking oestrogens. The main reason for self-administration of hormones seems to be the lack of access to specialised care due to discrimination and long waiting lists. We advocate for clinicians to be aware of the phenomenon and proactively help TGNC individuals by enquiring about self-prescribing of hormones, providing information and referring to the most appropriate treatment centre as well as encourage a public debate on the discrimination and the stigma that TGNC population suffer from. Overall, there is an urgent need for the implementation of different and innovative health care services for TGNC individuals as well as more targeted prevention strategies on such underreported and highly risky behaviours. Furthermore, it is necessary for every clinician involved in the care for TGNC people to be aware of their special needs and be able to be an allied and an advocate to help in reducing stigma and discrimination that affect the access to care for this often underserved population.
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Affiliation(s)
- Antonio Metastasio
- Camden and Islington NHS Foundation Trust, London NW1 0PE, UK.
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK.
| | - Attilio Negri
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK.
| | - Giovanni Martinotti
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK.
- Department of Neuroscience, Imaging, and Clinical Science, "G. d'Annunzio" University of Chieti-Pescara, 66100 Chieti, Italy.
| | - Ornella Corazza
- Centre for Clinical & Health Research Services, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK.
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19
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Schifano F, Chiappini S, Corkery JM, Guirguis A. Abuse of Prescription Drugs in the Context of Novel Psychoactive Substances (NPS): A Systematic Review. Brain Sci 2018; 8:E73. [PMID: 29690558 PMCID: PMC5924409 DOI: 10.3390/brainsci8040073] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 04/11/2018] [Accepted: 04/20/2018] [Indexed: 02/07/2023] Open
Abstract
Recently, a range of prescription and over-the-counter drugs have been reportedly used as Novel Psychoactive Substances (NPS), due to their potential for abuse resulting from their high dosage/idiosyncratic methods of self-administration. This paper provides a systematic review of the topic, focusing on a range of medications which have emerged as being used recreationally, either on their own or in combination with NPS. Among gabapentinoids, pregabalin may present with higher addictive liability levels than gabapentin, with pregabalin being mostly identified in the context of opioid, polydrug intake. For antidepressants, their dopaminergic, stimulant-like, bupropion activities may explain their recreational value and diversion from the therapeutic intended use. In some vulnerable clients, a high dosage of venlafaxine (‘baby ecstasy’) is ingested for recreational purposes, whilst the occurrence of a clinically-relevant withdrawal syndrome may be a significant issue for all venlafaxine-treated patients. Considering second generation antipsychotics, olanzapine appears to be ingested at very large dosages as an ‘ideal trip terminator’, whilst the immediate-release quetiapine formulation may possess proper abuse liability levels. Within the image- and performance- enhancing drugs (IPEDs) group, the beta-2 agonist clenbuterol (‘size zero pill’) is reported to be self-administered for aggressive slimming purposes. Finally, high/very high dosage ingestion of the antidiarrhoeal loperamide has shown recent increasing levels of popularity due to its central recreational, anti-withdrawal, opiatergic effects. The emerging abuse of prescription drugs within the context of a rapidly modifying drug scenario represents a challenge for psychiatry, public health and drug-control policies.
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Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK.
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK.
| | - John M Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK.
| | - Amira Guirguis
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire AL10 9AB, UK.
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20
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Is There a Potential of Misuse for Quetiapine?: Literature Review and Analysis of the European Medicines Agency/European Medicines Agency Adverse Drug Reactions' Database. J Clin Psychopharmacol 2018; 38:72-79. [PMID: 29210868 DOI: 10.1097/jcp.0000000000000814] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
PURPOSE/BACKGROUND A recent years' increase in both prescribing and availability of second-generation antipsychotics (SGAs) has been observed. According to the literature, typically made up by case studies/series, quetiapine seems to be the most commonly misused SGA, with both intranasal and intravenous intake modalities having been described. Another SGA that has been anecdotally reported to be misused is olanzapine. For these molecules, both a previous history of drug misuse and being an inmate have been described as factors associated with misuse. Hence, while providing here an updated literature review of the topic, we aimed at assessing all cases of quetiapine misuse/abuse/dependence/withdrawal as reported to the European Medicines Agency's EudraVigilance (EV) database; this was carried out in comparison with the reference drug olanzapine. METHODS All spontaneous, European Medicines Agency database reports relating to both quetiapine (2005-2016) and olanzapine (2004-2016) misuse/abuse/dependence/withdrawal issues were retrieved, and a descriptive analysis was performed. RESULTS From the EV database, 18,112 (8.64% of 209,571) and 4178 (7.58% of 55,100) adverse drug reaction reports of misuse/abuse/dependence/withdrawal were associated with quetiapine and olanzapine, respectively. The resulting proportional reporting ratio values suggested that the misuse/abuse-, dependence-, and withdrawal-related adverse drug reactions were more frequently reported for quetiapine (1.07, 1.01, and 5.25, respectively) in comparison with olanzapine. CONCLUSIONS Despite data collection limitations, present EV data may suggest that, at least in comparison with olanzapine, quetiapine misuse may be a cause for concern.
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21
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Satoh T, Kubo A, Hazama H. Matrix-Assisted Laser Desorption Ionization Imaging Mass Spectrometry of Drug Distribution in Mouse Brain Tissue by High-Resolution Time-of-Flight Mass Spectrometry. Methods Mol Biol 2018; 1810:133-139. [PMID: 29974425 DOI: 10.1007/978-1-4939-8579-1_13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Matrix-assisted laser desorption/ionization (MALDI) imaging mass spectrometry provides the opportunity to visualize the distributions of drugs and metabolites in tissue specimens without requiring radioisotopes, as are used for whole-body autoradiography. However, the analysis of low-molecular-weight compounds is often difficult using the common reflectron-type MALDI time-of-flight mass spectrometers. Insufficient mass resolving power causes overlapping of the target drug peak with matrix compound or surface contaminant peaks. To solve this issue, we describe the procedure for imaging mass spectrometry using a high-mass-resolution mass spectrometer that can separate isobaric peaks.
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22
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Simonato P, Bersani FS, Santacroce R, Cinosi E, Schifano F, Bersani G, Martinotti G, Corazza O. Can mobile phone technology support a rapid sharing of information on novel psychoactive substances among health and other professionals internationally? Hum Psychopharmacol 2017; 32. [PMID: 28568113 DOI: 10.1002/hup.2580] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/15/2017] [Accepted: 02/20/2017] [Indexed: 01/11/2023]
Abstract
BACKGROUND The diffusion of novel psychoactive substances (NPSs), combined with the ability of the Internet to act as an online marketplace, has led to unprecedented challenges for governments, health agencies, and substance misuse services. Despite increasing research, there is a paucity of reliable information available to professionals working in the field. The paper will present the pilot results of the first mobile application (SMAIL) for rapid information sharing on NPSs among health professionals. METHODS The development of SMAIL was divided into 2 parts: (a) the creation of the application for registered users, enabling them to send an SMS or email with the name or "street name" of an NPS and receive within seconds emails or SMS with the information, when available and (b) the development of a database to support the incoming requests. RESULTS One hundred twenty-two professionals based in 22 countries used the service over the pilot period of 16 months (from May 2012 to September 2013). Five hundred fifty-seven enquires were made. Users received rapid information on NPSs, and 61% of them rated the service as excellent. CONCLUSIONS This is the right time to use mobile phone technologies for rapid information sharing and prevention activities on NPSs.
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Affiliation(s)
- Pierluigi Simonato
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK
| | - Francesco S Bersani
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Rita Santacroce
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University, Chieti, Italy
| | - Eduardo Cinosi
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University, Chieti, Italy
| | - Fabrizio Schifano
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK
| | - Giuseppe Bersani
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
| | - Giovanni Martinotti
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University, Chieti, Italy
| | - Ornella Corazza
- Novel Psychoactive Substance Unit, Centre for Clinical & Health Research Services, University of Hertfordshire, Hatfield, UK.,Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Rome, Italy
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23
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Schifano F, Papanti GD, Orsolini L, Corkery JM. The consequences of drug misuse on post-marketing surveillance. Expert Rev Clin Pharmacol 2016; 9:867-71. [PMID: 27095119 DOI: 10.1080/17512433.2016.1178571] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Affiliation(s)
- Fabrizio Schifano
- a Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
| | - Gabriele Duccio Papanti
- a Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
| | - Laura Orsolini
- a Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
| | - John Martin Corkery
- a Psychopharmacology, Drug Misuse, and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
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24
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Following "the Roots" of Kratom (Mitragyna speciosa): The Evolution of an Enhancer from a Traditional Use to Increase Work and Productivity in Southeast Asia to a Recreational Psychoactive Drug in Western Countries. BIOMED RESEARCH INTERNATIONAL 2015; 2015:968786. [PMID: 26640804 PMCID: PMC4657101 DOI: 10.1155/2015/968786] [Citation(s) in RCA: 126] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Revised: 10/13/2015] [Accepted: 10/15/2015] [Indexed: 12/17/2022]
Abstract
The use of substances to enhance human abilities is a constant and cross-cultural feature in the evolution of humanity. Although much has changed over time, the availability on the Internet, often supported by misleading marketing strategies, has made their use even more likely and risky. This paper will explore the case of Mitragyna speciosa Korth. (kratom), a tropical tree used traditionally to combat fatigue and improve work productivity among farm populations in Southeast Asia, which has recently become popular as novel psychoactive substance in Western countries. Specifically, it (i) reviews the state of the art on kratom pharmacology and identification; (ii) provides a comprehensive overview of kratom use cross-culturally; (iii) explores the subjective experiences of users; (iv) identifies potential risks and side-effects related to its consumption. Finally, it concludes that the use of kratom is not negligible, especially for self-medication, and more clinical, pharmacological, and socioanthropological studies as well as a better international collaboration are needed to tackle this marginally explored phenomenon.
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25
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Bersani FS, Santacroce R, Coviello M, Imperatori C, Francesconi M, Vicinanza R, Minichino A, Corazza O. Cannabis: a self-medication drug for weight management? The never ending story. Drug Test Anal 2015; 8:177-9. [DOI: 10.1002/dta.1891] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 08/21/2015] [Accepted: 09/01/2015] [Indexed: 01/15/2023]
Affiliation(s)
- Francesco Saverio Bersani
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
- School of Life and Medical Sciences; University of Hertfordshire; Hatfield UK
| | - Rita Santacroce
- School of Life and Medical Sciences; University of Hertfordshire; Hatfield UK
- Department of Neuroscience and Imaging; Gabriele D'Annunzio University; Chieti Italy
| | - Marialuce Coviello
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | | | - Marta Francesconi
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | - Roberto Vicinanza
- Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences; Sapienza University of Rome; Rome Italy
| | - Amedeo Minichino
- Department of Neurology and Psychiatry; Sapienza University of Rome; Rome Italy
| | - Ornella Corazza
- School of Life and Medical Sciences; University of Hertfordshire; Hatfield UK
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26
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Bersani FS, Coviello M, Imperatori C, Francesconi M, Hough CM, Valeriani G, De Stefano G, Bolzan Mariotti Posocco F, Santacroce R, Minichino A, Corazza O. Adverse Psychiatric Effects Associated with Herbal Weight-Loss Products. BIOMED RESEARCH INTERNATIONAL 2015; 2015:120679. [PMID: 26457296 PMCID: PMC4589574 DOI: 10.1155/2015/120679] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/28/2015] [Accepted: 08/02/2015] [Indexed: 12/24/2022]
Abstract
Obesity and overeating are among the most prevalent health concerns worldwide and individuals are increasingly using performance and image-enhancing drugs (PIEDs) as an easy and fast way to control their weight. Among these, herbal weight-loss products (HWLPs) often attract users due to their health claims, assumed safety, easy availability, affordable price, extensive marketing, and the perceived lack of need for professional oversight. Reports suggest that certain HWLPs may lead to onset or exacerbation of psychiatric disturbances. Here we review the available evidence on psychiatric adverse effects of HWLPs due to their intrinsic toxicity and potential for interaction with psychiatric medications.
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Affiliation(s)
- F. Saverio Bersani
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
| | - Marialuce Coviello
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Claudio Imperatori
- Department of Human Sciences, European University of Rome, 00163 Rome, Italy
| | - Marta Francesconi
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Christina M. Hough
- Department of Psychiatry, University of California San Francisco, San Francisco, CA 94143, USA
| | - Giuseppe Valeriani
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
- Department of Psychiatry, Sahlgrenska University Hospital, 413 45 Gothenburg, Sweden
| | - Gianfranco De Stefano
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Rita Santacroce
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
- Department of Neuroscience and Imaging, Gabriele D'Annunzio University, 66100 Chieti, Italy
| | - Amedeo Minichino
- Department of Neurology and Psychiatry, Sapienza University of Rome, 00185 Rome, Italy
| | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK
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27
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Schifano F, Orsolini L, Duccio Papanti G, Corkery JM. Novel psychoactive substances of interest for psychiatry. World Psychiatry 2015; 14:15-26. [PMID: 25655145 PMCID: PMC4329884 DOI: 10.1002/wps.20174] [Citation(s) in RCA: 236] [Impact Index Per Article: 26.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Novel psychoactive substances include synthetic cannabinoids, cathinone derivatives, psychedelic phenethylamines, novel stimulants, synthetic opioids, tryptamine derivatives, phencyclidine-like dissociatives, piperazines, GABA-A/B receptor agonists, a range of prescribed medications, psychoactive plants/herbs, and a large series of performance and image enhancing drugs. Users are typically attracted by these substances due to their intense psychoactive effects and likely lack of detection in routine drug screenings. This paper aims at providing psychiatrists with updated knowledge of the clinical pharmacology and psychopathological consequences of the use of these substances. Indeed, these drugs act on a range of neurotransmitter pathways/receptors whose imbalance has been associated with psychopathological conditions, including dopamine, cannabinoid CB1, GABA-A/B, 5-HT2A, glutamate, and k opioid receptors. An overall approach in terms of clinical management is briefly discussed.
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Affiliation(s)
- Fabrizio Schifano
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts, UK
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