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Basedow LA, Majić T, Hafiz NJ, Algharably EAE, Kreutz R, Riemer TG. Cognitive functioning associated with acute and subacute effects of classic psychedelics and MDMA - a systematic review and meta-analysis. Sci Rep 2024; 14:14782. [PMID: 38926480 PMCID: PMC11208433 DOI: 10.1038/s41598-024-65391-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 06/19/2024] [Indexed: 06/28/2024] Open
Abstract
Classic psychedelics and MDMA have a colorful history of recreational use, and both have recently been re-evaluated as tools for the treatment of psychiatric disorders. Several studies have been carried out to assess potential long-term effects of a regular use on cognition, delivering distinct results for psychedelics and MDMA. However, to date knowledge is scarce on cognitive performance during acute effects of those substances. In this systematic review and meta-analysis, we investigate how cognitive functioning is affected by psychedelics and MDMA during the acute drug effects and the sub-acute ("afterglow") window. Our quantitative analyses suggest that acute cognitive performance is differentially affected by psychedelics when compared to MDMA: psychedelics impair attention and executive function, whereas MDMA primarily affects memory, leaving executive functions and attention unaffected. Our qualitative analyses reveal that executive functioning and creativity may be increased during a window of at least 24 h after the acute effects of psychedelics have subsided, whereas no such results have been observed for MDMA. Our findings may contribute to inform recommendations on harm reduction for recreational settings and to help fostering differential approaches for the use of psychedelics and MDMA within a therapeutic framework.
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Affiliation(s)
- Lukas A Basedow
- Department of Psychology, Clinical Psychology and Psychotherapy, Philipps-Universität Marburg, Gutenbergstraße 18, 35037, Marburg, Germany.
| | - Tomislav Majić
- Psychedelic Substances Research Group, Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry und Neurosciences, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Nicklas Jakob Hafiz
- Institute for Educational Quality Improvement (IQB), Humboldt-Universität zu Berlin, Berlin, Germany
| | - Engi A E Algharably
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Reinhold Kreutz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
| | - Thomas G Riemer
- Psychedelic Substances Research Group, Department of Psychiatry and Neurosciences, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Institute of Clinical Pharmacology and Toxicology, Charité Campus Mitte, Charitéplatz 1, 10117, Berlin, Germany
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Yao Y, Guo D, Lu TS, Liu FL, Huang SH, Diao MQ, Li SX, Zhang XJ, Kosten TR, Shi J, Bao YP, Lu L, Han Y. Efficacy and safety of psychedelics for the treatment of mental disorders: A systematic review and meta-analysis. Psychiatry Res 2024; 335:115886. [PMID: 38574699 DOI: 10.1016/j.psychres.2024.115886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/14/2024] [Accepted: 03/27/2024] [Indexed: 04/06/2024]
Abstract
We aim to systematically review and meta-analyze the effectiveness and safety of psychedelics [psilocybin, ayahuasca (active component DMT), LSD and MDMA] in treating symptoms of various mental disorders. Web of Science, Embase, EBSCO, and PubMed were searched up to February 2024 and 126 articles were finally included. Results showed that psilocybin has the largest number of articles on treating mood disorders (N = 28), followed by ayahuasca (N = 7) and LSD (N = 6). Overall, psychedelics have therapeutic effects on mental disorders such as depression and anxiety. Specifically, psilocybin (Hedges' g = -1.49, 95% CI [-1.67, -1.30]) showed the strongest therapeutic effect among four psychedelics, followed by ayahuasca (Hedges' g = -1.34, 95% CI [-1.86, -0.82]), MDMA (Hedges' g = -0.83, 95% CI [-1.33, -0.32]), and LSD (Hedges' g = -0.65, 95% CI [-1.03, -0.27]). A small amount of evidence also supports psychedelics improving tobacco addiction, eating disorders, sleep disorders, borderline personality disorder, obsessive-compulsive disorder, and body dysmorphic disorder. The most common adverse event with psychedelics was headache. Nearly a third of the articles reported that no participants reported lasting adverse effects. Our analyses suggest that psychedelics reduce negative mood, and have potential efficacy in other mental disorders, such as substance-use disorders and PTSD.
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Affiliation(s)
- Yuan Yao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Dan Guo
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Tang-Sheng Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Fang-Lin Liu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Shi-Hao Huang
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Meng-Qi Diao
- School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Su-Xia Li
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China
| | - Xiu-Jun Zhang
- School of Psychology, College of Public Health, North China University of Science and Technology, Tangshan 063210, Hebei Province, China
| | - Thomas R Kosten
- Department of Psychiatry, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jie Shi
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China
| | - Yan-Ping Bao
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China.
| | - Lin Lu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China; Peking University Sixth Hospital, Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China; Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing 100871, China; Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder, Chinese Academy of Medical Sciences (No.2018RU006).
| | - Ying Han
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence Research, Peking University, Beijing 100191, China.
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Affiliation(s)
- Maude Marillier
- Department of Continuing Education of the Faculty of Medicine Lille University Lille France
| | - Alain G. Verstraete
- Department of Diagnostic Sciences Ghent University Ghent Belgium
- Department of Laboratory Medicine Ghent University Hospital Ghent Belgium
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4
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Kuypers KPC, de Sousa Fernandes Perna EB, Dolder PC, Toennes SW, Theunissen EL, Mason NL, Hutten NRPW, Ramaekers JG. Drug liking and wanting, not impulsive action or reflection is increased by 4-fluoroamphetamine. Psychopharmacology (Berl) 2018; 235:2349-2356. [PMID: 29855660 PMCID: PMC6061712 DOI: 10.1007/s00213-018-4931-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 05/22/2018] [Indexed: 02/08/2023]
Abstract
BACKGROUND New psychoactive substances (NPS) are chemical analogues designed to mimic the effects of various classic recreational drugs of abuse including MDMA, LSD, and cannabis. NPS use is associated with concern about the acute and longer-term effects particular substances might have, with abuse and addiction as potential consequences. Impulsivity and sensitivity to the rewarding effects of drugs have been considered as risk factors for drug abuse. In light of the popularity of 4-fluoroamphetamine (4-FA), it is important to assess whether 4-FA can lead to subjective drug liking and wanting, and impulsive behavior, all factors contributing to the abuse likelihood of a substance. METHODS A placebo-controlled 2-way crossover study in 12 healthy poly-drug using participants was conducted to test subjective and behavioral effects of 4-FA (100 mg). 4-FA concentrations were determined in serum up to 12 h after administration and two impulsivity tasks and two drug experience questionnaires assessing drug liking and wanting, and good and bad drug effect, were administered between 1 and 11 h post-administration. RESULTS Findings showed that 4-FA did not affect impulsive behavior. Self-ratings of drug liking and wanting and good drug effect were increased 1 h after administration; this effect was absent 11 h after drug intake. DISCUSSION AND CONCLUSION To conclude, 4-FA (single dose) increased self-rated liking and wanting, which is known to contribute to the abuse likelihood of a substance; however, it left another factor impulsive behavior unaffected. It has to be noted that the current picture is limited and might change with increased sample size, and/or different 4-FA doses. CLINICAL TRIAL REGISTRATION Trial acronym: 4-FA. URL: http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=6164 . Registration number: NTR6164 (Dutch clinical trial registry number).
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Affiliation(s)
- K P C Kuypers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P. O. Box 616, 6200 MD, Maastricht, the Netherlands.
| | - E B de Sousa Fernandes Perna
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P. O. Box 616, 6200 MD, Maastricht, the Netherlands
| | - P C Dolder
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P. O. Box 616, 6200 MD, Maastricht, the Netherlands
| | - S W Toennes
- Department of Forensic Toxicology, Institute of Legal Medicine, Goethe University of Frankfurt, Frankfurt, Germany
| | - E L Theunissen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P. O. Box 616, 6200 MD, Maastricht, the Netherlands
| | - N L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P. O. Box 616, 6200 MD, Maastricht, the Netherlands
| | - N R P W Hutten
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P. O. Box 616, 6200 MD, Maastricht, the Netherlands
| | - J G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P. O. Box 616, 6200 MD, Maastricht, the Netherlands
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5
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Papaseit E, Torrens M, Pérez-Mañá C, Muga R, Farré M. Key interindividual determinants in MDMA pharmacodynamics. Expert Opin Drug Metab Toxicol 2018; 14:183-195. [DOI: 10.1080/17425255.2018.1424832] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Affiliation(s)
- E. Papaseit
- Departments of Clinical Pharmacology and Internal Medicine, Hospital Universitari Germans Trias I Pujol-IGTP, Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - M. Torrens
- Department of Pharmacology, Therapeutics and Toxicology and Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
- Drug Addiction Program, Institut de Neuropsiquiatria i Addiccions-INAD, Hospital del Mar Medical Research Institute-IMIM, Barcelona, Spain
| | - C. Pérez-Mañá
- Departments of Clinical Pharmacology and Internal Medicine, Hospital Universitari Germans Trias I Pujol-IGTP, Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - R. Muga
- Departments of Clinical Pharmacology and Internal Medicine, Hospital Universitari Germans Trias I Pujol-IGTP, Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
| | - M. Farré
- Departments of Clinical Pharmacology and Internal Medicine, Hospital Universitari Germans Trias I Pujol-IGTP, Badalona, Spain
- Department of Pharmacology, Therapeutics and Toxicology and Department of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallés, Spain
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6
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de Sousa Fernandes Perna EB, Papaseit E, Pérez-Mañá C, Mateus J, Theunissen EL, Kuypers K, de la Torre R, Farré M, Ramaekers JG. Neurocognitive performance following acute mephedrone administration, with and without alcohol. J Psychopharmacol 2016; 30:1305-1312. [PMID: 27562197 DOI: 10.1177/0269881116662635] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Recreational use of mephedrone, alone and in combination with alcohol, has increased over the past years. Pharmacological properties of mephedrone share similarities with methylenedioxymethamphetamine (MDMA), but its effect on neurocognitive function has not been well established in humans. The present study assessed the effect of mephedrone alone and after co-administration with alcohol on neurocognitive function. It was hypothesised that mephedrone would improve psychomotor performance but impair memory performance, when administered alone. Neurocognitive performance was expected to be impaired following mephedrone when combined with alcohol. Eleven participants received single doses of 200 mg mephedrone or placebo combined with 0.8 g/kg alcohol or placebo. Neurocognitive performance was assessed at baseline (T0), at one hour (T1) and four hours after (T2) mephedrone administration, by means of the Divided Attention Task (DAT), Critical Tracking Task (CTT), and the Spatial Memory Test (SMT). Mephedrone intoxication impaired short-term spatial memory at T1 and improved critical tracking performance at T2 Mephedrone alone did not affect divided attention, but did show an interaction with alcohol on reaction time at T2 Reaction time decreased when mephedrone was combined with alcohol as compared to alcohol alone. Alcohol intoxication impaired both short- and long-term spatial memory at T1 and divided attention at T1 and T2 Critical tracking performance was not affected by alcohol intoxication. The current findings support the hypothesis that mephedrone improves psychomotor performance, impairs spatial memory and does not affect divided attention performance. Stimulatory effects of mephedrone were not sufficient to compensate for the impairing effects of alcohol on most performance parameters.
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Affiliation(s)
| | - E Papaseit
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Universitat Autonoma de Barcelona, Barcelona, Spain.,Hospital Universitari Germans Trias i Pujol, Clinical Pharmacology, Badalona, Spain
| | - C Pérez-Mañá
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Universitat Autonoma de Barcelona, Barcelona, Spain
| | - J Mateus
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Universitat Autonoma de Barcelona, Barcelona, Spain
| | - E L Theunissen
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
| | - Kpc Kuypers
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
| | - R de la Torre
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Spanish Biomedical Research Centre in Physiopathology of Obesity and Nutrition (CIBEROBN), Santiago de Compostela, Spain.,Universitat Pompeu Fabra, CEXS-UPF, Barcelona, Spain
| | - M Farré
- Integrative Pharmacology & Neurosciences Systems Research Group, Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, Spain.,Universitat Autonoma de Barcelona, Barcelona, Spain.,Hospital Universitari Germans Trias i Pujol, Clinical Pharmacology, Badalona, Spain
| | - J G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, the Netherlands
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7
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van Heugten-Van der Kloet D, Giesbrecht T, van Wel J, Bosker WM, Kuypers KPC, Theunissen EL, Spronk DB, Jan Verkes R, Merckelbach H, Ramaekers JG. MDMA, cannabis, and cocaine produce acute dissociative symptoms. Psychiatry Res 2015; 228:907-12. [PMID: 26003508 DOI: 10.1016/j.psychres.2015.04.028] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Revised: 03/31/2015] [Accepted: 04/18/2015] [Indexed: 11/16/2022]
Abstract
Some drugs of abuse may produce dissociative symptoms, but this aspect has been understudied. We explored the dissociative potential of three recreational drugs (3,4-methylenedioxymethamphetamine (MDMA), cannabis, and cocaine) during intoxication and compared their effects to literature reports of dissociative states in various samples. Two placebo-controlled studies were conducted. In Study 1 (N=16), participants received single doses of 25, 50, and 100 mg of MDMA, and placebo. In Study 2 (N=21), cannabis (THC 300 µg/kg), cocaine (HCl 300 mg), and placebo were administered. Dissociative symptoms as measured with the Clinician-Administered Dissociative States Scale (CADSS) significantly increased under the influence of MDMA and cannabis. To a lesser extent, this was also true for cocaine. Dissociative symptoms following MDMA and cannabis largely exceeded those observed in schizophrenia patients, were comparable with those observed in Special Forces soldiers undergoing survival training, but were lower compared with ketamine-induced dissociation. Cocaine produced dissociative symptoms that were comparable with those observed in schizophrenia patients, but markedly less than those in Special Forces soldiers and ketamine users. Thus, MDMA and cannabis can produce dissociative symptoms that resemble dissociative pathology. The study of drug induced dissociation is important, because it may shed light on the mechanisms involved in dissociative psychopathology.
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Affiliation(s)
- Dalena van Heugten-Van der Kloet
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.
| | - Timo Giesbrecht
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Janelle van Wel
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Wendy M Bosker
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Kim P C Kuypers
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Eef L Theunissen
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
| | - Desirée B Spronk
- Department of Psychiatry (966), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Robbert Jan Verkes
- Department of Psychiatry (966), Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Harald Merckelbach
- Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands
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Jongen S, Perrier J, Vuurman EF, Ramaekers JG, Vermeeren A. Sensitivity and validity of psychometric tests for assessing driving impairment: effects of sleep deprivation. PLoS One 2015; 10:e0117045. [PMID: 25668292 PMCID: PMC4323110 DOI: 10.1371/journal.pone.0117045] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Accepted: 12/18/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To assess drug induced driving impairment, initial screening is needed. However, no consensus has been reached about which initial screening tools have to be used. The present study aims to determine the ability of a battery of psychometric tests to detect performance impairing effects of clinically relevant levels of drowsiness as induced by one night of sleep deprivation. METHODS Twenty four healthy volunteers participated in a 2-period crossover study in which the highway driving test was conducted twice: once after normal sleep and once after one night of sleep deprivation. The psychometric tests were conducted on 4 occasions: once after normal sleep (at 11 am) and three times during a single night of sleep deprivation (at 1 am, 5 am, and 11 am). RESULTS On-the-road driving performance was significantly impaired after sleep deprivation, as measured by an increase in Standard Deviation of Lateral Position (SDLP) of 3.1 cm compared to performance after a normal night of sleep. At 5 am, performance in most psychometric tests showed significant impairment. As expected, largest effect sizes were found on performance in the Psychomotor Vigilance Test (PVT). Large effects sizes were also found in the Divided Attention Test (DAT), the Attention Network Test (ANT), and the test for Useful Field of View (UFOV) at 5 and 11 am during sleep deprivation. Effects of sleep deprivation on SDLP correlated significantly with performance changes in the PVT and the DAT, but not with performance changes in the UFOV. CONCLUSION From the psychometric tests used in this study, the PVT and DAT seem most promising for initial evaluation of drug impairment based on sensitivity and correlations with driving impairment. Further studies are needed to assess the sensitivity and validity of these psychometric tests after benchmark sedative drug use.
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Affiliation(s)
- Stefan Jongen
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- * E-mail:
| | - Joy Perrier
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- U 1075 COMETE, INSERM, Caen, France
| | - Eric F. Vuurman
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Johannes G. Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Annemiek Vermeeren
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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9
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de Sousa Fernandes Perna E, Theunissen E, Kuypers K, Heckman P, de la Torre R, Farre M, Ramaekers J. Memory and mood during MDMA intoxication, with and without memantine pretreatment. Neuropharmacology 2014; 87:198-205. [DOI: 10.1016/j.neuropharm.2014.03.008] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Revised: 03/10/2014] [Accepted: 03/12/2014] [Indexed: 12/11/2022]
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10
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Alcohol calibration of tests measuring skills related to car driving. Psychopharmacology (Berl) 2014; 231:2435-47. [PMID: 24408210 PMCID: PMC4039994 DOI: 10.1007/s00213-013-3408-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 12/11/2013] [Indexed: 11/27/2022]
Abstract
RATIONALE Medication and illicit drugs can have detrimental side effects which impair driving performance. A drug's impairing potential should be determined by well-validated, reliable, and sensitive tests and ideally be calibrated by benchmark drugs and doses. To date, no consensus has been reached on the issue of which psychometric tests are best suited for initial screening of a drug's driving impairment potential. OBJECTIVE The aim of this alcohol calibration study is to determine which performance tests are useful to measure drug-induced impairment. The effects of alcohol are used to compare the psychometric quality between tests and as benchmark to quantify performance changes in each test associated with potentially impairing drug effects. METHODS Twenty-four healthy volunteers participated in a double-blind, four-way crossover study. Treatments were placebo and three different doses of alcohol leading to blood alcohol concentrations (BACs) of 0.2, 0.5, and 0.8 g/L. RESULTS Main effects of alcohol were found in most tests. Compared with placebo, performance in the Divided Attention Test (DAT) was significantly impaired after all alcohol doses and performance in the Psychomotor Vigilance Test (PVT) and the Balance Test was impaired with a BAC of 0.5 and 0.8 g/L. The largest effect sizes were found on postural balance with eyes open and mean reaction time in the divided attention and the psychomotor vigilance test. CONCLUSIONS The preferable tests for initial screening are the DAT and the PVT, as these tests were most sensitive to the impairing effects of alcohol and being considerably valid in assessing potential driving impairment.
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Spronk DB, van Wel JHP, Ramaekers JG, Verkes RJ. Characterizing the cognitive effects of cocaine: a comprehensive review. Neurosci Biobehav Rev 2013; 37:1838-59. [PMID: 23876288 DOI: 10.1016/j.neubiorev.2013.07.003] [Citation(s) in RCA: 146] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 07/02/2013] [Accepted: 07/03/2013] [Indexed: 12/20/2022]
Abstract
Understanding the cognitive sequela of repeated cocaine use is a growing area of research and is crucial to the development of cognitive models of addiction. We systematically reviewed all available placebo-controlled and case-controlled studies on the acute and long-term effects of cocaine on cognitive functioning. In order to compare the magnitude of cognitive effects across cognitive domains we conducted several meta-analyses on a subset of data from long-term effect studies. Studies on acute cocaine administration suggest enhancement of response inhibition and psychomotor speed, while all other domains appear to be unaffected or not investigated adequately. Long-term effects of cocaine show a wide array of deteriorated cognitive functions, indicating that long term cocaine use is characterized by a general cognitive impairment across functions, rather than by specific cognitive deficits. Literature on long-term cocaine effects is more substantial than literature on acute effects. This comprehensive review outlines possible dissociations and similarities of acute vs. long-term cocaine effects in the human brain. Atherosclerosis after cocaine exposure may underlie cognitive dysfunction, suggesting involvement of multiple brain areas. Acute drug studies are important to the future development of addiction models.
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Affiliation(s)
- Desirée B Spronk
- Department of Psychiatry (966), Radboud University Nijmegen Medical Centre, Nijmegen, Postbox 9101, 6500 HB Nijmegen, The Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University Nijmegen, Nijmegen, The Netherlands.
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Bosker WM, Karschner EL, Lee D, Goodwin RS, Hirvonen J, Innis RB, Theunissen EL, Kuypers KPC, Huestis MA, Ramaekers JG. Psychomotor function in chronic daily Cannabis smokers during sustained abstinence. PLoS One 2013; 8:e53127. [PMID: 23301031 PMCID: PMC3534640 DOI: 10.1371/journal.pone.0053127] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 11/27/2012] [Indexed: 11/19/2022] Open
Abstract
Background The present study assessed psychomotor function in chronic, daily cannabis smokers during 3 weeks continuously monitored abstinence on a secure research unit. We hypothesized that psychomotor performance would improve during abstinence of chronic, daily cannabis smokers. Methodology/Principal Findings Performance on the critical tracking (CTT) and divided attention (DAT) tasks was assessed in 19 male chronic, daily cannabis smokers at baseline and after 8, 14–16 and 21–23 days of continuously monitored abstinence. Psychomotor performance was compared to a control group of non-intoxicated occasional drug users. Critical frequency (λc) of the CTT and tracking error and control losses of the DAT were the primary outcome measures. Results showed that chronic cannabis smokers’ performance on the CTT (p<0.001) and the DAT (p<0.001) was impaired during baseline relative to the comparison group. Psychomotor performance in the chronic cannabis smokers improved over 3 weeks of abstinence, but did not recover to equivalent control group performance. Conclusions/Significance Sustained cannabis abstinence moderately improved critical tracking and divided attention performance in chronic, daily cannabis smokers, but impairment was still observable compared to controls after 3 weeks of abstinence. Between group differences, however, need to be interpreted with caution as chronic smokers and controls were not matched for education, social economic status, life style and race.
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Affiliation(s)
- Wendy M. Bosker
- Departments of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Erin L. Karschner
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institute of Health, Baltimore, Maryland, United States of America
| | - Dayong Lee
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institute of Health, Baltimore, Maryland, United States of America
| | - Robert S. Goodwin
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institute of Health, Baltimore, Maryland, United States of America
| | - Jussi Hirvonen
- Molecular Imaging Branch, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland, United States of America
| | - Robert B. Innis
- Molecular Imaging Branch, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland, United States of America
| | - Eef L. Theunissen
- Departments of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Kim P. C. Kuypers
- Departments of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Marilyn A. Huestis
- Chemistry and Drug Metabolism, Intramural Research Program, National Institute on Drug Abuse, National Institute of Health, Baltimore, Maryland, United States of America
| | - Johannes G. Ramaekers
- Departments of Neuropsychology and Psychopharmacology, Maastricht University, Maastricht, The Netherlands
- * E-mail:
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van Wel JHP, Kuypers KPC, Theunissen EL, Bosker WM, Bakker K, Ramaekers JG. Effects of acute MDMA intoxication on mood and impulsivity: role of the 5-HT2 and 5-HT1 receptors. PLoS One 2012; 7:e40187. [PMID: 22808116 PMCID: PMC3393729 DOI: 10.1371/journal.pone.0040187] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Accepted: 06/02/2012] [Indexed: 11/24/2022] Open
Abstract
MDMA induces positive mood and increases impulse control during intoxication, but only a few studies on the neuropharmacological mechanisms underlying these processes have been conducted. It was hypothesized that pretreatment with 5-HT1 and 5-HT2 receptor blockers would prevent MDMA effects on mood and impulsivity. Subjects (N = 17) participated in a double-blind, placebo controlled, within-subject design involving 6 experimental conditions consisting of pretreatment (T1) and treatment (T2). T1 preceded T2 by 30 minutes. T1–T2 combinations were: placebo-placebo, 20 mg pindolol-placebo, 50 mg ketanserin-placebo, placebo-75 mg MDMA, 20 mg pindolol-75 mg MDMA and 50 mg ketanserin-75 g MDMA. Subjects completed a Profile of Mood States (POMS) questionnaire and several impulsivity tasks (Stop signal task, Matching familiar figures task, Cue dependent reversal learning task) at 1.5 hrs post-treatment. MDMA alone increased both positive (vigor, arousal, friendliness, elation, positive mood) and negative affect (anxiety, confusion) as assessed by the POMS questionnaire. MDMA also increased stop reaction time in the Stop signal task and reaction time in the Matching familiar figures task. Pretreatment with ketanserin blocked MDMA effects on positive affect, but not negative affect. Ketanserin did not influence the effects of MDMA on impulsivity. Pindolol did not interact with MDMA on any of the measures. In conclusion, 5-HT2 receptors mediate positive moods induced by MDMA but not negative moods or impulsivity. 5-HT1 receptors do not appear to be involved in MDMA effects on mood and impulse control.
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Affiliation(s)
- Janelle H P van Wel
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.
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Stough C, King R, Papafotiou K, Swann P, Ogden E, Wesnes K, Downey LA. The acute effects of 3,4-methylenedioxymethamphetamine and d-methamphetamine on human cognitive functioning. Psychopharmacology (Berl) 2012; 220:799-807. [PMID: 22020992 DOI: 10.1007/s00213-011-2532-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2011] [Accepted: 10/03/2011] [Indexed: 12/24/2022]
Abstract
RATIONALE This study investigated the acute (3-h) and 24-h post-dose cognitive effects of oral 3,4-methylenedioxymethamphetamine (MDMA), d-methamphetamine, and placebo in a within-subject double-blind laboratory-based study in order to compare the effect of these two commonly used illicit drugs on a large number of recreational drug users. METHODS Sixty-one abstinent recreational users of illicit drugs comprised the participant sample, with 33 females and 28 males, mean age 25.45 years. The three testing sessions involved oral consumption of 100 mg MDMA, 0.42 mg/kg d-methamphetamine, or a matching placebo. The drug administration was counter-balanced, double-blind, and medically supervised. Cognitive performance was assessed during drug peak (3 h) and at 24 h post-dosing time-points. Blood samples were also taken to quantify the levels of drug present at the cognitive testing time-points. RESULTS Blood concentrations of both methamphetamine and MDMA at drug peak samples were consistent with levels observed in previous studies. The major findings concern poorer performance in the MDMA condition at peak concentration for the trail-making measures and an index of working memory (trend level), and more accurate performance on a choice reaction task within the methamphetamine condition. Most of the differences in performance between the MDMA, methamphetamine, and placebo treatments diminished by the 24-h testing time-point, although some performance improvements subsisted for choice reaction time for the methamphetamine condition. CONCLUSIONS Further research into the acute effects of amphetamine preparations is necessary to further quantify the acute disruption of aspects of human functioning crucial to complex activities such as attention, selective memory, and psychomotor performance.
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Affiliation(s)
- Con Stough
- Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorn, VIC, 3122, Australia.
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Bosker WM, Kuypers KPC, Conen S, Kauert GF, Toennes SW, Skopp G, Ramaekers JG. MDMA (ecstasy) effects on actual driving performance before and after sleep deprivation, as function of dose and concentration in blood and oral fluid. Psychopharmacology (Berl) 2012; 222:367-76. [PMID: 21952668 PMCID: PMC3395348 DOI: 10.1007/s00213-011-2497-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2011] [Accepted: 08/01/2011] [Indexed: 11/25/2022]
Abstract
RATIONALE Experimental research has shown that 3,4-methylenedioxymethamphetamine (MDMA) can improve some psychomotor driving skills when administered during the day. In real life, however, MDMA is taken during the night, and driving may likely occur early in the morning after a night of "raving" and sleep loss. OBJECTIVES The present study assessed the effects of MDMA on road-tracking and car-following performance in on-the-road driving tests in normal traffic. METHODS Sixteen recreational MDMA users participated in a randomized double-blind placebo-controlled four-way cross-over design. They received single, evening doses of 0, 25, 50, and 100 mg MDMA on separate occasions. Actual driving tests were conducted in the evening when MDMA serum concentrations were maximal and in the morning after a night of sleep loss. RESULTS The primary measure of driving, i.e., standard deviation of lateral position (SDLP, a measure of weaving) was significantly increased during driving tests in the morning in all treatment conditions, irrespective of MDMA dose and concentration. The increments in SDLP were of high clinical relevance and comparable to those observed for alcohol at blood alcohol concentrations >0.8 mg/mL. These impairments were primarily caused by sleep loss. CONCLUSIONS In general, MDMA did not affect driving performance nor did it change the impairing effects of sleep loss. It is concluded that MDMA cannot compensate for the impairing effects of sleep loss and that drivers who are under the influence of MDMA and sleep deprived are unfit to drive.
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Affiliation(s)
- Wendy M. Bosker
- Department Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Kim P. C. Kuypers
- Department Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Silke Conen
- Department Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Gerold F. Kauert
- Institute of Forensic Toxicology, University of Frankfurt, Frankfurt/Main, Germany
| | - Stefan W. Toennes
- Institute of Forensic Toxicology, University of Frankfurt, Frankfurt/Main, Germany
| | - Gisela Skopp
- Institute of Legal Medicine, University Hospital, Heidelberg, Germany
| | - Johannes G. Ramaekers
- Department Neuropsychology & Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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