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Daziani G, Lo Faro AF, Montana V, Goteri G, Pesaresi M, Bambagiotti G, Montanari E, Giorgetti R, Montana A. Synthetic Cathinones and Neurotoxicity Risks: A Systematic Review. Int J Mol Sci 2023; 24:ijms24076230. [PMID: 37047201 PMCID: PMC10093970 DOI: 10.3390/ijms24076230] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
According to the EU Early Warning System (EWS), synthetic cathinones (SCs) are the second largest new psychoactive substances (NPS) class, with 162 synthetic cathinones monitored by the EU EWS. They have a similar structure to cathinone, principally found in Catha Edulis; they have a phenethylamine related structure but also exhibit amphetamine-like stimulant effects. Illegal laboratories regularly develop new substances and place them on the market. For this reason, during the last decade this class of substances has presented a great challenge for public health and forensic toxicologists. Acting on different systems and with various mechanisms of action, the spectrum of side effects caused by the intake of these drugs of abuse is very broad. To date, most studies have focused on the substances’ cardiac effects, and very few on their associated neurotoxicity. Specifically, synthetic cathinones appear to be involved in different neurological events, including increased alertness, mild agitation, severe psychosis, hyperthermia and death. A systematic literature search in PubMed and Scopus databases according to PRISMA guidelines was performed. A total of 515 studies published from 2005 to 2022 (350 articles from PubMed and 165 from Scopus) were initially screened for eligibility. The papers excluded, according to the criteria described in the Method Section (n = 401) and after full text analyses (n = 82), were 483 in total. The remaining 76 were included in the present review, as they met fully the inclusion criteria. The present work provides a comprehensive review on neurotoxic mechanisms of synthetic cathinones highlighting intoxication cases and fatalities in humans, as well as the toxic effects on animals (in particular rats, mice and zebrafish larvae). The reviewed studies showed brain-related adverse effects, including encephalopathy, coma and convulsions, and sympathomimetic and hallucinogenic toxidromes, together with the risk of developing excited/agitated delirium syndrome and serotonin syndrome.
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Affiliation(s)
- Gloria Daziani
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Alfredo Fabrizio Lo Faro
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Vincenzo Montana
- Dipartimento di Anestesia, Rianimazione e Emergenza-Urgenza, Fondazione IRCCS (Istituto di Ricovero e Cura a Carattere Scientifico) Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy;
| | - Gaia Goteri
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Mauro Pesaresi
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Giulia Bambagiotti
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Eva Montanari
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Raffaele Giorgetti
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
| | - Angelo Montana
- Department of Excellence Biomedical Sciences and Public Health, Marche Polytechnic University, 60121 Ancona, Italy; (G.D.); (A.F.L.F.); (G.G.); (M.P.); (G.B.); (E.M.); (R.G.)
- Correspondence:
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Gearlds C, Bouldin JB, McKinney M, Schreiner S, Brown SD, Pond BB. Pharmacokinetics of Synthetic Cathinones Found in Bath Salts in Mouse Brain and Plasma Using High-Pressure Liquid Chromatography-Tandem Mass Spectrometry. Eur J Drug Metab Pharmacokinet 2021; 46:771-778. [PMID: 34427910 DOI: 10.1007/s13318-021-00712-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES Approximately 10 years ago, "bath salts" became popular as legal alternatives to the psychostimulants cocaine and the amphetamines. These products contained synthetic cathinones, including 3,4-methylenedioxypyrovalerone (MDPV), 4-methylmethcathinone (mephedrone), and 3,4-methylenedioxymethcathinone (methylone). Most preclinical investigations have only assessed the effects of these synthetic cathinones independently; however, case reports and Drug Enforcement Administration (DEA) studies indicate that bath salts contain mixtures of these substances. In this study, we examine the pharmacokinetic interactions of the drug combination. We hypothesized that combined exposure to MDPV, mephedrone, and methylone would result in increased drug concentrations and enhanced total drug concentrations when compared to individual administration. METHODS Adolescent male Swiss-Webster mice were injected intraperitoneally with either 10 mg/kg MDPV, 10 mg/kg mephedrone, 10 mg/kg methylone, or 10 mg/kg combined MDPV, mephedrone, and methylone. Following injection, brains and plasma were collected at 1, 10, 15, 30, 60, and 120 min. Drugs were extracted via solid-phase extraction, and concentrations were determined using a previously published high-pressure liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method. RESULTS All drugs crossed the blood-brain barrier quickly. For methylone, the maximal concentration (Cmax) and the total drug exposure [as represented by the area under the concentration-time curve (AUC)] were significantly higher when combined with mephedrone and MDPV in both matrices (2.89-fold increase for both Cmax and AUC with combined treatment). For mephedrone, the Cmax was unchanged, but the AUC in brain was increased when in combination by approximately 34%. Interestingly, for MDPV, the Cmax was unchanged, yet the AUC was higher when MDPV was administered individually (there was a 62% decrease in AUC with combined treatment). CONCLUSIONS The pharmacokinetics of methylone, mepedrone, and MDPV are altered when the drugs are used in combination. These data provide insight into the consequences of co-exposure to synthetic cathinones in popular bath salt products.
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Affiliation(s)
- Courtney Gearlds
- Department of Pharmaceutical Sciences, East Tennessee State University Bill Gatton College of Pharmacy, Box 70594, Johnson City, TN, 37614, USA
| | - Jessica Brooke Bouldin
- Department of Pharmaceutical Sciences, East Tennessee State University Bill Gatton College of Pharmacy, Box 70594, Johnson City, TN, 37614, USA
| | - Mariah McKinney
- Department of Pharmaceutical Sciences, East Tennessee State University Bill Gatton College of Pharmacy, Box 70594, Johnson City, TN, 37614, USA
| | - Shannon Schreiner
- Department of Pharmaceutical Sciences, East Tennessee State University Bill Gatton College of Pharmacy, Box 70594, Johnson City, TN, 37614, USA
| | - Stacy D Brown
- Department of Pharmaceutical Sciences, East Tennessee State University Bill Gatton College of Pharmacy, Box 70594, Johnson City, TN, 37614, USA
| | - Brooks B Pond
- Department of Pharmaceutical Sciences, East Tennessee State University Bill Gatton College of Pharmacy, Box 70594, Johnson City, TN, 37614, USA.
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Couto RAS, Coelho C, Mounssef B, Morais SFDA, Lima CD, dos Santos WTP, Carvalho F, Rodrigues CMP, Braga AAC, Gonçalves LM, Quinaz MB. 3,4-Methylenedioxypyrovalerone (MDPV) Sensing Based on Electropolymerized Molecularly Imprinted Polymers on Silver Nanoparticles and Carboxylated Multi-Walled Carbon Nanotubes. NANOMATERIALS (BASEL, SWITZERLAND) 2021; 11:353. [PMID: 33535439 PMCID: PMC7912732 DOI: 10.3390/nano11020353] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 01/20/2023]
Abstract
3,4-methylenedioxypyrovalerone (MDPV) is a harmful and controlled synthetic cathinone used as a psychostimulant drug and as sport-enhancing substance. A sensor was developed for the direct analysis of MDPV by transducing its oxidation signal by means of an electropolymerized molecularly imprinted polymer (e-MIP) built in-situ on the screen-printed carbon electrode's (SPCE) surface previously covered with multi-walled carbon nanotubes (MWCNTs) and silver nanoparticles (AgNPs). Benzene-1,2-diamine was used as the functional monomer while the analyte was used as the template monomer. Each step of the sensor's development was studied by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) in a solution containing ferricyanide, however no redox probe was required for the actual MDPV measurements. The interaction between the poly(o-phenylenediamine) imprinted polymer and MDPV was studied by density-functional theory (DFT) methods. The SPCE-MWCNT-AgNP-MIP sensor responded adequately to the variation of MDPV concentration. It was shown that AgNPs enhanced the electrochemical signal by around a 3-fold factor. Making use of square-wave voltammetry (SWV) the developed sensor provided a limit of detection (LOD) of 1.8 μmol L-1. The analytical performance of the proposed sensor paves the way to the development of a portable device for MDPV on-site sensing to be applied in forensic and doping analysis.
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Affiliation(s)
- Rosa A. S. Couto
- REQUIMTE, LAQV, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-213 Porto, Portugal; (R.A.S.C.); (C.C.)
| | - Constantino Coelho
- REQUIMTE, LAQV, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-213 Porto, Portugal; (R.A.S.C.); (C.C.)
| | - Bassim Mounssef
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo (USP), São Paulo, SP 05508-000, Brazil; (B.M.J.); (S.F.d.A.M.); (A.A.C.B.)
| | - Sara F. de A. Morais
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo (USP), São Paulo, SP 05508-000, Brazil; (B.M.J.); (S.F.d.A.M.); (A.A.C.B.)
| | - Camila D. Lima
- Departamento de Química, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG 39100-000, Brazil;
| | - Wallans T. P. dos Santos
- Departamento de Farmácia, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Diamantina, MG 39100-000, Brazil;
| | - Félix Carvalho
- REQUIMTE, UCIBIO, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-213 Porto, Portugal;
| | - Cecília M. P. Rodrigues
- Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, 1649-003 Lisbon, Portugal;
| | - Ataualpa A. C. Braga
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo (USP), São Paulo, SP 05508-000, Brazil; (B.M.J.); (S.F.d.A.M.); (A.A.C.B.)
| | - Luís Moreira Gonçalves
- Departamento de Química Fundamental, Instituto de Química, Universidade de São Paulo (USP), São Paulo, SP 05508-000, Brazil; (B.M.J.); (S.F.d.A.M.); (A.A.C.B.)
| | - M. Beatriz Quinaz
- REQUIMTE, LAQV, Laboratory of Applied Chemistry, Department of Chemical Sciences, Faculty of Pharmacy, University of Porto, 4050-213 Porto, Portugal; (R.A.S.C.); (C.C.)
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Wojcieszak J, Kuczyńska K, Zawilska JB. Behavioral Effects of 4-CMC and 4-MeO-PVP in DBA/2J Mice After Acute and Intermittent Administration and Following Withdrawal from Intermittent 14-Day Treatment. Neurotox Res 2021; 39:575-587. [PMID: 33428180 PMCID: PMC8096775 DOI: 10.1007/s12640-021-00329-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 12/21/2020] [Accepted: 01/01/2021] [Indexed: 01/06/2023]
Abstract
Synthetic cathinones appeared on the market in the 2000s as new psychoactive substances and gained significant prevalence among drug abusers. Cathinones produce psychostimulant and empathogenic effects by enhancing dopaminergic, noradrenergic, and serotoninergic neurotransmission in the brain, and those which potently and selectively enhance dopaminergic transmission are considered to have higher abuse potential. The present study examines the behavioral effects related to psychostimulant properties, abuse potential, and addiction in DBA/2J mice of two cathinones with different profile of action on monoamine system, 4-chloromethcathinone (4-CMC), and 4-methoxy-pyrrolidinopentiophenone (4-MeO-PVP). 4-CMC and 4-MeO-PVP increase spontaneous locomotor activity after acute treatment and produce behavioral sensitization after 7-day intermittent treatment, which is a common feature of drugs of abuse. 4-MeO-PVP, but not 4-CMC, produces conditioned place preference after 4 days, indicating its rewarding properties. Finally, the ability of 4-CMC and 4-MeO-PVP to induce withdrawal symptoms after discontinuation from 14-day treatment was assessed using a battery of tests for behavioral markers of depression in mice: a tail suspension test, a forced swim test, measuring despair, and a sucrose preference test, measuring anhedonia. None of the three tests revealed increased depressive symptoms. Moreover, neither spontaneous locomotor activity nor motor performance on a rotarod was impaired after 14-day treatment with the tested compounds. These results indicate that 14-day treatment of mice with 4-CMC or 4-MeO-PVP does not induce significant withdrawal symptoms after cessation, nor significant impairment of dopaminergic circuitry resulting in motor impairment. The current study shows that 4-CMC and 4-MeO-PVP produce abuse-related behavioral changes in mice, which are more pronounced after more dopamine-selective 4-MeO-PVP.
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Affiliation(s)
- Jakub Wojcieszak
- Department of Pharmacodynamics, Medical University of Lodz, 90-151, Lodz, Poland.
| | - Katarzyna Kuczyńska
- Department of Pharmacodynamics, Medical University of Lodz, 90-151, Lodz, Poland
| | - Jolanta B Zawilska
- Department of Pharmacodynamics, Medical University of Lodz, 90-151, Lodz, Poland
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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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Wojcieszak J, Andrzejczak D, Wojtas A, Gołembiowska K, Zawilska JB. Comparative neuropharmacological studies on three pyrrolidine-containing synthetic cathinones. Forensic Toxicol 2020. [DOI: 10.1007/s11419-020-00523-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Abstract
Purpose
3,4-Methylenedioxypyrovalerone (3,4-MDPV) is a prevalent member of α-pyrrolidinophenones, a group of new psychoactive substances, known for its strong psychostimulant effect resulting from potent stimulation of dopamine (DA) circuitry in the brain. As 3,4-MDPV and its derivatives are successively being scheduled, each year novel analogs appear on the market. This study aimed at examination and direct comparison of psychostimulant properties of structural isomer of 3,4-MDPV, namely 2,3-MDPV along with a model α-pyrrolidinophenone, pyrovalerone.
Methods
Open field spontaneous locomotor activity of mice was assessed as a measure of psychostimulant potency. To evaluate the in vivo pharmacological properties of the drugs, extracellular levels of DA and serotonin (5-HT) in the mouse striatum were measured using an in vivo microdialysis technique followed by high-performance liquid chromatography with electrochemical detection. Involvement of dopaminergic system in the behavioral effects of the tested α-pyrrolidinophenones was examined by pre-treatment with a selective D1-DA receptor antagonist, SCH 23390, before measurement of locomotor activity in response to the drugs.
Results
3,4-MDPV, 2,3-MDPV and pyrovalerone produced time- and dose-dependent stimulation of locomotor activity, with 3,4-MDPV being more potent than the other two compounds. Observed locomotor stimulation was mediated by elevated DA-ergic neurotransmission, as all compounds caused a significant increase of extracellular DA levels in the striatum, with 3,4-MDPV being the most potent, and psychostimulant effects were abolished by SCH 23390. Interestingly, the tested pyrovalerones caused in vivo elevation of extracellular 5-HT levels, which contrasted with their in vitro pharmacologic properties.
Conclusions
Pyrovalerone, 2,3-MDPV and 3,4-MDPV produced psychostimulant effects mediated by stimulation of dopaminergic neurotransmission. Additionally, all tested compounds elevated extracellular levels of 5-HT in vivo.
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