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Wolf CJH, Spoelder M, Beurmanjer H, Bulthuis R, Schellekens AFA, Homberg JR. Individual differences in GHB consumption in a new voluntary GHB self-administration model in outbred rats. Psychopharmacology (Berl) 2024; 241:613-625. [PMID: 38334790 PMCID: PMC10884067 DOI: 10.1007/s00213-024-06537-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 01/17/2024] [Indexed: 02/10/2024]
Abstract
BACKGROUND AND PURPOSE The use of the recreational drug gamma-hydroxybutyric acid (GHB) has increased over the past decade, concomitantly leading to a higher incidence of GHB use disorder. Evidence-based treatment interventions are hardly available and cognitive effects of long-term GHB use remain elusive. In order to study the development of GUD and the causal effects of chronic GHB consumption, a GHB self-administration model is required. EXPERIMENTAL APPROACH Long Evans rats had access to GHB in their home cage according to a two-bottle choice procedure for 3 months. Intoxication and withdrawal symptoms were assessed using an automated sensor-based setup for longitudinal behavioral monitoring. Rats were trained in an operant environment according to a fixed ratio (FR) 1, 2, and 4 schedule of reinforcement. Addiction-like behaviors were assessed through progressive ratio-, non-reinforced-, and quinine-adulterated operant tests. In addition, the novel object recognition test and elevated plus maze test were performed before and after GHB self-administration to assess memory performance and anxiety-like behavior, respectively. KEY RESULTS All rats consumed pharmacologically relevant levels of GHB in their home cage, and their intake remained stable over a period of 3 months. No clear withdrawal symptoms were observed following abstinence. Responding under operant conditions was characterized by strong inter-individual differences, where only a subset of rats showed high motivation for GHB, habitual GHB-seeking, and/or continued responding for GHB despite an aversive taste. Male rats showed a reduction in long-term memory performance 3 months after home-cage GHB self-administration. Anxiety-like behavior was not affected by GHB self-administration. CONCLUSION AND IMPLICATIONS The GHB self-administration model was able to reflect individual susceptibility for addiction-like behavior. The reduction in long-term memory performance upon GHB self-administration calls for further research into the cognitive effects of chronic GHB use in humans.
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Affiliation(s)
- Casper J H Wolf
- Donders Institute for Brain, Department of Psychiatry, Radboudumc, Cognition, and Behaviour, Reinier Postlaan 4, 6525 GC, Nijmegen, The Netherlands.
- Donders Institute for Brain Cognition and Behaviour, Department of Cognitive Neuroscience, Radboudumc, 6525 EN, Nijmegen, The Netherlands.
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR, Nijmegen, The Netherlands.
| | - Marcia Spoelder
- Department of Primary and Community Care, Radboud University Medical Center, 6500 HB, Nijmegen, The Netherlands
| | - Harmen Beurmanjer
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR, Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, 6525 GD, Nijmegen, The Netherlands
- Novadic-Kentron Addiction Care, 5261 LX, Vught, The Netherlands
| | | | - Arnt F A Schellekens
- Donders Institute for Brain, Department of Psychiatry, Radboudumc, Cognition, and Behaviour, Reinier Postlaan 4, 6525 GC, Nijmegen, The Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR, Nijmegen, The Netherlands
| | - Judith R Homberg
- Donders Institute for Brain Cognition and Behaviour, Department of Cognitive Neuroscience, Radboudumc, 6525 EN, Nijmegen, The Netherlands
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Arfè R, Bilel S, Tirri M, Corli G, Bergamin E, Serpelloni G, Bassi M, Borsari M, Boccuto F, Bernardi T, Caruso L, Alkilany AM, Rachid O, Botrè F, De-Giorgio F, Marti M. Comprehensive evaluation of the pharmacological and toxicological effects of γ-valerolactone as compared to γ-hydroxybutyric acid: Insights from in vivo and in silico models. Drug Alcohol Depend 2023; 252:110951. [PMID: 37717308 DOI: 10.1016/j.drugalcdep.2023.110951] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/24/2023] [Accepted: 08/28/2023] [Indexed: 09/19/2023]
Abstract
Γ-valerolactone (GVL), marketed online as "Tranquilli-G" and "excellent Valium", is used as a legal substitute for γ-hydroxybutyric acid (GHB); however, until now, GVL has only been connected to one Drug-Facilitated Sexual Assault (DFSA) case. Moreover, the pharmaco-toxicological effects of GVL are poorly studied. The aim of this study was to investigate the 1) in vivo effects of gavage administration of GVL (100-3000 mg/kg) on neurological (myoclonia, convulsions), sensorimotor (visual, acoustic, and overall tactile) responses, righting reflex, thermoregulation, motor activity (bar, drag, and accelerod test) and cardiorespiratory changes (heart rate, breath rate, oxygen saturation, and pulse distension) in CD-1 male mice and the 2) in silico ADMET profile of GVL in comparison to GHB and the open active form γ-hydroxyvaleric acid (GHV). The present study demonstrates that GVL inhibits, in a dose-dependent manner, sensorimotor and motor responses and induces cardiorespiratory depression (at a dose of 3000 mg/kg) in mice. The determination of the ED50 in sensorimotor and motor responses revealed that GVL is about 4-5 times less potent than GHB. In silico prediction of ADMET profiles revealed toxicokinetic similarities between GHB and GHV, and differences with GVL. These results suggest that GVL could be used as a substitute for GHB and should be added to forensic toxicology screenings.
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Affiliation(s)
- Raffaella Arfè
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Sabrine Bilel
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Giorgia Corli
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Eva Bergamin
- Università Cattolica del Sacro Cuore, Roma, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy
| | | | - Marta Bassi
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Martina Borsari
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Federica Boccuto
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy
| | - Tatiana Bernardi
- Department of Environmental Sciences and Prevention University of Ferrara, Ferrara, Italy
| | - Lorenzo Caruso
- Department of Environmental Sciences and Prevention University of Ferrara, Ferrara, Italy
| | - Alaaldin M Alkilany
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Qatar
| | - Ousama Rachid
- Department of Pharmaceutical Sciences, College of Pharmacy, QU Health, Qatar University, Qatar
| | - Francesco Botrè
- Antidoping Laboratory FMSI, Rome, Italy; REDs - Research and Expertise in antidoping Sciences, ISSUL - Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Fabio De-Giorgio
- Università Cattolica del Sacro Cuore, Roma, Italy; Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine and LTTA Centre, University of Ferrara, Ferrara, Italy; Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, Italy.
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3
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Wolf CJH, Venselaar H, Spoelder M, Beurmanjer H, Schellekens AFA, Homberg JR. An Overview of the Putative Structural and Functional Properties of the GHBh1 Receptor through a Bioinformatics Approach. Life (Basel) 2023; 13:life13040926. [PMID: 37109455 PMCID: PMC10142108 DOI: 10.3390/life13040926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/24/2023] [Accepted: 03/30/2023] [Indexed: 04/05/2023] Open
Abstract
The neurotransmitter γ-hydroxybutyric acid (GHB) is suggested to be involved in neuronal energy homeostasis processes, but the substance is also used as a recreational drug and as a prescription medication for narcolepsy. GHB has several high-affinity targets in the brain, commonly generalized as the GHB receptor. However, little is known about the structural and functional properties of GHB receptor subtypes. This opinion article discusses the literature on the putative structural and functional properties of the GHBh1 receptor subtype. GHBh1 contains 11 transmembrane helices and at least one intracellular intrinsically disordered region (IDR). Additionally, GHBh1 shows a 100% overlap in amino acid sequence with the Riboflavin (vitamin B2) transporter, which opens the possibility of a possible dual-function (transceptor) structure. Riboflavin and GHB also share specific neuroprotective properties. Further research into the GHBh1 receptor subtype may pave the way for future therapeutic possibilities for GHB.
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Affiliation(s)
- Casper J. H. Wolf
- Department of Psychiatry, Radboudumc, 6525 GC Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain Cognition and Behaviour, Radboudumc, 6525 EN Nijmegen, The Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - Hanka Venselaar
- Center for Molecular and Biomolecular Informatics, Radboudumc, 6525 GA Nijmegen, The Netherlands
| | - Marcia Spoelder
- Department of Primary and Community Care, Radboudumc, 6525 GC Nijmegen, The Netherlands
| | - Harmen Beurmanjer
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
- Behavioural Science Institute, Radboud University, 6525 GD Nijmegen, The Netherlands
- Novadic-Kentron Addiction Care, 5261 LX Vught, The Netherlands
| | - Arnt F. A. Schellekens
- Department of Psychiatry, Radboudumc, 6525 GC Nijmegen, The Netherlands
- Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), 6525 HR Nijmegen, The Netherlands
| | - Judith R. Homberg
- Department of Cognitive Neuroscience, Donders Institute for Brain Cognition and Behaviour, Radboudumc, 6525 EN Nijmegen, The Netherlands
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Asadi L, Saadati Z, Salehpour M. Theoretical evaluation of Al-doped biphenylene nanosheet sensing properties toward gamma-butyrolactone. Struct Chem 2022. [DOI: 10.1007/s11224-022-01964-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zeng T, Li S, Wu L, Feng Z, Fan X, Yuan J, Wang X, Meng J, Ma H, Zeng G, Kang C, Yang J. A Comparison Study of Impulsiveness, Cognitive Function, and P300 Components Between Gamma-Hydroxybutyrate and Heroin-Addicted Patients: Preliminary Findings. Front Hum Neurosci 2022; 16:835922. [PMID: 35529779 PMCID: PMC9067320 DOI: 10.3389/fnhum.2022.835922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/14/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose The aim of this study was to investigate and compare impulsiveness, negative emotion, cognitive function, and P300 components among gamma-hydroxybutyrate (GHB)-addicted patients, heroin-dependent patients, and methadone maintenance treatment (MMT) subjects. Methods A total of 48 men including 17 GHB addicts, 16 heroin addicts, 15 MMT subjects, and 15 male mentally healthy controls (HC) were recruited. All subjects were evaluated for symptoms of depression, anxiety, impulsiveness, and cognitive function through the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder 7-item (GAD-7), the Barratt Impulsiveness Scale version II (BIS-II), the Beijing version of the Montreal Cognitive Assessment (BJ-MoCA), the behavioral test (response time), and event-related potential P300 detection. Results (1) The mean scores of BIS-II in the GHB addiction group, heroin dependence group, and MMT group were significantly higher than those of the HC group (F = 30.339, P = 0.000). (2) The total scores of BJ-MOCA in GHB addiction group was the worst among the four groups, followed by heroin addiction, MMT group and HC group (F = 27.880, P = 0.000). (3) The response time in the GHB addiction group was the longest among the four groups, followed by the heroin addiction, MMT, and HC groups (F = 150.499, P = 0.000). (4) The amplitude and latency of P300 in GHB addiction subjects were significantly lower and longer than those of the MMT group and the HC group. (5) For the three types of addiction, the P300 amplitudes at Fz, Cz, Pz, T5, and T6 were negatively correlated with the scores of GAD-7, PHQ-9, and BIS-II; the P300 latencies were positively correlated with the response time and negatively correlated with the scores of the BJ-MoCA. Conclusion People with an addiction were likely to have increased impulsiveness. The cognitive function of the GHB and heroin-addicted subjects, including the heroin detoxification and the MMT groups, was severely impaired, especially for the GHB-addicted patients. The impairment manifested as abnormalities of BJ-MoCA, response time, and P300 components.
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Affiliation(s)
- Tingting Zeng
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shida Li
- The Guangzhou Baiyun Psychological Hospital, Guangzhou, China
| | - Li Wu
- Department of Substance Use Disorders, The Psychiatry Hospital of Yunnan, Kunming, China
| | - Zuxing Feng
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xinxin Fan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Jing Yuan
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xin Wang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Junyu Meng
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Huan Ma
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Guanyong Zeng
- The Guangzhou Baiyun Psychological Hospital, Guangzhou, China
- *Correspondence: Guanyong Zeng
| | - Chuanyuan Kang
- Department of Psychosomatic Medicine, Tongji University School of Medicine, Shanghai East Hospital, Shanghai, China
- Chuanyuan Kang
| | - Jianzhong Yang
- Department of Psychiatry, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
- Jianzhong Yang
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6
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van Amsterdam J, Brunt TM, Pereira FR, Crunelle CL, van den Brink W. Cognitive Impairment Following Clinical or Recreational Use of Gammahydroxybutyric Acid (GHB): A Systematic Review. Curr Neuropharmacol 2022; 20:809-819. [PMID: 34151766 PMCID: PMC9878963 DOI: 10.2174/1570159x19666210610094352] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/24/2021] [Accepted: 05/05/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND GHB (gamma-hydroxybutyric acid; sodium oxybate) is a general anaesthetic that is clinically used for the treatment of narcolepsy, cataplexy, alcohol withdrawal and alcohol relapse prevention. In addition, GHB is recreationally used. Most clinical and recreational users regard GHB as an innocent drug devoid of adverse effects, despite its high dependence potential and possible neurotoxic effects. At high doses, GHB may lead to a comatose state. This paper systematically reviews possible cognitive impairments due to clinical and recreational GHB use. METHODS PubMed and PsychINFO were searched for literature data about the acute and residual cognitive deficits following GHB use. This review is conducted using the PRISMA protocol. RESULTS A total of 43 reports covering human and animal data on GHB-induced cognitive impairments were eligible and reviewed. This systematic review found no indication for cognitive impairments after clinical GHB use. However, it supports the view that moderate GHB use may result in acute short-term cognitive impairments, whereas regular high-dose GHB use and/or multiple GHB-induced comas are probably neurotoxic resulting in long-term residual cognitive impairments. CONCLUSION These results emphasize the need for awareness among clinicians and recreational users to minimize negative health consequences of recreational GHB use, particularly when high doses are used and GHB-induced comas occur.
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Affiliation(s)
- Jan van Amsterdam
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands;,Address correspondence to this author at the Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands; E-mails: ;
| | - Tibor M. Brunt
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Filipa R. Pereira
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
| | - Cleo L. Crunelle
- Department of Psychiatry, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam University Medical Center, University of Amsterdam, P.O. Box 22660, 1100 DD Amsterdam, The Netherlands
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7
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Dijkstra BAG, Beurmanjer H, Goudriaan AE, Schellekens AFA, Joosten EAG. Unity in diversity: A systematic review on the GHB using population. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 94:103230. [PMID: 33892279 DOI: 10.1016/j.drugpo.2021.103230] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Over the past decades gamma-hydroxybutyrate (GHB) has emerged as a popular drug with high potential of (ab)use due to its euphoric and relaxing effects. An overview of different populations using GHB is urgently needed, since this would enable development of adequate prevention and treatment policies to diminish the risks associated with GHB use. We systematically reviewed literature on different GHB using populations, comparing demographic characteristics, GHB use patterns, psychosocial aspects and psychiatric comorbidity. METHODS We conducted a systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using Rayyan software. Original studies published from January 1997 up to October 2019 on GHB use were included. Out of 80 full-text articles, 60 articles of 51 unique studies were included. Most studies included people using GHB 1) presenting at emergency departments (n = 22), 2) recruited from the general population (n = 11), or 3) presenting at addiction care (n = 8). RESULTS Three main sub-populations of people using GHB are described in the literature: people using GHB recreationally without adverse effects; people using GHB recreationally with adverse effects, and people with dependence on GHB. These groups show considerable overlap in gender, age range, and comorbid substance use, as well as amount of GHB use per occasion. Differences are related to frequency and function of GHB use, the number of comas experienced, as well as work status, and psychiatric comorbidity. CONCLUSION Policy interventions should aim at preventing the transition from recreational substance use to GHB use, as most users are experienced recreational substance users prior to starting GHB use. When people use GHB regularly, interventions should aim at reducing the level of GHB use and preventing GHB use-related harm. Longitudinal studies and population-based probability sampling are required for more insight in the dynamics of GHB use in different sub-populations, and the transition from one group to the other, ultimately leading to dependence on GHB.
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Affiliation(s)
- B A G Dijkstra
- Nijmegen Institute for Scientist-Practitioner in Addiction (NISPA), Radboud University, Nijmegen, the Netherlands; Radboudumc, Department of Psychiatry, Nijmegen, the Netherlands; Novadic-Kentron Addiction Treatment Center, Vught, the Netherlands.
| | - H Beurmanjer
- Nijmegen Institute for Scientist-Practitioner in Addiction (NISPA), Radboud University, Nijmegen, the Netherlands; Novadic-Kentron Addiction Treatment Center, Vught, the Netherlands
| | - A E Goudriaan
- Jellinek and Arkin, Amsterdam, the Netherlands; Amsterdam University Medical Center, Department of Psychiatry, University of Amsterdam, Amsterdam, the Netherlands
| | - A F A Schellekens
- Nijmegen Institute for Scientist-Practitioner in Addiction (NISPA), Radboud University, Nijmegen, the Netherlands; Radboudumc, Department of Psychiatry, Nijmegen, the Netherlands
| | - E A G Joosten
- Nijmegen Institute for Scientist-Practitioner in Addiction (NISPA), Radboud University, Nijmegen, the Netherlands; Radboudumc, Department of Psychiatry, Nijmegen, the Netherlands
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8
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Donnadieu-Rigole H, Peyrière H, Benyamina A, Karila L. Complications Related to Sexualized Drug Use: What Can We Learn From Literature? Front Neurosci 2020; 14:548704. [PMID: 33328844 PMCID: PMC7732585 DOI: 10.3389/fnins.2020.548704] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Accepted: 11/09/2020] [Indexed: 12/13/2022] Open
Abstract
Chemsex is described as the use of specific psychoactive substances (PS) during sexual activity to sustain, enhance, disinhibit or facilitate the sexual experience. It preferentially concerns men who have sex with men (MSM). They use new synthetic substances like cathinones, methamphetamines, gamma-butyrolactone/gamma-hydroxybutyrate (GBL/GHB), ketamine, and cocaine. The prevalence of chemsex varies from 3 to 31% during lifetime. The Internet has participated significantly in the evolution of sexual behaviors, both in terms of sexual dating and the availability of new synthetic substances. The advent of geolocation applications contributed to the development of chemsex. The literature describes many complications linked to these sexual practices; the main clinical effects related to cathinones consumption were psychiatric symptoms; agitation, hallucinations, anxiety, suicidal ideation, paranoia, and confusion. Regular GBL/GHB consumption alter cognitive functions, particularly memory and emotion management. Use of these drugs in party and play is dramatically associated with high-risk sexual behaviors. The prevalence of hepatitis B, hepatitis C syphilis, and HIV is higher in men who use methamphetamine and Viagra and/or who declared they practiced slamming, chemsex, and fisting. Other sexually transmitted infections (STIs) such as gonorrhea have increased with methamphetamine and GHB/GBL use. Actually, the care of individuals who practice Chemsex in a problematic way is currently not codified, but the use of integrative and specific interventions is necessary.
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Affiliation(s)
- Hélène Donnadieu-Rigole
- Addictions Department, Saint Eloi Hospital, University Hospital of Montpellier, Montpellier, France.,INSERM U 1058, Pathogenesis and Control of Chronic Infections (PCCI), Montpellier, France
| | - Hélène Peyrière
- INSERM U 1058, Pathogenesis and Control of Chronic Infections (PCCI), Montpellier, France.,Addictovigilance Center, Department of Medical Pharmacology and Toxicology, University Hospital of Montpellier, Montpellier, France
| | - Amine Benyamina
- Centre d'Enseignement, de Recherche et de Traitement des Addictions, Hôpital Universitaire Paul-Brousse (APHP), Villejuif, France.,Paris-Saclay University, Saint-Aubin, France
| | - Laurent Karila
- Centre d'Enseignement, de Recherche et de Traitement des Addictions, Hôpital Universitaire Paul-Brousse (APHP), Villejuif, France.,Paris-Saclay University, Saint-Aubin, France.,Unité de Recherche PSYCOMADD, Villejuif, France
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9
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Vos CF, Pop-Purceleanu M, van den Berg MJW, Schellekens AFA. Successful treatment of severe, treatment resistant GHB withdrawal through thiopental-coma. Subst Abus 2020; 42:33-38. [PMID: 33044905 DOI: 10.1080/08897077.2020.1827124] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND In patients with gamma-hydroxybutyrate (GHB) use disorder (GUD), withdrawal can have a fulminant course with rapid progression of severe, potentially life-threatening complications. Case: We present a 45-year old man with severe GHB withdrawal, resistant to conventional treatment with pharmaceutical GHB, high doses of benzodiazepines and baclofen. GHB withdrawal finally responded to thiopental-induced coma therapy, with burst suppression pattern on electroencephalography (EEG). The patient fully recovered, without withdrawal or residual neuropsychiatric symptoms. Discussion: To our knowledge, this is the first case report in which barbiturates were used to induce a coma to treat severe, treatment resistant GHB withdrawal. This case suggests barbiturate coma therapy might be considered in severe GHB withdrawal which does not respond to conventional treatment.
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Affiliation(s)
- Cornelis F Vos
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Monica Pop-Purceleanu
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Arnt F A Schellekens
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands.,Nijmegen Institute for Scientist-Practitioners in Addiction (NISPA), Radboud University, Nijmegen, The Netherlands
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10
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Achterbergh R, Hoornenborg E, Boyd A, Coyer L, Meuzelaar S, Hogewoning A, Davidovich U, van Rooijen M, Schim van der Loeff M, Prins M, de Vries H. Changes in mental health and drug use among men who have sex with men using daily and event-driven pre-exposure prophylaxis: Results from a prospective demonstration project in Amsterdam, the Netherlands. EClinicalMedicine 2020; 26:100505. [PMID: 33089120 PMCID: PMC7564518 DOI: 10.1016/j.eclinm.2020.100505] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Revised: 07/03/2020] [Accepted: 07/28/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Gay, bisexual and other men who have sex with men (GBMSM) are at increased risk of mental health disorders and drug use. In GBMSM taking pre-exposure prophylaxis (PrEP) for HIV, the proportion engaging in risk behaviors could increase due to decreased perception in HIV risk. In turn, this could leave them further susceptible to mental health disorders. METHODS The AMsterdam PrEP study (AMPrEP) is a demonstration project offering a choice of daily PrEP or event-driven PrEP regimen at the STI clinic of the Public Health Service of Amsterdam. Eligible participants were HIV-negative GBMSM and transgender people at risk of HIV, aged ≥18 years. We assessed anxiety and depressive mood disorders (Mental Health Inventory 5), sexual compulsivity (Sexual Compulsivity Scale), alcohol use disorder (Alcohol Use Disorder Identification Test), and drug use disorder (Drug Use Disorder Identification Test) using yearly self-administered assessments (August 2015-September 2018). The proportion of mental health problems were analyzed and changes over time and between regimen were assessed using a logistic regression model. Variables associated with the development or recovery of disorders were assessed using a multistate Markov model. OUTCOMES Of 376 enrolled, we analyzed 341 participants with data at baseline and at least one follow-up visit. During a median follow-up of 2.5 years (IQR=2.3-2.7), the proportion assessed with sexual compulsivity decreased from 23% at baseline to 10% at the last visit (p<0.001) and drug use disorder decreased from 38% at baseline to 31% at the last visit (p = 0.004). No changes occurred in proportion assessed with anxiety/depressive mood disorders (20% at baseline, 18% at last visit, p = 0.358) or alcohol use disorder (28% at baseline, 22% at the last visit, p = 0.106). During follow-up, participants reported significant less use of alcohol (p<0.001), nitrites (p<0.001) and ecstasy (p<0.001). We found no differences between daily and event-driven PrEP users. The development and recovery of disorders during follow-up were highly interrelated. INTERPRETATION Mental health disorders are prevalent among those initiating PrEP. We did not find increases in mental health disorders during PrEP use, but rather a decrease in sexual compulsivity and drug use disorders. The initial prevalence of mental health disorders in our study point at the continuous need to address mental health disorders within PrEP programs. FUNDING ZonMw, H-TEAM, Internal GGD research funds, Aidsfonds, Stichting AmsterdamDiner Foundation, Gilead Sciences, Janssen Pharmaceutica, M A C AIDS Fund, and ViiV Healthcare.
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Affiliation(s)
- R.C.A. Achterbergh
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - E. Hoornenborg
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - A. Boyd
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - L. Coyer
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - S.J.A. Meuzelaar
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - A.A. Hogewoning
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - U. Davidovich
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - M.S. van Rooijen
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - M.F. Schim van der Loeff
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - M. Prins
- Research and Prevention, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Infectious Diseases, Amsterdam Institute for Infection and Immunity (AI&II), Meibergdreef 9, AII, the Netherlands
| | - H.J.C. de Vries
- STI outpatient clinic, Department of infectious diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Amsterdam UMC, University of Amsterdam, Department of Dermatology, Amsterdam Institute for Infection and Immunity (AI&II), Meibergdreef 9, AII, the Netherlands
- Corresponding author at: STI Outpatient Clinic, Department of Infectious Diseases, Public Health Service Amsterdam, Nieuwe Achtergracht 100, 1018 WT, Amsterdam, the Netherlands.
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11
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Raposo Pereira F, McMaster MTB, Schellekens A, Polderman N, de Vries YDAT, van den Brink W, van Wingen GA. Effects of Recreational GHB Use and Multiple GHB-Induced Comas on Brain Structure and Impulsivity. Front Psychiatry 2020; 11:166. [PMID: 32300311 PMCID: PMC7142256 DOI: 10.3389/fpsyt.2020.00166] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2019] [Accepted: 02/21/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND AND AIMS The regular use of gamma-hydroxybutyrate acid (GHB) can induce GHB-induced comas. Other substance use disorders are associated with alterations in brain structure and impulsivity. Here we aim to investigate if these are also modulated by either regular GHB use or GHB-induced comas. METHODS In a sample of human males, structural and diffusion neuroimaging data were collected for 27 GHB users with ≥4 GHB-induced comas (GHB-Coma), 27 GHB users without GHB-induced comas (GHB-NoComa), and 27 polydrug users who never used GHB (No-GHB). The structural brain parameters were analyzed macroscopically using voxel-based morphometry and microscopically using tract-based spatial statistics (TBSS) and tractography. Impulsivity was assessed with the Barrat Impulsivity Scale. RESULTS In comparison to the other two groups, the GHB-Coma group showed a higher fractional anisotropy in the body of the corpus callosum and a lower mean diffusivity in the forceps minor (i.e., whole-brain TBSS analysis). No macrostructural differences nor microstructural differences, as assessed with tractography, were observed. The GHB-Coma group also reported higher impulsivity, which was more strongly associated with white matter volume and fractional anisotropy in tracts involved in impulse control (post-hoc analysis). GHB use per se was associated neither with differences in brain structure nor with impulsivity. CONCLUSIONS The results suggest that multiple GHB-induced comas, but not GHB use per se, are associated with microstructural alterations in white matter and with higher self-reported impulsivity, which in turn was associated with white matter tracts involved in impulse control.
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Affiliation(s)
- Filipa Raposo Pereira
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Minni T. B. McMaster
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Arnt Schellekens
- Department of Psychiatry, Radboud University Medical Centre (Radboudumc), Nijmegen, Netherlands
- Nijmegen Institute for Scientist Practitioners in Addiction (NISPA), Nijmegen, Netherlands
| | - Nikki Polderman
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Yvon D. A. T. de Vries
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
| | - Guido A. van Wingen
- Department of Psychiatry, Amsterdam Neuroscience, University of Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, Netherlands
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12
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Metabolic regulation of Ganoderma lucidum extracts in high sugar and fat diet-induced obese mice by regulating the gut-brain axis. J Funct Foods 2020. [DOI: 10.1016/j.jff.2019.103639] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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13
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Raposo Pereira F, McMaster MTB, de Vries YAT, van den Brink W, van Wingen GA. Demographic and Clinical Characteristics of Regular GHB-Users with and without GHB-Induced Comas. Subst Use Misuse 2020; 55:2148-2155. [PMID: 32772606 DOI: 10.1080/10826084.2020.1793368] [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: 10/23/2022]
Abstract
Gamma hydroxybutyric acid (GHB) has been used recreationally for nearly three decades and its chronic use is frequently associated with serious adverse events including GHB-intoxication with GHB-induced comas. Moreover, despite its low prevalence, the number of individuals with GHB-use disorders is steadily increasing. However, the risk-factors associated with chronic GHB-use or the development of a GHB-use disorders remain poorly understood. Purpose: This study aims to profile two types of GHB-users, those with and those without GHB-induced comas. Methods: We included 27 GHB users with ≥4 GHB-induced comas (GHB-Coma), 27 GHB users without a coma (GHB-NoComa), and 27 polydrug users who never used GHB (No-GHB). Participants completed self-reported questionnaires in order to assess their demographic and clinical features, and their use profile of GHB and other drugs. Results: The typical GHB user in our sample was young, single, living alone, well-educated, and a student. The GHB-Coma group had lower self-control and reported higher negative affect than the GHB-NoComa group. GHB-Coma participants were heavier GHB users and mostly used GHB alone at home, whereas the GHB-NoComa group mostly used GHB with friends and in nightclubs. Remarkably, the majority of participants were not concerned about potential neurocognitive impairments induced by GHB-intoxication and/or GHB-induced comas. Conclusion: In this assessment, different profiles for recreational users with and without GHB-induced comas were well expressed. Their description contributes to a better understanding of the risk factors associated with recreational GHB-use, GHB-induced coma, and the development of GHB-use disorders.
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Affiliation(s)
- Filipa Raposo Pereira
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, The Netherlands
| | - Minni T B McMaster
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, The Netherlands
| | - YvonD A T de Vries
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Wim van den Brink
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, The Netherlands
| | - Guido A van Wingen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Amsterdam Brain and Cognition, University of Amsterdam, The Netherlands
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14
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Bonomo Y, Norman A, Biondo S, Bruno R, Daglish M, Dawe S, Egerton-Warburton D, Karro J, Kim C, Lenton S, Lubman DI, Pastor A, Rundle J, Ryan J, Gordon P, Sharry P, Nutt D, Castle D. The Australian drug harms ranking study. J Psychopharmacol 2019; 33:759-768. [PMID: 31081439 DOI: 10.1177/0269881119841569] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND/AIM The aim of the current study was to review drug harms as they occur in Australia using the Multi-criteria Decision Analysis (MCDA) methodology adopted in earlier studies in other jurisdictions. METHOD A facilitated workshop with 25 experts from across Australia, was held to score 22 drugs on 16 criteria: 9 related to harms that a drug produces in the individual and 7 to harms to others. Participants were guided by facilitators through the methodology and principles of MCDA. In open discussion, each drug was scored on each criterion. The criteria were then weighted using a process of swing weighting. Scoring was captured in MCDA software tool. RESULTS MCDA modelling showed the most harmful substances to users were fentanyls (part score 50), heroin (part score 45) and crystal methamphetamine (part score 42). The most harmful substances to others were alcohol (part score 41), crystal methamphetamine (part score 24) and cigarettes/tobacco (part score 14). Overall, alcohol was the most harmful drug when harm to users and harm to others was combined. A supplementary analysis took into consideration the prevalence of each substance in Australia. Alcohol was again ranked the most harmful substance overall, followed by cigarettes, crystal methamphetamine, cannabis, heroin and pharmaceutical opioids. CONCLUSIONS The results of this study make an important contribution to the emerging international picture of drug harms. They highlight the persistent and pervasive harms caused by alcohol. Policy implications and recommendations are discussed. Policies to reduce harm from alcohol and methamphetamine should be a priority.
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Affiliation(s)
- Yvonne Bonomo
- 1 Department of Addiction Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
| | - Amanda Norman
- 1 Department of Addiction Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
| | - Sam Biondo
- 2 Victorian Alcohol and Drug Association (VAADA), Melbourne, VIC, Australia
| | - Raimondo Bruno
- 3 School of Medicine (Psychology), University of Tasmania, Hobart, TAS, Australia
| | - Mark Daglish
- 4 Alcohol and Drug Service, Metro North Hospital and Health Service, The University of Queensland, St Lucia, Brisbane, QLD, Australia
| | - Sharon Dawe
- 5 School of Applied Psychology, Griffith University, Brisbane, QLD, Australia
| | - Diana Egerton-Warburton
- 6 Department of Medicine, School of Clinical Sciences at Monash Health, Melbourne, VIC, Australia
| | - Jonathan Karro
- 7 Emergency Department, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Charles Kim
- 8 Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, University of Melbourne, Melbourne, VIC, Australia
| | - Simon Lenton
- 9 National Drug Research Institute, Curtin University, Perth, WA, Australia
| | - Dan I Lubman
- 10 Turning Point, Eastern Health and Monash University, Melbourne, VIC, Australia
| | - Adam Pastor
- 1 Department of Addiction Medicine, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
| | - Jill Rundle
- 11 Western Australian Network of Alcohol and Drug Agencies, Perth, WA, Australia
| | - John Ryan
- 12 Penington Institute, Melbourne, VIC, Australia
| | | | - Patrick Sharry
- 14 Australian Graduate School of Management, University of New South Wales, Sydney, NSW, Australia
| | | | - David Castle
- 16 Mental Health, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
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15
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Raposo Pereira F, Zhutovsky P, Mcmaster MT, Polderman N, de Vries YD, van den Brink W, van Wingen GA. Recreational use of GHB is associated with alterations of resting state functional connectivity of the central executive and default mode networks. Hum Brain Mapp 2019; 40:2413-2421. [PMID: 30720906 PMCID: PMC6590661 DOI: 10.1002/hbm.24532] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Revised: 12/11/2018] [Accepted: 01/16/2019] [Indexed: 12/18/2022] Open
Abstract
Gamma-hydroxybutyrate acid (GHB) is a recreational drug with a high addictive potential. Severe side effects such as GHB-induced coma are common and linked to increased emergency room attendances. Task-based functional-imaging studies have revealed an association between the regular use of GHB and multiple GHB-induced comas, and altered neurocognitive function. However the effects of multiple GHB-induced comas and regular GHB-use on intrinsic brain connectivity during rest remain unknown. The study population consisted of 23 GHB-users with ≥4 GHB-induced comas (GHB-Coma), 22 GHB-users who never experienced a GHB-induced coma (GHB-NoComa) and 24 polydrug users who never used GHB (No-GHB). Resting-state scans were collected to assess resting-state functional-connectivity within and between the default mode network (DMN), the bilateral central executive network (CEN) and the salience network (SN). The GHB-NoComa group showed decreased rsFC of the right CEN with a region in the anterior cingulate cortex (pFWE = 0.048) and decreased rsFC between the right CEN and the DMN (pFWE = 0.048) when compared with the No-GHB group. These results suggest that regular GHB-use is associated with decreased rsFC within the right CEN and between the right CEN and the DMN. The presence of multiple GHB-induced comas is not associated with (additional) alterations in rsFC.
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Affiliation(s)
- Filipa Raposo Pereira
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
- Amsterdam Brain and CognitionUniversity of AmsterdamAmsterdamthe Netherlands
| | - Paul Zhutovsky
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
- Amsterdam Brain and CognitionUniversity of AmsterdamAmsterdamthe Netherlands
| | - Minni T.B. Mcmaster
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
- Amsterdam Brain and CognitionUniversity of AmsterdamAmsterdamthe Netherlands
| | - Nikki Polderman
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Yvon D.A.T. de Vries
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
- Amsterdam Brain and CognitionUniversity of AmsterdamAmsterdamthe Netherlands
| | - Guido A. van Wingen
- Department of Psychiatry, Amsterdam NeuroscienceAmsterdam UMC, University of AmsterdamAmsterdamthe Netherlands
- Amsterdam Brain and CognitionUniversity of AmsterdamAmsterdamthe Netherlands
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16
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Raposo Pereira F, McMaster MT, de Vries YD, Polderman N, van den Brink W, van Wingen GA. Influence of Gamma-Hydroxybutyric Acid-Use and Gamma-Hydroxybutyric Acid-Induced Coma on Affect and the Affective Network. Eur Addict Res 2019; 25:173-181. [PMID: 30999293 PMCID: PMC7050670 DOI: 10.1159/000497381] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/30/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Gamma-hydroxybutyric acid (GHB) is a drug of abuse associated with increased emergency room attendances, due to GHB-induced comas. Withdrawal from GHB often increases social anxiety and is linked to alterations in emotion processing. However, little is known about the effects of GHB-use and GHB-induced comas on affect regulation in humans. OBJECTIVES We aimed to assess the effect of GHB-use and GHB-induced comas on the affective network. METHOD We recruited 27 GHB users with ≥4 GHB-induced comas (GHB-Coma), 27 GHB users without a GHB-induced coma (GHB-NoComa), and 27 polydrug users who never used GHB (No-GHB). Participants completed self-report questionnaires assessing negative affect (depression, anxiety and stress) and performed an emotional face matching task during functional magnetic resonance imaging to probe activity of the amygdala and the hippocampus. RESULTS The GHB-Coma group reported higher levels of depression, anxiety, and stress; showed decreased activity of the hippocampus; and increased functional connectivity of the left hippocampus with the left fusiform gyrus and a cluster on the left temporal-parietal-occipital junction, when compared with the 2 other groups. The GHB-NoComa group showed decreased functional connectivity of the left hippocampus with the amygdala in comparison with the No-GHB group. CONCLUSIONS GHB-use but in particular GHB-induced comas, are associated with altered emotion identification and hippocampal functioning. Awareness campaigns are required to raise consciousness about the adverse effects of GHB-induced comas on affect regulation, despite the absence of subjective side effects.
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Affiliation(s)
- Filipa Raposo Pereira
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands,*Filipa Raposo Pereira, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, AMC (PA.3-220), Meibergdreef 9, 1105 AZ Amsterdam (The Netherlands), E-Mail
| | - Minni T.B. McMaster
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Yvon D.A.T. de Vries
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Nikki Polderman
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Wim van den Brink
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
| | - Guido A. van Wingen
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands,Amsterdam Brain and Cognition, University of Amsterdam, Amsterdam, The Netherlands
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17
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Raposo Pereira F, McMaster MTB, Polderman N, de Vries YDAT, van den Brink W, van Wingen GA. Effect of GHB-use and GHB-induced comas on dorsolateral prefrontal cortex functioning in humans. Neuroimage Clin 2018; 20:923-930. [PMID: 30308378 PMCID: PMC6178194 DOI: 10.1016/j.nicl.2018.09.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Revised: 08/15/2018] [Accepted: 09/25/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Gamma-hydroxybutyric acid (GHB) is a recreational drug associated with increasing numbers of GHB-dependent patients and emergency attendances often related to GHB-induced comas. Working memory (WM) deficits have been reported in association with GHB use, and animal studies have shown that GHB induces oxidative stress in vulnerable WM-related brain areas such as the dorsolateral prefrontal cortex (DLPFC). However, the effects of chronic GHB use and multiple GHB-induced comas on WM-related brain function in humans remains unknown. METHODS We recruited 27 GHB users with ≥4 GHB-induced comas (GHB-Coma), 27 GHB users who never experienced GHB-induced coma (GHB-NoComa), and 27 polydrug users who never used GHB (No-GHB). Participants performed an n-back WM task during functional magnetic resonance imaging (fMRI) to probe DLPFC functioning. RESULTS The GHB-Coma group had lower premorbid IQ (p = .006) than the GHB-NoComa group despite comparable age and education level. There were also group differences in the use of other drugs than GHB. Therefore, all group comparisons were adjusted for IQ and drug use other than GHB. Compared with the GHB-NoComa and the No-GHB groups, the GHB-Coma group showed increased activity in the right DLPFC (pSVC = 0.028) and increased functional connectivity of the right DLPFC with a cluster comprising the left anterior cingulate and medial frontal gyrus (pFWE = 0.003). No significant fMRI differences were observed between the GHB-NoComa and No-GHB groups. Due to technical problems, no behavioural data were collected. DISCUSSION These results suggest that multiple GHB-induced comas, but not GHB-use per se, are associated with alterations in WM-related brain function. Public awareness campaigns are required to minimize the potential adverse effects induced by GHB recreational use, and especially GHB-induced comas, even if no immediate side effects are experienced.
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Affiliation(s)
- Filipa Raposo Pereira
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, the Netherlands.
| | - Minni T B McMaster
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, the Netherlands
| | - Nikki Polderman
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Yvon D A T de Vries
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Wim van den Brink
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, the Netherlands
| | - Guido A van Wingen
- Amsterdam UMC, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Amsterdam, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, the Netherlands
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