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Driver C, Jackson TNW, Lagopoulos J, Hermens DF. Molecular mechanisms underlying the N-methyl-d-aspartate receptor antagonists: Highlighting their potential for transdiagnostic therapeutics. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110609. [PMID: 35878675 DOI: 10.1016/j.pnpbp.2022.110609] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Revised: 07/17/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022]
Abstract
The so-called "psychedelic renaissance" has stimulated expanded interest in several classes of drugs that appear to possess transdiagnostic effects in the treatment of mental health disorders, specifically. N-methyl-d-aspartate receptor (NMDAR) antagonists are one such class with diverse therapeutic potential. NMDARs mediate excitatory postsynaptic signalling in the central nervous system (CNS) and are integral to normal neurobiological processes including neuronal development, synaptic transmission, and plasticity, and thus involved in learning and memory. However, NMDAR hyper-function is also implicated in acute CNS trauma, neuropsychiatric and neurodegenerative disorders, as well as chronic pain. The complex structure of NMDARs permits several locations for therapeutic inhibition, making these receptors a potential target for multiple drugs which modulate them in different ways. NMDAR antagonists, which may be competitive, non-competitive, or uncompetitive, either block glutamate from binding the receptor or modulate the response to glutamate binding. Despite longstanding concerns about side effects of NMDAR antagonists, recent research suggests that, when appropriately used, these agents have favourable safety profiles. Furthermore, their fast-acting mechanism of action, resulting in rapid effects compared to other therapeutic agents, makes them a promising class of drugs that may yield effective therapeutics for multiple CNS disorders.
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Affiliation(s)
- Christina Driver
- Mental Health and Neuroscience, Thompson Institute, University of the Sunshine Coast, Queensland, Australia.
| | - Timothy N W Jackson
- Australian Venom Research Unit, Department of Biochemistry and Pharmacology, University of Melbourne, Australia
| | - Jim Lagopoulos
- Thompson Institute, University of the Sunshine Coast, Queensland, Australia
| | - Daniel F Hermens
- Youth Mental Health and Neurobiology, Thompson Institute, University of the Sunshine Coast, Queensland, Australia
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Tang H, Tang W, An X, Lu Z, Jia Z. Tracking the Trend of Ketamine Use in China During 2010–2015: a Retrospective Observational Study. Int J Ment Health Addict 2022. [DOI: 10.1007/s11469-021-00741-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Ketamine has remained the most commonly used illicit drug among adolescents in Taiwan. A dual process model proposes that addictive behaviors develop in adolescents as a result of an imbalance between an appetitive, approach-oriented system (implicit and explicit attitudes) and a regulatory executive system (cool and hot executive functions). We aimed to examine the appetitive and regulatory processes in adolescent ketamine users in comparison to matched healthy adolescents. Method: The participants were 30 adolescent ketamine users and 32 nondrug controls, matched with gender, age, education years, and education systems. Both groups completed the affective priming task (APT), the stop-signal task (SST), an Iowa Gambling Task (IGT), and finally a Drug Use Disorders Identification Test: Extended (DUDIT-E). Results: The controls had higher positive and negative outcome expectancy with respect to using ketamine compared to the adolescent ketamine users. There was no significant between-group performance difference in APT. The adolescent ketamine users may have shown marginally poorer performance compared to the controls in hot executive functions (IGT), but their cold executive functions (SST) remained intact. Conclusion: The current study reported that the adolescent ketamine users may not have imbalanced dual processes (biased appetitive motivation and impaired regulatory executive process). A different therapeutic focus on adolescent ketamine users may be developed accordingly. More advocacies on ketamine's aversive outcomes are needed, particularly on campus in order to reduce substance misuse.
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Affiliation(s)
- Hao-Han Chang
- Department of Clinical Psychology, TsaoTun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Chieh-Liang Huang
- Department of Addiction Treatment, TsaoTun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan
| | - Ming-Chou Ho
- Department of Psychology, Chung Shan Medical University, Taichung, Taiwan.,Clinical Psychological Room, Chung Shan Medical University Hospital Taichung, Taichung, Taiwan
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Mis-anaesthetized society: expectancies and recreational use of ketamine in Taiwan. BMC Public Health 2019; 19:1307. [PMID: 31623586 PMCID: PMC6798441 DOI: 10.1186/s12889-019-7616-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 09/12/2019] [Indexed: 12/31/2022] Open
Abstract
Background The popularity of ketamine for recreational use has been increasing in Asia, including Taiwan. Still, little known about the pattern of ketamine expectancies and whether such patterns are related to ketamine use. This study aimed to examine whether the positive and negative ketamine expectancies are differentially associated with ketamine-using behavior, and whether such relationship may differ by early-onset use of tobacco or alcohol. Methods Participants were recruited using respondent-driven sampling (RDS) among regular tobacco and alcohol users, aged 18 to 50, residing in Taipei from 2007 to 2010. Totally 1115 participants (with an age distribution skewed to the right, median = 26; interquartile range: 22–32) had information on substance use and completed a 12-item ketamine expectancies questionnaire (with 6 positive and 6 negative statements). Using two axes of High and Low expectancies, the four combinations of binary positive and binary negative ketamine expectancies were created. Each participant’s drug-using experience was categorized into illicit drug naïve, exclusive ketamine use, polydrug ketamine use, or other illicit drug use. Using the weights in the network output by RDS Analysis Tool, multivariable logistic regression analysis was then conducted. Results The weighted prevalence was 2.4% for exclusive ketamine use, 9.0% for polydrug ketamine use, and 9.1% for the other illicit drug use. Ketamine users (11.4%) had greater positive expectancies and lower negative expectancies, particularly the combination of High Positive with Low Negative, as compared to the illicit drug-naïve or other illicit drug users. After adjustment for early-onset tobacco (or alcohol) use and sociodemographic characteristics, High Positive, Low Negative, and their combination of High Positive-Low Negative expectancies remained strongly associated with ketamine uses, without evidence of moderation from early-onset use of tobacco or alcohol. Conclusions Positive and negative ketamine expectancies were associated in opposite directions with ketamine use, independent of early-onset use of tobacco or alcohol. Our results indicate ketamine expectancies as possible targets for future intervention and prevention of ketamine use, with a less confrontational feedback on decreasing an individual’s positive expectancies is essential in preventing young people from the initiation of ketamine use.
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Yang SSD, Jang MY, Lee KH, Hsu WT, Chen YC, Chen WS, Chang SJ. Sexual and bladder dysfunction in male ketamine abusers: A large-scale questionnaire study. PLoS One 2018; 13:e0207927. [PMID: 30485367 PMCID: PMC6261603 DOI: 10.1371/journal.pone.0207927] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 11/08/2018] [Indexed: 12/20/2022] Open
Abstract
Purpose To evaluate the prevalence of lower urinary tract symptoms (LUTS) and erectile dysfunction (ED) in the illicit male ketamine abusers (KA). Materials and methods The male street KAs caught by policemen and patients visiting urologic clinics were invited to answer a structured questionnaire including demographic data, illicit drug use related details (duration, frequency, dosage and abstinence status), international prostate symptoms score (IPSS), interstitial cystitis symptoms and problem index (ICSI and ICPI) and International index of erectile function (IIEF-5). Erectile dysfunction was defined as IIEF-5 ≦21. Results Finally, we included 1056 participants (993 street, 63 hospital KAs) with a mean age of 27.4 ±6.2 years. ED presented in 30.8% of all KAs. and Hospital KAs were more subject to having ED than street KAs (69.6% vs. 28.0%, p<0.01). Multi-variate analysis revealed that risk factor for male ED were age ≧30 years (OR = 1.765). Subgroup analysis on male street KAs disclosed that abstinence ≧3 months is a protective factor for ED. Lower urinary tract symptoms (ICSI+ICPI ≧12) was prevalent in KAs and multivariate analysis disclosed that significant risk factors for LUTS (ICSI+ICPI ≧12) were age ≧30 years, duration ≧24 months and co-use of other illicit drugs. Conclusions Male ED and LUTS were frequently observed in the ketamine abusers. We suggested that street ketamine abuse should be considered in young men presented with ED and LUTS in the clinics.
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Affiliation(s)
- Stephen She-Dei Yang
- Department of Urology, Taipei Tzu Chi Hospital, New Taipei, Taiwan
- School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
| | - Mei-Yu Jang
- Department of Urology, Kaohsiung Municipal Hsia-Kang Hospital, Kaohsiung City, Taiwan
| | - Kau-Han Lee
- Division of Urology, Department of Surgery, Chi Mei Medical Center, Tainan City, Taiwan
| | - Wen-Tsang Hsu
- Department of Urology, Keelung Hospital, Ministry of Health and Wealthfare, Keelung City, Taiwan
| | - Yi-Chu Chen
- Department of Urology, Taipei Tzu Chi Hospital, New Taipei, Taiwan
| | - Wan-San Chen
- Department of Urology, Taipei Tzu Chi Hospital, New Taipei, Taiwan
| | - Shang-Jen Chang
- Department of Urology, Taipei Tzu Chi Hospital, New Taipei, Taiwan
- School of Medicine, Buddhist Tzu Chi University, Hualien, Taiwan
- * E-mail:
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Zuo D, Liu Y, Liu Z, Cui J, Zhou X, Liu Y, Li Z, Wu Y. Alcohol aggravates ketamine-induced behavioral, morphological and neurochemical alterations in adolescent rats: The involvement of CREB-related pathways. Behav Brain Res 2018; 349:80-90. [PMID: 29738804 DOI: 10.1016/j.bbr.2018.05.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 04/17/2018] [Accepted: 05/03/2018] [Indexed: 01/03/2023]
Abstract
Currently, an increasing proportion of adolescent ketamine users simultaneously consume alcohol. However, the potential behavioural and neurological alterations induced by such a drug combination and the underlying mechanisms have not been systematically examined. Therefore, in the present study, the behavioural and morphological changes and the underlying mechanisms were studied in adolescent rats after repeated alcohol and/or ketamine treatment. This study provided the first evidence that co-administration of alcohol (2 and 4 g/kg, i.g.) in adolescent rats significantly potentiated the neurotoxic properties of repeated ketamine (30 mg/kg, i.p.) treatments over 14 days, manifesting as increased locomotor activity, stereotypic behaviour, ataxia and morphological changes. This potentiation was associated with the enhancement by alcohol of ketamine-induced glutamate (Glu) and dopamine (DA) release in the cortex and hippocampus. Further mechanistic study demonstrated that alcohol potentiated ketamine-induced neurotoxicity through down-regulation of Akt (a serine/threonine kinase or protein kinase, PKB), protein kinase A (PKA), calmodulin-dependent kinase IV (CaMK-IV)-mediated cyclic AMP-responsive element binding protein (CREB) pathways and induction of neuronal apoptosis in the cortex and hippocampus of the adolescent rats. As this study provides strong evidence that repeated alcohol and ketamine co-exposure may cause serious neurotoxicity, attention needs to be drawn to the potential risk of this consumption behaviour, especially for adolescents.
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Affiliation(s)
- Daiying Zuo
- Department of pharmacology, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, PR China.
| | - Yumiao Liu
- Department of pharmacology, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, PR China
| | - Zi Liu
- Department of pharmacology, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, PR China
| | - Jiahui Cui
- Department of pharmacology, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, PR China
| | - Xuejiao Zhou
- Department of pharmacology, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, PR China
| | - Yang Liu
- Department of pharmacology, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, PR China
| | - Zengqiang Li
- Department of pharmacology, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, PR China
| | - Yingliang Wu
- Department of pharmacology, Shenyang Pharmaceutical University, 103 Wenhua Road, Shenyang, Liaoning, 110016, PR China.
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CHEN IC, LEE MH, CHEN WC, HU TC, LIN HY. Risk Factors of Lower Urinary Tract Syndrome among Ketamine Users. Low Urin Tract Symptoms 2017; 10:281-286. [DOI: 10.1111/luts.12178] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Revised: 01/19/2017] [Accepted: 03/07/2017] [Indexed: 12/01/2022]
Affiliation(s)
- I-Chun CHEN
- Department of Psychiatry; Taichung General Veterans Hospital; Taichung Taiwan
| | - Ming-Huei LEE
- Department of Urology; Feng-Yuan Hospital, Ministry of Health and Welfare; Taichung Taiwan
- Central Taiwan University of Science and Technology; Taichung Taiwan
| | - Wei-Chih CHEN
- Central Taiwan University of Science and Technology; Taichung Taiwan
| | - Tsung-Ching HU
- Department of Rheumatology; Feng-Yuan Hospital, Ministry of Health and Welfare; Taichung Taiwan
| | - Hsiu-Ying LIN
- Department of Obstetrics and Gynecology; Feng-Yuan Hospital, Ministry of Health and Welfare; Taichung Taiwan
- Department of Anaesthesiology; Feng-Yuan Hospital, Ministry of Health and Welfare; Taichung Taiwan
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Sobel RM, Steck AR. Low dose ketamine in the age of opioids. Am J Emerg Med 2017; 35:917-918. [DOI: 10.1016/j.ajem.2017.03.062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 03/23/2017] [Indexed: 12/19/2022] Open
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Fernández-Calderón F, Vidal-Giné C, López-Guerrero J, Lozano-Rojas ÓM. Reliability, convergent and structural validity and cut-off score of the Severity of Dependence Scale for recreational ketamine users. Addict Behav 2016; 60:1-7. [PMID: 27082261 DOI: 10.1016/j.addbeh.2016.03.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 01/27/2016] [Accepted: 03/29/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND AIMS There is a lack of instruments for measuring ketamine substance use disorders. The aims were (i) to estimate the reliability and provide evidence of validity of the Severity of Dependence Scale (SDS) in a sample of recreational users, and (ii) propose a cut-off point to determine the presence of dependence. METHODS We conducted a web-based cross-sectional survey with recreational users who accessed webs related to recreational drug use and harm reduction. 264 recreational ketamine users who had taken it in the past month participated in the study. The Spanish version of the SDS was used. Information on ketamine use-related problems and ketamine use patterns was also collected. RESULTS The reliability estimation calculated by the Cronbach's alpha coefficient was 0.776. SDS showed evidence of convergent validity based on relationships with other variables. Two comparisons were made in this study to analyze the Receiver Operating Characteristic Curve. For frequency of use in the last month the area under curve (AUC) was 0.835 (CI=0.775-0.895) with optimal discrimination at an SDS score of 3. For having been in treatment for decreasing or quitting ketamine use the AUC was 0.902 (CI=0.840-0.963) and the cut-off point was 4. Confirmatory factor analysis showed a one-dimensional structure when Items 3 and 4 were correlated. CONCLUSIONS This study has provided evidence of reliability and validity of the ketamine version of the SDS for recreational users. Considering that ketamine use is linked to young people and its strong potential for causing serious impairment, a cut-off of 3 is proposed as indicative of dependence.
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Vidal Giné C, Fernández Calderón F, López Guerrero J. Patterns of use, harm reduction strategies, and their relation to risk behavior and harm in recreational ketamine users. THE AMERICAN JOURNAL OF DRUG AND ALCOHOL ABUSE 2016; 42:358-69. [DOI: 10.3109/00952990.2016.1141211] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Abstract
This session, "Emerging Drug Problems in Asia," focused on emerging drug problems in Asia. Dr. Juana Tomás-Rosselló discussed "East and Southeast Asia: Emerging Drug Problems and Response" and Dr. Wei J. Chen discussed "Ketamine Use among Regular Tobacco and Alcohol Users as Revealed by Respondent Driven Sampling in Taipei: Prevalence, Expectancy, and Users' Risky Decision Making."
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Affiliation(s)
- Gavin Bart
- Division of Addiction Medicine, Hennepin County Medical Center, Minneapolis, MN, USA
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