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Yeh SHH, Kuo YY, Huang WS, Chiu CH, Yu TH, II LGF, Tsai CJ, Cheng CY, Ma KH. Preliminary Results on the Long-Term Effects of Dextromethorphan on MDMA-Mediated Serotonergic Deficiency and Volumetric Changes in Primates Based on 4-[18F]-ADAM PET/MRI. Front Neurosci 2022; 16:837194. [PMID: 35692422 PMCID: PMC9175743 DOI: 10.3389/fnins.2022.837194] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Alterations to the serotonergic system due to 3,4-methylenedioxymethamphetamine (MDMA) (ecstasy) consumption have been extensively documented. However, knowledge of the reversibility of these neurotoxic effects based on in vivo evaluations of serotonin transport (SERT) availability remains limited. This study aimed to evaluate the long-term neurotoxicity of MDMA after 66 months abstinence and explored whether Dextromethorphan, a non-competitive N-methyl-D-aspartate (NMDA) receptor, could attenuate MDMA-induced neurotoxicity using 4-[18F]-ADAM, an imaging ligand that selectively targets SERT, with positron emission tomography technology (PET). Nine monkeys (Macaca cyclopis) were used in this study: control, MDMA, and DM + MDMA. Static 4-[18F]-ADAM PET was performed at 60 and 66 months after drug treatment. Serotonin transport (SERT) availability was presented as the specific uptake ratios (SURs) of 4-[18F]-ADAM in brain regions. Voxel-based region-specific SERT availability was calculated to generate 3D PET/MR images. Structural Magnetic Resonance Imaging (MRI) volumetric analysis was also conducted at 60 months. Significantly decreased 4-[18F]-ADAM SURs were observed in the striatum and thalamus of the MDMA group at 60 and 66 months compared to controls; the midbrain and frontal cortex SURs were similar at 60 and 66 months in the MDMA and control groups. All eleven brain regions showed significantly lower (∼13%) self-recovery rates over time; the occipital cortex and cingulate recovered to baseline by 66 months. DM attenuated MDMA-induced SERT deficiency on average, by ∼8 and ∼1% at 60 and 66 months, respectively; whereas significant differences were observed between the thalamus and amygdala of the MDMA and DM + MDMA groups at 66 months. Compared to controls, the MDMA group exhibited significantly increased (∼6.6%) gray matter volumes in the frontal cortex, occipital cortex, caudate nucleus, hippocampus, midbrain, and amygdala. Moreover, the gray matter volumes of the occipital cortex, hippocampus and amygdala correlated negatively with the 4-[18F]-ADAM SURs of the same regions. DM (n = 2) did not appear to affect MDMA-induced volumetric changes. The 4-[18F]-ADAM SURs, lower self-recovery rate and increased volumetric values indicate the occipital cortex, hippocampus and amygdala still exhibit MDMA-induced neurotoxicity after 66 months’ abstinence. Moreover, DM may prevent MDMA-induced serotonergic deficiency, as indicated by increased 4-[18F]-ADAM SURs and SERT availability, but not volumetric changes.
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Affiliation(s)
- Skye Hsin-Hsien Yeh
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
- School of Medicine, National Defense Medical Center, Taipei, Taiwan
| | - Yu-Yeh Kuo
- Department of Nursing, Hsin-Sheng College of Medical Care and Management, Taoyuan, Taiwan
| | - Wen-Sheng Huang
- Department of Nuclear Medicine, Cheng-Hsin General Hospital, Taipei, Taiwan
- Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chuang-Hsin Chiu
- Department of Nuclear Medicine, Tri-Service General Hospital, Taipei, Taiwan
| | - Tsung-Hsun Yu
- Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | - Chi-Jung Tsai
- Department of Nuclear Medicine, Taipei Medical University Hospital, Taipei, Taiwan
- *Correspondence: Kuo-Hsing Ma,
| | - Cheng-Yi Cheng
- Department of Nuclear Medicine, Tri-Service General Hospital, Taipei, Taiwan
- *Correspondence: Kuo-Hsing Ma,
| | - Kuo-Hsing Ma
- Department of Biology and Anatomy, National Defense Medical Center, Taipei, Taiwan
- *Correspondence: Kuo-Hsing Ma,
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Schifano F, Chiappini S, Miuli A, Mosca A, Santovito MC, Corkery JM, Guirguis A, Pettorruso M, Di Giannantonio M, Martinotti G. Focus on Over-the-Counter Drugs' Misuse: A Systematic Review on Antihistamines, Cough Medicines, and Decongestants. Front Psychiatry 2021; 12:657397. [PMID: 34025478 PMCID: PMC8138162 DOI: 10.3389/fpsyt.2021.657397] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 03/15/2021] [Indexed: 12/18/2022] Open
Abstract
Background: Over the past 20 years or so, the drug misuse scenario has seen the emergence of both prescription-only and over-the-counter (OTC) medications being reported as ingested for recreational purposes. OTC drugs such as antihistamines, cough/cold medications, and decongestants are reportedly the most popular in being diverted and misused. Objective: While the current related knowledge is limited, the aim here was to examine the published clinical data on OTC misuse, focusing on antihistamines (e.g., diphenhydramine, promethazine, chlorpheniramine, and dimenhydrinate), dextromethorphan (DXM)- and codeine-based cough medicines, and the nasal decongestant pseudoephedrine. Methods: A systematic literature review was carried out with the help of Scopus, Web of Science databases, and the related gray literature. For data gathering purposes, both the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and PROSPERO guidelines were followed (PROSPERO identification code CRD42020209261). Results: After completion of the selection, eligibility, and screening phases, some 92 articles were here taken into consideration; case reports, surveys, and retrospective case series analyses were included. Findings were organized according to the specific OTC recorded. Most articles focused here on DXM (n = 54) and diphenhydramine (n = 12). When specified, dosages, route(s) of administration, toxicity symptoms (including both physical and psychiatric ones), and outcomes were here reported. Conclusion: Results from the systematic review showed that the OTC misusing issues are both widespread worldwide and popular; vulnerable categories include adolescents and young adults, although real prevalence figures remain unknown, due to a lack of appropriate monitoring systems. Considering the potential, and at times serious, adverse effects associated with OTC misusing issues, healthcare professionals should be vigilant, and ad hoc preventative actions should be designed and implemented.
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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, United Kingdom
| | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom.,Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Andrea Miuli
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Maria Chiara Santovito
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - John M Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Amira Guirguis
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Swansea, United Kingdom
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Massimo Di Giannantonio
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging and Clinical Sciences, "G. D'Annunzio" University, Chieti, Italy
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Karami S, Major JM, Calderon S, McAninch JK. Trends in dextromethorphan cough and cold products: 2000–2015 National Poison Data System intentional abuse exposure calls. Clin Toxicol (Phila) 2017; 56:656-663. [DOI: 10.1080/15563650.2017.1416124] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sara Karami
- Office of Surveillance and Epidemiology, Center for Drug and Evaluation, Food and Drug Administration Silver Spring, Silver Spring, MD, USA
| | - Jacqueline M. Major
- Office of Surveillance and Epidemiology, Center for Drug and Evaluation, Food and Drug Administration Silver Spring, Silver Spring, MD, USA
| | - Silvia Calderon
- Center for Drug Evaluation and Research (CDER), Food and Drug Administration (FDA), Silver Spring, MD, USA
| | - Jana K. McAninch
- Office of Surveillance and Epidemiology, Center for Drug and Evaluation, Food and Drug Administration Silver Spring, Silver Spring, MD, USA
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Bao S, Zhang J, Lin Z, Su K, Mo J, Hong L, Qian S, Chen L, Sun F, Wen C, Wu Q, Hu L, Lin G, Wang X. Serum metabolic changes in rats after intragastric administration of dextromethorphan. Biomed Chromatogr 2016; 31. [PMID: 27528536 DOI: 10.1002/bmc.3814] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2015] [Revised: 08/01/2016] [Accepted: 08/11/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Shihui Bao
- The Second Affiliated Hospital & Yuying Children's Hospital; Wenzhou Medical University; Wenzhou China
| | - Jing Zhang
- Anlytical and Testing Center of Wenzhou Medical University; Wenzhou China
| | - Zixia Lin
- Anlytical and Testing Center of Wenzhou Medical University; Wenzhou China
| | - Ke Su
- Anlytical and Testing Center of Wenzhou Medical University; Wenzhou China
| | - Jingjing Mo
- Anlytical and Testing Center of Wenzhou Medical University; Wenzhou China
| | - Lin Hong
- Anlytical and Testing Center of Wenzhou Medical University; Wenzhou China
| | - Shuyi Qian
- Anlytical and Testing Center of Wenzhou Medical University; Wenzhou China
| | - Lianguo Chen
- Department of Pharmacy; Wenzhou People's Hospital; Wenzhou China
| | - Fa Sun
- Anlytical and Testing Center of Wenzhou Medical University; Wenzhou China
| | - Congcong Wen
- Anlytical and Testing Center of Wenzhou Medical University; Wenzhou China
| | - Qing Wu
- The First Affiliated Hospital of Wenzhou Medical University; Wenzhou China
| | - Lufeng Hu
- The First Affiliated Hospital of Wenzhou Medical University; Wenzhou China
| | - Guanyang Lin
- The First Affiliated Hospital of Wenzhou Medical University; Wenzhou China
| | - Xianqin Wang
- Anlytical and Testing Center of Wenzhou Medical University; Wenzhou China
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