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Johnson-Ferguson L, Shanahan L, Bechtiger L, Steinhoff A, Zimmermann J, Baumgartner MR, Binz TM, Eisner M, Ribeaud D, Quednow BB. Associations of psychoactive substances and steroid hormones in hair: Findings relevant to stress research from a large cohort of young adults. Psychoneuroendocrinology 2023; 157:106369. [PMID: 37639800 DOI: 10.1016/j.psyneuen.2023.106369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/03/2023] [Accepted: 08/13/2023] [Indexed: 08/31/2023]
Abstract
OBJECTIVE Epidemiological studies increasingly use hair samples to assess people's cumulative exposure to steroid hormones, but how the use of different psychoactive substances may affect steroid hormone levels in hair is, so far, largely unknown. The current study addresses this gap by establishing the substance exposure correlates of cortisol, cortisone, and testosterone in hair, while also accounting for a number of relevant covariates. METHOD Data came from a large urban community-sample of young adults with a high prevalence of substance use (N = 1002, mean age=20.6 years, 50.2% female), who provided 3 cm of hair samples. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) quantified cortisol, cortisone, and testosterone, as well as delta-9-tetrahydrocannabinol (THC), 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy"), cocaine, several opioids, and their respective metabolites. Multiple linear regression models with covariates were used to predict steroid hormone levels from substance exposure in a four-step approach: In the full sample, low and high substance hair concentrations (median split) were first tested against no use for each substance individually (step 1) and for all substances together (step 2). Then, within the participants with any substance in hair only, the continuous hair concentration of each substance in pg/mg (step 3) and finally of all substances together, were regressed (step 4). RESULTS Low, high, and continuous levels of THC in hair were robustly associated with higher levels of cortisol (sig. in step 1 low THC: β = 0.29, p = .021; high THC: β = 0.42, p = .001; step 2: low THC: β = 0.27, p = 0.036, and high THC: β = 0.40, p = .004, and step 4: β = 0.12, p = .041). Participants with high MDMA levels had higher levels of cortisone without adjusting for other substances (step 1: β = 0.34, p = .026), but this effect was not significant in the other models. While high THC levels were associated with lower levels of testosterone in step 2 (β = -0.35, p = .018), MDMA concentration was positively related to testosterone concentration with and without adjusting for other substances (step 3: β = 0.24, p = .041; step 4: β = 0.17, 95%, p = .015) in male participants. CONCLUSION The use of psychoactive substances, especially of cannabis and ecstasy, should be considered in studies investigating steroid hormones in hair.
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Affiliation(s)
- Lydia Johnson-Ferguson
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland.
| | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| | - Annekatrin Steinhoff
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland
| | - Josua Zimmermann
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
| | - Markus R Baumgartner
- Zurich Institute of Legal Medicine, University of Zurich, Switzerland; Center for Forensic Hair Analytics, University of Zurich, Switzerland
| | - Tina M Binz
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstrasse 111, 3000 Bern, Switzerland
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Institute of Criminology, University of Cambridge, United Kingdom
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
| | - Boris B Quednow
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy, and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, ETH Zurich and University of Zurich, Zurich, Switzerland
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2
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Bouso JC, Révész D, Ona G, Rossi GN, Rocha JM, Dos Santos RG, Hallak JEC, Alcázar-Corcoles MÁ. Longitudinal and transcultural assessment of the relationship between hallucinogens, well-being, and post-traumatic growth during the COVID-19 pandemic. Sci Rep 2023; 13:14052. [PMID: 37696900 PMCID: PMC10495368 DOI: 10.1038/s41598-023-41199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023] Open
Abstract
The COVID-19 pandemic has had a devastating impact on the health and wellbeing of the global population. This paper presents the results of a longitudinal transcultural study that was begun at the peak of the pandemic (in April, 2020). An online survey was used to collect data from English-, Spanish-, and Portuguese-speaking participants. The survey collected information about sociodemographics, lifestyle activities, COVID-19-related circumstances, and drug use (with an emphasis on hallucinogenic drugs), as well as involving psychometric questionnaires. Users of hallucinogenic drugs had higher psychological well-being and lower scores on psychopathology scales, both at baseline and during follow-ups. This difference was larger when users were distinguished by frequency of use, as regular users scored higher on psychological well-being and lower on psychopathology scales. Subjects with more psychological distress had lower scores for all scales of post-traumatic growth, but if they were regular hallucinogens users, they had higher scores for post-traumatic growth. When comparing the results between cultural contexts, heterogeneous results were obtained. There were more English-speaking regular users of hallucinogenic drugs. Further research should analyse the potential role of hallucinogens in large-scale catastrophes, with a special focus on post-traumatic growth.
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Affiliation(s)
- José Carlos Bouso
- ICEERS-International Center for Ethnobotanical Education, Research, and Service, C/ Sepúlveda, 65 Bajos 2, 08015, Barcelona, Catalunya, Spain.
- Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, Catalunya, Spain.
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
| | - Dóra Révész
- ICEERS-International Center for Ethnobotanical Education, Research, and Service, C/ Sepúlveda, 65 Bajos 2, 08015, Barcelona, Catalunya, Spain
| | - Genís Ona
- ICEERS-International Center for Ethnobotanical Education, Research, and Service, C/ Sepúlveda, 65 Bajos 2, 08015, Barcelona, Catalunya, Spain
- Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, Catalunya, Spain
| | - Giordano N Rossi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Juliana M Rocha
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Rafael G Dos Santos
- ICEERS-International Center for Ethnobotanical Education, Research, and Service, C/ Sepúlveda, 65 Bajos 2, 08015, Barcelona, Catalunya, Spain
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology-Translational Medicine, São Paulo, Brazil
| | - Jaime E C Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology-Translational Medicine, São Paulo, Brazil
| | - Miguel Ángel Alcázar-Corcoles
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid (UAM), Madrid, Spain
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3
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Baslam A, Aitbaba A, Lamrani Hanchi A, Tazart Z, Aboufatima R, Soraa N, Ait-El-Mokhtar M, Boussaa S, Baslam M, Chait A. Modulation of Gut Microbiome in Ecstasy/MDMA-Induced Behavioral and Biochemical Impairment in Rats and Potential of Post-Treatment with Anacyclus pyrethrum L. Aqueous Extract to Mitigate Adverse Effects. Int J Mol Sci 2023; 24:ijms24109086. [PMID: 37240429 DOI: 10.3390/ijms24109086] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 05/16/2023] [Accepted: 05/20/2023] [Indexed: 05/28/2023] Open
Abstract
The use of illicit substances continues to pose a substantial threat to global health, affecting millions of individuals annually. Evidence suggests the existence of a 'brain-gut axis' as the involving connection between the central nervous system and gut microbiome (GM). Dysbiosis of the GM has been associated with the pathogenesis of various chronic diseases, including metabolic, malignant, and inflammatory conditions. However, little is currently known about the involvement of this axis in modulating the GM in response to psychoactive substances. In this study, we investigated the effect of MDMA (3,4-methylenedioxymethamphetamine, "Ecstasy")-dependence on the behavioral and biochemical responses, and the diversity and abundance of the gut microbiome in rats post-treated (or not) with aqueous extract of Anacyclus pyrethrum (AEAP), which has been reported to exhibit anticonvulsant activity. The dependency was validated using the conditioned place preference (CPP) paradigm, behavioral, and biochemical tests, while the gut microbiota was identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The CPP and behavioral tests confirmed the presence of MDMA withdrawal syndrome. Interestingly, treatment with AEAP led to a compositional shift in the GM compared to the MDMA-treated rats. Specifically, the AEAP group yielded a higher relative abundance of Lactobacillus and Bifidobacter, while animals receiving MDMA had higher levels of E. coli. These findings suggest that A. pyrethrum therapy may directly modulate the gut microbiome, highlighting a potential target for regulating and treating substance use disorders.
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Affiliation(s)
- Abdelmounaim Baslam
- Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh 40000, Morocco
| | - Abdelfatah Aitbaba
- Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh 40000, Morocco
| | - Asmae Lamrani Hanchi
- Laboratory of Microbiology, University Hospital Mohamed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh 40000, Morocco
| | - Zakaria Tazart
- Department of Food Sciences and Nutrition, Faculty of Health Sciences, University of Malta, Msida 2080, Malta
| | - Rachida Aboufatima
- Laboratory of Biological Engineering, Faculty of Sciences and Technology, Sultan Moulay Slimane University, Beni Mellal 23000, Morocco
| | - Nabila Soraa
- Laboratory of Microbiology, University Hospital Mohamed VI, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakesh 40000, Morocco
| | - Mohamed Ait-El-Mokhtar
- Laboratory of Biochemistry, Environment & Agri-Food URAC 36, Department of Biology, Faculty of Science and Techniques-Mohammedia, Hassan II University of Casablanca, Mohammedia 20000, Morocco
| | - Samia Boussaa
- ISPITS-Higher Institute of Nursing and Health Techniques, Ministry of Health and Social Protection, Rabat 10000, Morocco
| | - Marouane Baslam
- Laboratory of Biochemistry, Department of Applied Biological Chemistry, Faculty of Agriculture, University of Niigata, Niigata 950-2181, Japan
- Centre d'Agrobiotechnologie et Bioingénierie, Unité de Recherche Labellisée CNRST (Centre AgroBiotech-URL-CNRST-05), Université Cadi Ayyad, Marrakesh 40000, Morocco
- Laboratory of Agro-Food, Biotechnologies and Valorization of Plant Bioresources (AGROBIOVAL), Department of Biology, Faculty of Science Semlalia, Cadi Ayyad University (UCA), Marrakesh 40000, Morocco
| | - Abderrahman Chait
- Laboratory of Pharmacology, Neurobiology, Anthropobiology and Environment, Faculty of Sciences Semlalia, Cadi Ayyad University, Marrakesh 40000, Morocco
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4
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Opitz A, Petasch MS, Klappauf R, Kirschgens J, Hinz J, Dittmann L, Dathe AS, Quednow BB, Beste C, Stock AK. Does chronic use of amphetamine-type stimulants impair interference control? - A meta-analysis. Neurosci Biobehav Rev 2023; 146:105020. [PMID: 36581170 DOI: 10.1016/j.neubiorev.2022.105020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 12/01/2022] [Accepted: 12/23/2022] [Indexed: 12/27/2022]
Abstract
In substance use and addiction, inhibitory control is key to ignoring triggers, withstanding craving and maintaining abstinence. In amphetamine-type stimulant (ATS) users, most research focused on behavioral inhibition, but largely neglected the equally important subdomain of cognitive interference control. Given its crucial role in managing consumption, we investigated the relationship between interference control and chronic ATS use in adults. A database search (Pubmed & Web of Science) and relevant reviews were used to identify eligible studies. Effect sizes were estimated with random effects models. Subgroup, meta-regression, and sensitivity analyses explored heterogeneity in effect sizes. We identified 61 studies (53 datasets) assessing interference control in 1873 ATS users and 1905 controls. Findings revealed robust small effect sizes for ATS-related deficits in interference control, which were mainly seen in methamphetamine, as compared to MDMA users. The differential effects are likely due to tolerance-induced dopaminergic deficiencies (presumably most pronounced in methamphetamine users). Similarities between different ATS could be due to noradrenergic deficiencies; but elucidating their functional role in ATS users requires further/more research.
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Affiliation(s)
- Antje Opitz
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Miriam-Sophie Petasch
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Regine Klappauf
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Josephine Kirschgens
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Julian Hinz
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Lena Dittmann
- Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland
| | - Anthea S Dathe
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Boris B Quednow
- Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Switzerland; Biopsychology, Department of Psychology, School of Science, TU Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany; Experimental and Clinical Pharmacopsychology, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, Switzerland.
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5
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Scholl JL, Solanki RR, Watt MJ, Renner KJ, Forster GL. Chronic administration of glucocorticoid receptor ligands increases anxiety-like behavior and selectively increase serotonin transporters in the ventral hippocampus. Brain Res 2023; 1800:148189. [PMID: 36462646 PMCID: PMC9837808 DOI: 10.1016/j.brainres.2022.148189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 11/11/2022] [Accepted: 11/26/2022] [Indexed: 12/05/2022]
Abstract
Organic cation transporter-3 (OCT3) is widely distributed in the brain with high expression in portions of the stress axis. These high capacity, polyspecific transporters function in monoamine clearance and are sensitive to the stress hormone corticosterone. In rats, withdrawal from chronic amphetamine increases OCT3 expression in specific limbic brain regions involved anxiety and stress responses, including the ventral hippocampus, central nucleus of amygdala (CeA) and dorsomedial hypothalamus. (DMH). Previous studies show that glucocorticoid receptor (GR) agonists increase OCT1 mRNA and OCT2 mRNA expression in non-neural tissues. Thus, we hypothesized that corticosterone increases OCT3 expression in the brain by activating GRs. Male Sprague-Dawley rats were pre-treated daily with the GR antagonist mifepristone (20 mg/kg; sc.) or vehicle followed 45 min later by injections of corticosterone or vehicle for 2 weeks. Corticosterone treatment significantly increased OCT3 expression in the ventral hippocampus and increased anxiety-like behavior. However, these effects were not blocked by mifepristone. Interestingly, treatment with mifepristone alone reduced plasma corticosterone levels and increased serotonin transporter and GR expression in the ventral hippocampus but did not significantly affect OCT3 expression or behavior. No treatment effects on OCT3, serotonin transporter or GR expression were observed in the DMH, CeA or dorsal hippocampus. Our findings suggest that corticosterone increases OCT3 expression in the ventral hippocampus by a mechanism independent of GRs, and that mifepristone and corticosterone can act in an independent manner to affect HPA axis-related physiological and behavioral parameters.
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Affiliation(s)
- Jamie L Scholl
- Center for Brain and Behavior Research, Division of Basic Biomedical Sciences, Sanford School of Medicine at the University of South Dakota, USA.
| | - Rajeshwari R Solanki
- Center for Brain and Behavior Research, Division of Basic Biomedical Sciences, Sanford School of Medicine at the University of South Dakota, USA.
| | - Michael J Watt
- Center for Brain and Behavior Research, Division of Basic Biomedical Sciences, Sanford School of Medicine at the University of South Dakota, USA; Center for Brain and Behavior Research, Department of Anatomy, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
| | - Kenneth J Renner
- Center for Brain and Behavior Research, Department of Biology, University of South Dakota, 414 East Clark St, Vermillion, SD, USA.
| | - Gina L Forster
- Center for Brain and Behavior Research, Division of Basic Biomedical Sciences, Sanford School of Medicine at the University of South Dakota, USA; Center for Brain and Behavior Research, Department of Anatomy, University of Otago, PO Box 56, Dunedin 9054, New Zealand.
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6
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Glavonic E, Mitic M, Adzic M. Hallucinogenic drugs and their potential for treating fear-related disorders: Through the lens of fear extinction. J Neurosci Res 2022; 100:947-969. [PMID: 35165930 DOI: 10.1002/jnr.25017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/17/2021] [Accepted: 01/05/2022] [Indexed: 12/29/2022]
Abstract
Fear-related disorders, mainly phobias and post-traumatic stress disorder, are highly prevalent, debilitating disorders that pose a significant public health problem. They are characterized by aberrant processing of aversive experiences and dysregulated fear extinction, leading to excessive expression of fear and diminished quality of life. The gold standard for treating fear-related disorders is extinction-based exposure therapy (ET), shown to be ineffective for up to 35% of subjects. Moreover, ET combined with traditional pharmacological treatments for fear-related disorders, such as selective serotonin reuptake inhibitors, offers no further advantage to patients. This prompted the search for ways to improve ET outcomes, with current research focused on pharmacological agents that can augment ET by strengthening fear extinction learning. Hallucinogenic drugs promote reprocessing of fear-imbued memories and induce positive mood and openness, relieving anxiety and enabling the necessary emotional engagement during psychotherapeutic interventions. Mechanistically, hallucinogens induce dynamic structural and functional neuroplastic changes across the fear extinction circuitry and temper amygdala's hyperreactivity to threat-related stimuli, effectively mitigating one of the hallmarks of fear-related disorders. This paper provides the first comprehensive review of hallucinogens' potential to alleviate symptoms of fear-related disorders by focusing on their effects on fear extinction and the underlying molecular mechanisms. We overview both preclinical and clinical studies and emphasize the advantages of hallucinogenic drugs over current first-line treatments. We highlight 3,4-methylenedioxymethamphetamine and ketamine as the most effective therapeutics for fear-related disorders and discuss the potential molecular mechanisms responsible for their potency with implications for improving hallucinogen-assisted psychotherapy.
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Affiliation(s)
- Emilija Glavonic
- Department of Molecular Biology and Endocrinology, "VINČA" Institute of Nuclear Sciences-National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Milos Mitic
- Department of Molecular Biology and Endocrinology, "VINČA" Institute of Nuclear Sciences-National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
| | - Miroslav Adzic
- Department of Molecular Biology and Endocrinology, "VINČA" Institute of Nuclear Sciences-National Institute of thе Republic of Serbia, University of Belgrade, Belgrade, Serbia
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7
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Mustafa NS, Bakar NHA, Mohamad N, Adnan LHM, Fauzi NFAM, Thoarlim A, Omar SHS, Hamzah MS, Yusoff Z, Jufri M, Ahmad R. MDMA and the Brain: A Short Review on the Role of Neurotransmitters in Neurotoxicity. Basic Clin Neurosci 2021; 11:381-388. [PMID: 33613876 PMCID: PMC7878040 DOI: 10.32598/bcn.9.10.485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 08/10/2018] [Accepted: 02/19/2019] [Indexed: 11/24/2022] Open
Abstract
N-Methyl-3, 4-methylenedioxyamphetamine (MDMA), or ecstasy is a recreational drug of abuse. It is a synthetic substance that affects the body’s systems, which its mechanism of action and treatment should be more investigated. MDMA provides an immediate enjoyable feeling by stimulating the release of neurotransmitters, such as dopamine and serotonin in the brain. Unfortunately, abnormal regulation of the brain neurotransmitters, as well as the increased oxidative stress causes damage to the brain neurons after the MDMA exposure. Only a few studies have been done regarding its treatment. Thus, the treatment of MDMA complications should be further explored mainly by targeting its mechanism of action in the neurotransmitter systems. Hence, this study presents a short review regarding the recent findings on the role of neurotransmitters to cause MDMA neurotoxicity. The results will be useful for future research in elucidating the potential treatment based on the targeted mechanisms to treat the neurotoxic effects of MDMA.
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Affiliation(s)
- Nor Suliana Mustafa
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Nor Hidayah Abu Bakar
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Nasir Mohamad
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Liyana Hazwani Mohd Adnan
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Nurul Farah Aina Md Fauzi
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Abdulsoma Thoarlim
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Islamic Contemporary Studies, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Syed Hadzrullathfi Syed Omar
- Centre for Research in Addiction (CentRenA), University of Sultan Zainal Abidin, Terengganu, Malaysia.,Research Institute for Islamic Products, Malay Civilization University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Mohd Shafiee Hamzah
- Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Islamic Contemporary Studies, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Zawawi Yusoff
- Faculty of Medicine, City Campus, University of Sultan Zainal Abidin, Terengganu, Malaysia.,Faculty of Islamic Contemporary Studies, University of Sultan Zainal Abidin, Terengganu, Malaysia
| | - Mahdi Jufri
- Faculty of Pharmacy, University of Indonesia, Indonesia
| | - Rashidi Ahmad
- Academic Unit of Emergency Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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8
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Bates MLS, Trujillo KA. Use and abuse of dissociative and psychedelic drugs in adolescence. Pharmacol Biochem Behav 2021; 203:173129. [PMID: 33515586 DOI: 10.1016/j.pbb.2021.173129] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 12/26/2022]
Abstract
Adolescence is a period of profound developmental changes, which run the gamut from behavioral and neural to physiological and hormonal. It is also a time at which there is an increased propensity to engage in risk-taking and impulsive behaviors like drug use. This review examines the human and preclinical literature on adolescent drug use and its consequences, with a focus on dissociatives (PCP, ketamine, DXM), classic psychedelics (LSD, psilocybin), and MDMA. It is the case for all the substances reviewed here that very little is known about their effects in adolescent populations. An emerging aspect of the literature is that dissociatives and MDMA produce mixed reinforcing and aversive effects and that the balance between reinforcement and aversion may differ between adolescents and adults, with consequences for drug use and addiction. However, many studies have failed to directly compare adults and adolescents, which precludes definitive conclusions about these consequences. Other important areas that are largely unexplored are sex differences during adolescence and the long-term consequences of adolescent use of these substances. We provide suggestions for future work to address the gaps we identified in the literature. Given the widespread use of these drugs among adolescent users, and the potential for therapeutic use, this work will be crucial to understanding abuse potential and consequences of use in this developmental stage.
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Affiliation(s)
- M L Shawn Bates
- Department of Psychology, California State University Chico, 400 W. First St, Chico, CA 95929, USA.
| | - Keith A Trujillo
- Department of Psychology and Office for Training, Research and Education in the Sciences (OTRES), California State University San Marcos, 333 S. Twin Oaks Valley Rd, San Marcos, CA 92096, USA..
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9
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Wei Y, Shah R. Substance Use Disorder in the COVID-19 Pandemic: A Systematic Review of Vulnerabilities and Complications. Pharmaceuticals (Basel) 2020; 13:E155. [PMID: 32708495 PMCID: PMC7407364 DOI: 10.3390/ph13070155] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 01/18/2023] Open
Abstract
As the world endures the coronavirus disease 2019 (COVID-19) pandemic, the conditions of 35 million vulnerable individuals struggling with substance use disorders (SUDs) worldwide have not received sufficient attention for their special health and medical needs. Many of these individuals are complicated by underlying health conditions, such as cardiovascular and lung diseases and undermined immune systems. During the pandemic, access to the healthcare systems and support groups is greatly diminished. Current research on COVID-19 has not addressed the unique challenges facing individuals with SUDs, including the heightened vulnerability and susceptibility to the disease. In this systematic review, we will discuss the pathogenesis and pathology of COVID-19, and highlight potential risk factors and complications to these individuals. We will also provide insights and considerations for COVID-19 treatment and prevention in patients with SUDs.
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Affiliation(s)
- Yufeng Wei
- Department of Chemistry, New Jersey City University, Jersey City, NJ 07305, USA;
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10
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A systematic review of the Trier Social Stress Test methodology: Issues in promoting study comparison and replicable research. Neurobiol Stress 2020; 13:100235. [PMID: 33344691 PMCID: PMC7739033 DOI: 10.1016/j.ynstr.2020.100235] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/27/2022] Open
Abstract
Since its development in 1993, the Trier Social Stress Test (TSST) has been used widely as a psychosocial stress paradigm to activate the sympathetic nervous system and hypothalamic-pituitary-adrenal axis (HPAA) stress systems, stimulating physiological functions (e.g. heart rate) and cortisol secretion. Several methodological variations introduced over the years have led the scientific community to question replication between studies. In this systematic review, we used the Preferred Reporting Items of Systematic Reviews and Meta-Analysis (PRISMA) to synthesize procedure-related data available about the TSST protocol to highlight commonalities and differences across studies. We noted significant discrepancies across studies in how researchers applied the TSST protocol. In particular, we highlight variations in testing procedures (e.g., number of judges, initial number in the arithmetic task, time of the collected saliva samples for cortisol) and discuss possible misinterpretation in comparing findings from studies failing to control for variables or using a modified version from the original protocol. Further, we recommend that researchers use a standardized background questionnaire when using the TSST to identify factors that may influence physiological measurements in tandem with a summary of this review as a protocol guide. More systematic implementation and detailed reporting of TSST methodology will promote study replication, optimize comparison of findings, and foster an informed understanding of factors affecting responses to social stressors in healthy people and those with pathological conditions.
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11
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Mead J, Parrott A. Mephedrone and MDMA: A comparative review. Brain Res 2020; 1735:146740. [PMID: 32087112 DOI: 10.1016/j.brainres.2020.146740] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 02/13/2020] [Accepted: 02/18/2020] [Indexed: 01/10/2023]
Abstract
Mephedrone and MDMA are both constituents of party drugs, with mephedrone being relatively new compared to MDMA. This review compares current knowledge regarding the patterns of usage and neuropsychobiological effects of both mephedrone and MDMA. Both drugs share common psychoactive effects, the duration of which is significantly shorter with mephedrone use, attributing towards a pattern of binge use among users. Both drugs have also been associated with adverse health, psychiatric, and neurocognitive problems. Whilst there is extensive research into the psychobiological problems induced by MDMA, the evidence for mephedrone is comparatively limited. The adverse effect profile of mephedrone appears to be less severe than that of MDMA. Users often believe it to be safer, although both drugs have been associated with overdoses. The neurotoxic potential of mephedrone appears to be low, whereas MDMA can cause long-term damage to the serotonergic system, although this needs further investigation. The abuse liability of mephedrone is significantly greater than that of MDMA, raising concerns regarding the impact of lifetime usage on users. Given that mephedrone is relatively new, the effects of long-term exposure are yet to be documented. Future research focused on lifetime users may highlight more severe neuropsychobiological effects from the drug.
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Affiliation(s)
- Jessica Mead
- Department of Psychology, School of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom.
| | - Andrew Parrott
- Department of Psychology, School of Human and Health Sciences, Swansea University, Swansea, Wales, United Kingdom
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12
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Aguilar MA, García-Pardo MP, Parrott AC. Of mice and men on MDMA: A translational comparison of the neuropsychobiological effects of 3,4-methylenedioxymethamphetamine ('Ecstasy'). Brain Res 2020; 1727:146556. [PMID: 31734398 DOI: 10.1016/j.brainres.2019.146556] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 11/09/2019] [Accepted: 11/12/2019] [Indexed: 11/19/2022]
Abstract
MDMA (3,4-methylendioxymethamphetamine), also known as Ecstasy, is a stimulant drug recreationally used by young adults usually in dance clubs and raves. Acute MDMA administration increases serotonin, dopamine and noradrenaline by reversing the action of the monoamine transporters. In this work, we review the studies carried out over the last 30 years on the neuropsychobiological effects of MDMA in humans and mice and summarise the current knowledge. The two species differ with respect to the neurochemical consequences of chronic MDMA, since it preferentially induces serotonergic dysfunction in humans and dopaminergic neurotoxicity in mice. However, MDMA alters brain structure and function and induces hormonal, psychomotor, neurocognitive, psychosocial and psychiatric outcomes in both species, as well as physically damaging and teratogen effects. Pharmacological and genetic studies in mice have increased our knowledge of the neurochemical substrate of the multiple effects of MDMA. Future work in this area may contribute to developing pharmacological treatments for MDMA-related disorders.
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Affiliation(s)
- Maria A Aguilar
- Department of Psychobiology, Faculty of Psychology, Valencia University, Valencia, Spain.
| | | | - Andrew C Parrott
- Department of Psychology, Swansea University, Swansea, United Kingdom; Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
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13
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Huang MC, Chen CH, Chen LY, Chang HM, Chen CK, Lin SK, Xu K. Chronic ketamine abuse is associated with orexin-A reduction and ACTH elevation. Psychopharmacology (Berl) 2020; 237:45-53. [PMID: 31377886 DOI: 10.1007/s00213-019-05342-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2019] [Accepted: 07/25/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND Ketamine has emerged as a major substance of abuse worldwide. Evidence suggests a role of orexin system in reward processing, withdrawal, and stress response. It also interacts with the stress mechanisms of hypothalamic-pituitary-adrenal (HPA) axis to regulate drug-taking behavior. The study aimed to explore the relevance of orexin and stress hormones to chronic ketamine abuse. METHODS We enrolled 67 ketamine-dependent (KD) patients and 64 controls. The levels of orexin-A, adrenocorticotropic hormone (ACTH), and cortisol were measured at baseline, 1 week, and 2 weeks after ketamine discontinuation. KD patients were assessed by Beck Depression Inventory, Beck Anxiety Inventory, and Visual Analogue Scale for ketamine craving at baseline. RESULTS Compared with the controls, KD patients had significantly lower orexin-A (0.65 ± 0.12 vs. 0.74 ± 0.10 ng/mL, p < 0.001) and increased ACTH (32.3 ± 16.3 vs. 22.3 ± 11.0 pg/mL, p = 0.008) levels at baseline, whereas cortisol levels were similar between two groups. Levels of the three markers did not correlate with ketamine use variables, craving, depression, or anxiety symptoms. The levels did not alter after 1 or 2 weeks of ketamine discontinuation. Notably, those with higher anxiety had lower orexin-A but increased cortisol levels than did those with lower anxiety. CONCLUSIONS This study showed that KD patients had persistent orexin-A reduction and stress hormone dysregulation in early abstinence. The anxious phenotype of KD might be associated with a lower orexin-A expression. These results point to a promising pathway to investigate the neurochemical mechanisms of ketamine addiction.
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Affiliation(s)
- Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309, Song-De Road, Xinyi District, Taipei City, 110, Taiwan.,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Xing St., Taipei, 110, Taiwan.,Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - Chun-Hsin Chen
- Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, 111, Sec. 3, Hsing-Long Rd, Taipei, 116, Taiwan
| | - Lian-Yu Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309, Song-De Road, Xinyi District, Taipei City, 110, Taiwan.,Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Hu-Ming Chang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309, Song-De Road, Xinyi District, Taipei City, 110, Taiwan
| | - Chih-Ken Chen
- Department of Psychiatry & Community Medicine Research Center, Chang Gung Memorial Hospital, 200, Ln 208, Ji-Jing 1st Rd, Keelung, Taiwan. .,Chang Gung University School of Medicine, 5, Fu-Hsing Rd, Gue-Shan District Taoyuan City, 333, Taiwan.
| | - Shih-Ku Lin
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, 309, Song-De Road, Xinyi District, Taipei City, 110, Taiwan. .,Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, 250 Wu-Xing St., Taipei, 110, Taiwan.
| | - Ke Xu
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
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14
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Strajhar P, Vizeli P, Patt M, Dolder PC, Kratschmar DV, Liechti ME, Odermatt A. Effects of lisdexamfetamine on plasma steroid concentrations compared with d-amphetamine in healthy subjects: A randomized, double-blind, placebo-controlled study. J Steroid Biochem Mol Biol 2019; 186:212-225. [PMID: 30381248 DOI: 10.1016/j.jsbmb.2018.10.016] [Citation(s) in RCA: 10] [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: 10/10/2018] [Revised: 10/18/2018] [Accepted: 10/24/2018] [Indexed: 01/08/2023]
Abstract
The novel d-amphetamine prodrug lisdexamfetamine is applied to treat attention-deficit/hyperactivity disorder (ADHD). d-Amphetamine releases dopamine and norepinephrine and stimulates the hypothalamic-pituitary-adrenal (HPA) axis, which may contribute to its reinforcing effects and risk of abuse. However, no data is currently available on the effects of lisdexamfetamine on circulating steroids. This randomized, double-blind, placebo-controlled, cross-over study evaluated the effects of equimolar doses of d-amphetamine (40 mg) and lisdexamfetamine (100 mg) and placebo on circulating steroids in 24 healthy subjects. Plasma steroid and d-amphetamine levels were determined up to 24 h. Delayed increase and peak levels of plasma d-amphetamine concentrations were observed following lisdexamfetamine treatment compared with d-amphetamine administration, however the maximal concentrations and total exposure (area under the curve [AUC]) were similar. Lisdexamfetamine and d-amphetamine significantly enhanced plasma levels of adrenocorticotropic hormone, glucocorticoids (cortisol, cortisone, corticosterone, 11-dehydrocorticosterone, and 11-deoxycortisol), androgens (dehydroepiandrosterone, dehydroepiandrosterone sulfate, and Δ4-androstene-3,17-dione [androstenedione]), and progesterone (only in men) compared with placebo. Steroid concentration-time curves were shifted to later time points due to a non-significantly later onset following lisdexamfetamine administration than after d-amphetamine, however maximal plasma steroid concentrations and AUCs did not differ between the active treatments. None of the active treatments altered plasma levels of the mineralocorticoids aldosterone and 11-deoxycorticosterone or the androgen testosterone compared with placebo. The effects of the amphetamines on glucocorticoid production were similar to those that were previously reported for methylphenidate (60 mg) but weaker than those for the serotonin releaser 3,4-methylenedioxymethamphetamine (MDMA; 125 mg) or direct serotonin receptor agonist lysergic acid diethylamide (LSD; 0.2 mg). Lisdexamfetamine produced comparable HPA axis activation and had similar pharmacokinetics than d-amphetamine, except for a delayed time of onset. Thus, serotonin (MDMA, LSD) may more effectively stimulate the HPA axis than dopamine and norepinephrine (D-amphetamine).
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Affiliation(s)
- Petra Strajhar
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Patrick Vizeli
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Melanie Patt
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Patrick C Dolder
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Denise V Kratschmar
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Matthias E Liechti
- Division of Clinical Pharmacology and Toxicology, Department of Biomedicine and Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - Alex Odermatt
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
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15
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The role of substance use, smoking, and inflammation in risk for suicidal behavior. J Affect Disord 2019; 243:33-41. [PMID: 30223137 PMCID: PMC6241516 DOI: 10.1016/j.jad.2018.09.005] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Revised: 07/09/2018] [Accepted: 09/06/2018] [Indexed: 01/03/2023]
Abstract
BACKGROUND Alcohol and substance use disorders are important predictors for suicidal behavior. However, the role of individual substances as proximal risk factors for suicidal behavior and the mechanisms through which substance use affect risk are not entirely clear. We examine whether the frequency of substance use and whether biological markers in the HPA axis and inflammatory pathways are associated with clinical risk factors of suicidal behavior of aggression, impulsivity, hopelessness, and poor sleep. METHODS The sample consisted of psychiatric inpatients, aged 15-30 years, admitted for suicide attempt (n = 38), suicidal ideation (n = 40); and healthy controls (n = 37). We measured hair cortisol concentrations, glucocorticoid receptor (GR) sensitivity, stimulated production of interleukin- or IL-6, C-reactive protein, and mRNA expression of GR, SKA2, FKBP5, TNF-α, and IL-1β. RESULTS Smoking was associated with increased aggression [β = 2.9, 95% CI (-0.03, 6), p = 0.05], impulsivity [β = 3.1, 95% CI (1.6, 4.6), p < 0.001], and poor sleep [β = 0.5, 95% CI (0.03, 0.95), p = 0.04] even after controlling for demographics and group. Similarly, TNF-α mRNA was associated with impulsivity [β = 0.07, 95% CI (0.01, 0.1), p = 0.02] and hopelessness [β = 0.03, 95% CI (0.004, 0.05), p = 0.03]. Smoking tobacco (r = 0.32, p < 0.001) was positively associated with TNF-α mRNA. LIMITATIONS Study limitations include the cross-sectional design, retrospective assessment, and relatively small sample size. CONCLUSIONS Future longitudinal studies are needed to test whether inflammatory markers mediate the relationships between smoking, clinical risk factors, and suicidal behavior; and to examine whether smoking cessation could reduce the risk for suicidal behavior in at-risk patients.
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16
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Fernández-Calderón F, Díaz-Batanero C, Barratt MJ, Palamar JJ. Harm reduction strategies related to dosing and their relation to harms among festival attendees who use multiple drugs. Drug Alcohol Rev 2019; 38:57-67. [PMID: 30302851 PMCID: PMC6338512 DOI: 10.1111/dar.12868] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 09/10/2018] [Accepted: 09/17/2018] [Indexed: 02/05/2023]
Abstract
INTRODUCTION AND AIMS Polysubstance users are a high-risk population for negative health-related consequences. Although some studies have described harm reduction strategies adopted by polysubstance users, studies have not examined their effectiveness in minimising health-related consequences. We aimed to identify dosing-related harm reduction strategies in a sample of polysubstance-using dance festival attendees, and explore the relationship between harm reduction strategies and self-reported adverse health consequences. DESIGN AND METHODS Data were examined for 1226 past-year dance festival attendees who self-identified as past-year multiple drug users. We conducted bivariable and multivariable analyses to explore relationships between six dosing-related harm reduction strategies and 13 self-reported adverse consequences. RESULTS Self-reported use of dosing-related harm reduction strategies was prevalent, mainly avoidance of mixing depressants (69.2%) and setting limits on quantity (62.2%). Frequent users of harm reduction strategies reported experiencing fewer adverse health consequences (P values < 0.05). Those who reportedly set limits on quantity were at decreased odds of experiencing a bad mood after drug use, sexual difficulties while under drug influence, injuries or fractures while under drug influence, and involvement in fights or being attacked while under drug influence (P values < 0.05). Moreover, those who report frequently avoid mixing depressants were at decreased odds of experiencing headache, loss of consciousness, drop in blood pressure, injuries of fractures, and fights or attacks (P values < 0.05). DISCUSSION AND CONCLUSIONS Adoption of dosing-related harm reduction strategies appears to be associated with less drug-related harm among polysubstance-using festival attendees. Findings may inform organisations and policymakers in the designing of harm reduction interventions with this population.
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Affiliation(s)
- Fermín Fernández-Calderón
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Carmen Díaz-Batanero
- Department of Clinical and Experimental Psychology, University of Huelva, Huelva, Spain
- Research Center on Natural Resources, Health and the Environment, University of Huelva, Huelva, Spain
| | - Monica J Barratt
- Drug Policy Modelling Program, National Drug and Alcohol Research Centre, UNSW Australia, Sydney, Australia
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Australia
| | - Joseph J Palamar
- Department of Population Health, New York University Langone Medical Center, New York, USA
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17
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Pierluigi S, Laura B, Attilio N, Gurjeet K B, Gloria P, Davide M, Borgherini G, Giovanni M, Fabrizio S, Perini G, Ornella C. "Marvin, the Paranoid Android": The Case of an Alpha-PVP User in the Expanding Galaxy of NPS. J Psychoactive Drugs 2018; 50:306-313. [PMID: 29768112 DOI: 10.1080/02791072.2018.1447172] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
Alpha-PVP can be defined as a novel psychoactive substance (NPS)-more specifically, a novel synthetic cathinone with unpredictable stimulant effects in humans. "Marvin" arrived at a Dual Diagnosis Unit at Parco dei Tigli, Italy. He underwent a 30-day rehabilitation program to overcome his problematic Alpha-PVP use as a psychonaut. We conducted an online search to understand the properties of Alpha-PVP and its presence in scientific literature, reviewing official reports and the online drug market (e.g., fora, webpages). In the Dual Diagnosis Unit, Marvin completed the 30-day rehabilitation program that included assessments and group and individual cognitive behavioral therapy. Alpha-PVP is a synthetic cathinone with stimulant properties, available in the online market but with unpredictable effects in humans. The present case reports an important risk of psychosis in a psychonaut patient who arrived and declared its intense use before admission to our Unit. This article describes the psychopathological effects of the novel compound Alpha-PVP in a psychonaut patient. Patients attending clinics that have used Alpha-PVP pose a new challenge for traditional services of mental health and addiction.
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Affiliation(s)
- Simonato Pierluigi
- a School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK.,b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | - Bulsis Laura
- b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | - Negri Attilio
- c Postgraduate School of Clinical Pharmacology and Toxicology , University of Milan , Milan , Italy
| | - Bansal Gurjeet K
- a School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
| | - Pessa Gloria
- b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | - Mioni Davide
- b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | | | - Martinotti Giovanni
- d Department of Neuroscience and Imaging , University "G. D'Annunzio , Chieti-Pescara , Italy
| | - Schifano Fabrizio
- a School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
| | - Giulia Perini
- b Dual Diagnosis Unit , Casa di Cura Parco dei Tigli , Padova , Italy
| | - Corazza Ornella
- a School of Life and Medical Sciences , University of Hertfordshire , Hatfield , UK
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18
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Mood Fluctuation and Psychobiological Instability: The Same Core Functions Are Disrupted by Novel Psychoactive Substances and Established Recreational Drugs. Brain Sci 2018. [PMID: 29533974 PMCID: PMC5870361 DOI: 10.3390/brainsci8030043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Many novel psychoactive substances (NPS) have entered the recreational drug scene in recent years, yet the problems they cause are similar to those found with established drugs. This article will debate the psychobiological effects of these newer and more traditional substances. It will show how they disrupt the same core psychobiological functions, so damaging well-being in similar ways. Every psychoactive drug causes mood states to fluctuate. Users feel better on-drug, then feel worse off-drug. The strength of these mood fluctuations is closely related to their addiction potential. Cyclical changes can occur with many other core psychobiological functions, such as information processing and psychomotor speed. Hence the list of drug-related impairments can include: homeostatic imbalance, HPA axis disruption, increased stress, altered sleep patterns, neurohormonal changes, modified brain rhythms, neurocognitive impairments, and greater psychiatric vulnerability. Similar patterns of deficit are found with older drugs such as cocaine, nicotine and cannabis, and newer substances such as 3,4-methylenedioxymethamphetamine (MDMA), mephedrone and spice. All psychoactive drugs damage human well-being through similar basic neuropsychobiological mechanisms.
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Bershad AK, Miller MA, de Wit H. MDMA does not alter responses to the Trier Social Stress Test in humans. Psychopharmacology (Berl) 2017; 234:2159-2166. [PMID: 28432376 PMCID: PMC5984654 DOI: 10.1007/s00213-017-4621-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/29/2017] [Indexed: 10/19/2022]
Abstract
RATIONALE ±3,4-Methylenedioxymethamphetamine (MDMA, "ecstasy") is a stimulant-psychedelic drug with unique social effects. It may dampen reactivity to negative social stimuli such as social threat and rejection. Perhaps because of these effects, MDMA has shown promise as a treatment for post-traumatic stress disorder (PTSD). However, the effect of single doses of MDMA on responses to an acute psychosocial stressor has not been tested. OBJECTIVES In this study, we sought to test the effects of MDMA on responses to stress in healthy adults using a public speaking task. We hypothesized that the drug would reduce responses to the stressful task. METHODS Volunteers (N = 39) were randomly assigned to receive placebo (N = 13), 0.5 mg/kg MDMA (N = 13), or 1.0 mg/kg MDMA (N = 13) during a stress and a no-stress session. Dependent measures included subjective reports of drug effects and emotional responses to the task, as well as salivary cortisol, heart rate, and blood pressure. RESULTS The stress task produced its expected increase in physiological responses (cortisol, heart rate) and subjective ratings of stress in all three groups, and MDMA produced its expected subjective and physiological effects. MDMA alone increased ratings of subjective stress, heart rate, and saliva cortisol concentrations, but contrary to our hypothesis, it did not moderate responses to the Trier Social Stress Test. CONCLUSIONS Despite its efficacy in PTSD and anxiety, MDMA did not reduce either the subjective or objective responses to stress in this controlled study. The conditions under which MDMA relieves responses to negative events or memories remain to be determined.
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Affiliation(s)
- Anya K. Bershad
- Interdisciplinary Scientist Training Program, University of Chicago, Chicago, IL, USA,Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave., MC3077, Chicago, IL 60637, USA
| | - Melissa A. Miller
- Interdisciplinary Scientist Training Program, University of Chicago, Chicago, IL, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, 5841 S. Maryland Ave., MC3077, Chicago, IL, 60637, USA.
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20
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Parrott AC, Downey LA. Psychoactive drug influences on hair cortisol. Psychoneuroendocrinology 2017; 81:159. [PMID: 28392096 DOI: 10.1016/j.psyneuen.2017.02.034] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 02/22/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Andrew C Parrott
- Department of Psychology, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales, UK; Centre for Human Psychopharmacology, Swinburne University, Hawthorn, Melbourne, VIC 3122, Australia.
| | - Luke A Downey
- Department of Psychology, College of Human and Health Sciences, Swansea University, Singleton Park, Swansea, SA2 8PP, Wales, UK; Centre for Human Psychopharmacology, Swinburne University, Hawthorn, Melbourne, VIC 3122, Australia
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21
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Parrott AC, Hayley AC, Downey LA. Recreational stimulants, herbal, and spice cannabis: The core psychobiological processes that underlie their damaging effects. Hum Psychopharmacol 2017; 32. [PMID: 28557129 DOI: 10.1002/hup.2594] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/13/2017] [Accepted: 03/18/2017] [Indexed: 12/19/2022]
Abstract
AIMS Recreational drugs are taken for their positive mood effects, yet their regular usage damages well-being. The psychobiological mechanisms underlying these damaging effects will be debated. METHODS The empirical literature on recreational cannabinoids and stimulant drugs is reviewed. A theoretical explanation for how they cause similar types of damage is outlined. RESULTS All psychoactive drugs cause moods and psychological states to fluctuate. The acute mood gains underlie their recreational usage, while the mood deficits on withdrawal explain their addictiveness. Cyclical mood changes are found with every central nervous system stimulant and also occur with cannabis. These mood state changes provide a surface index for more profound psychobiological fluctuations. Homeostatic balance is altered, with repetitive disturbances of the hypothalamic-pituitary-adrenal axis, and disrupted cortisol-neurohormonal secretions. Hence, these drugs cause increased stress, disturbed sleep, neurocognitive impairments, altered brain activity, and psychiatric vulnerability. Equivalent deficits occur with novel psychoactive stimulants such as mephedrone and artificial "spice" cannabinoids. These psychobiological fluctuations underlie drug dependency and make cessation difficult. Psychobiological stability and homeostatic balance are optimally restored by quitting psychoactive drugs. CONCLUSIONS Recreational stimulants such as cocaine or MDMA (3.4-methylenedioxymethamphetamine) and sedative drugs such as cannabis damage human homeostasis and well-being through similar core psychobiological mechanisms.
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Affiliation(s)
- Andrew C Parrott
- Department of Psychology, Swansea University, Swansea, UK.,Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
| | - Amie C Hayley
- Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
| | - Luke A Downey
- Department of Psychology, Swansea University, Swansea, UK.,Centre for Human Psychopharmacology, Swinburne University, Melbourne, Australia
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22
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García-Pardo M, Roger-Sánchez C, Rodríguez-Arias M, Miñarro J, Aguilar M. Cognitive and behavioural effects induced by social stress plus MDMA administration in mice. Behav Brain Res 2017; 319:63-72. [DOI: 10.1016/j.bbr.2016.11.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 10/25/2016] [Accepted: 11/07/2016] [Indexed: 12/22/2022]
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23
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Oxytocin, cortisol and 3,4-methylenedioxymethamphetamine: neurohormonal aspects of recreational ‘ecstasy’. Behav Pharmacol 2016; 27:649-658. [DOI: 10.1097/fbp.0000000000000262] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
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Altered diurnal pattern of steroid hormones in relation to various behaviors, external factors and pathologies: A review. Physiol Behav 2016; 164:68-85. [DOI: 10.1016/j.physbeh.2016.05.039] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2016] [Revised: 05/20/2016] [Accepted: 05/21/2016] [Indexed: 11/17/2022]
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Singer LT, Moore DG, Min MO, Goodwin J, Turner JJD, Fulton S, Parrott AC. Motor delays in MDMA (ecstasy) exposed infants persist to 2 years. Neurotoxicol Teratol 2016; 54:22-8. [PMID: 26806601 PMCID: PMC4789145 DOI: 10.1016/j.ntt.2016.01.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Revised: 01/05/2016] [Accepted: 01/20/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND Recreational use of 3,4 methylenedioxymethamphetamine (ecstasy, MDMA) is increasing worldwide. Its use by pregnant women causes concern due to potentially harmful effects on the developing fetus. MDMA, an indirect monoaminergic agonist and reuptake inhibitor, affects the serotonin and dopamine systems. Preclinical studies of fetal exposure demonstrate effects on learning, motor behavior, and memory. In the first human studies, we found prenatal MDMA exposure related to poorer motor development in the first year of life. In the present study we assessed the effects of prenatal exposure to MDMA on the trajectory of child development through 2 years of age. We hypothesized that exposure would be associated with poorer mental and motor outcomes. MATERIALS AND METHODS The DAISY (Drugs and Infancy Study, 2003-2008) employed a prospective longitudinal cohort design to assess recreational drug use during pregnancy and child outcomes in the United Kingdom. Examiners masked to drug exposures followed infants from birth to 4, 12, 18, and 24 months of age. MDMA, cocaine, alcohol, tobacco, cannabis, and other drugs were quantified through a standardized clinical interview. The Bayley Scales (III) of Mental (MDI) and Motor (PDI) Development and the Behavior Rating Scales (BRS) were primary outcome measures. Statistical analyses included a repeated measures mixed model approach controlling for multiple confounders. RESULTS Participants were pregnant women volunteers, primarily white, of middle class socioeconomic status, average IQ, with some college education, in stable partner relationships. Of 96 women enrolled, children of 93 had at least one follow-up assessment and 81 (87%) had ≥ two assessments. Heavier MDMA exposure (M=1.3±1.4 tablets per week) predicted lower PDI (p<.002), and poorer BRS motor quality from 4 to 24 months of age, but did not affect MDI, orientation, or emotional regulation. Children with heavier exposure were twice as likely to demonstrate poorer motor quality as lighter and non-exposed children (O.R.=2.2, 95%, CI=1.02-4.70, p<.05). DISCUSSION Infants whose mothers reported heavier MDMA use during pregnancy had motor delays from 4 months to two years of age that were not attributable to other drug or lifestyle factors. Women of child bearing age should be cautioned about the use of MDMA and MDMA-exposed infants should be screened for motor delays and possible intervention.
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Affiliation(s)
- Lynn T Singer
- Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States.
| | - Derek G Moore
- The University of East London, Docklands Campus, University Way, London E16 2RD, United Kingdom.
| | - Meeyoung O Min
- Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States.
| | - Julia Goodwin
- The University of East London, Docklands Campus, University Way, London E16 2RD, United Kingdom.
| | - John J D Turner
- The University of East London, Docklands Campus, University Way, London E16 2RD, United Kingdom.
| | - Sarah Fulton
- Case Western Reserve University, 10900 Euclid Avenue, Cleveland, OH 44106, United States.
| | - Andrew C Parrott
- Swansea University, Singleton Park, Swansea, Wales SA2 8PP, United Kingdom,.
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Navarro-Zaragoza J, Ros-Simó C, Milanés MV, Valverde O, Laorden ML. Binge Ethanol and MDMA Combination Exacerbates Toxic Cardiac Effects by Inducing Cellular Stress. PLoS One 2015; 10:e0141502. [PMID: 26509576 PMCID: PMC4624901 DOI: 10.1371/journal.pone.0141502] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 10/08/2015] [Indexed: 01/06/2023] Open
Abstract
Binge drinking is a common pattern of ethanol consumption among young people. Binge drinkers are especially susceptible to brain damage when other substances are co-administered, in particular 3,4 methylendioxymethamphetamine (MDMA). The aim of the present work was to study the mechanisms implicated in the adaptive changes observed after administration of these drugs of abuse. So, we have evaluated the cardiac sympathetic activity and the expression and activation of heat shock protein 27 (HSP27), after voluntary binge ethanol consumption, alone and in combination with MDMA. Both parameters are markers of stressful situations and they could be modified inducing several alterations in different systems. Adolescent mice received MDMA, ethanol or both (ethanol plus MDMA). Drinking in the dark (DID) procedure was used as a model of binge. Noradrenaline (NA) turnover, tyrosine hydroxylase (TH), TH phosphorylated at serine 31 and HSP27 expression and its phosphorylation at serine 82 were evaluated in adolescent mice 48 h, 72 h, and 7 days after treatments in the left ventricle. NA and normetanephrine (NMN) were determined by high-performance liquid chromatography (HPLC); TH and HSP27 expression and phosphorylation were measured by quantitative blot immunollabeling using specific antibodies. Ethanol and MDMA co-administration increased NA turnover and TH expression and phosphorylation versus the consumption of each one of these drugs. In parallel with the described modifications in the cardiac sympathetic activity, our results showed that binge ethanol+MDMA exposure is associated with an increase in HSP27 expression and phosphorylation in the left ventricle, supporting the idea that the combination of both drugs exacerbates the cellular stress induced by ethanol or MDMA alone.
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Affiliation(s)
- Javier Navarro-Zaragoza
- Department of Pharmacology, Faculty of Medicine, University of Murcia, Murcia, Spain
- * E-mail:
| | - Clara Ros-Simó
- Grup de Recerca en Neurobiologia del Comportament (GRNC), Universitat Pompeu Fabra, Barcelona, Spain
| | | | - Olga Valverde
- Grup de Recerca en Neurobiologia del Comportament (GRNC), Universitat Pompeu Fabra, Barcelona, Spain
| | - María-Luisa Laorden
- Department of Pharmacology, Faculty of Medicine, University of Murcia, Murcia, Spain
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Moratalla R, Khairnar A, Simola N, Granado N, García-Montes JR, Porceddu PF, Tizabi Y, Costa G, Morelli M. Amphetamine-related drugs neurotoxicity in humans and in experimental animals: Main mechanisms. Prog Neurobiol 2015; 155:149-170. [PMID: 26455459 DOI: 10.1016/j.pneurobio.2015.09.011] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 09/04/2015] [Accepted: 09/15/2015] [Indexed: 12/13/2022]
Abstract
Amphetamine-related drugs, such as 3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine (METH), are popular recreational psychostimulants. Several preclinical studies have demonstrated that, besides having the potential for abuse, amphetamine-related drugs may also elicit neurotoxic and neuroinflammatory effects. The neurotoxic potentials of MDMA and METH to dopaminergic and serotonergic neurons have been clearly demonstrated in both rodents and non-human primates. This review summarizes the species-specific cellular and molecular mechanisms involved in MDMA and METH-mediated neurotoxic and neuroinflammatory effects, along with the most important behavioral changes elicited by these substances in experimental animals and humans. Emphasis is placed on the neuropsychological and neurological consequences associated with the neuronal damage. Moreover, we point out the gap in our knowledge and the need for developing appropriate therapeutic strategies to manage the neurological problems associated with amphetamine-related drug abuse.
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Affiliation(s)
- Rosario Moratalla
- Instituto Cajal, Consejo Superior de Investigaciones Científicas, CSIC, Madrid, Spain; CIBERNED, ISCIII, Madrid, Spain.
| | - Amit Khairnar
- Applied Neuroscience Research Group, CEITEC - Central European Institute of Technology, Masaryk University, Brno, Czech Republic
| | - Nicola Simola
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Via Ospedale 72, 09124 Cagliari, Italy
| | - Noelia Granado
- Instituto Cajal, Consejo Superior de Investigaciones Científicas, CSIC, Madrid, Spain; CIBERNED, ISCIII, Madrid, Spain
| | - Jose Ruben García-Montes
- Instituto Cajal, Consejo Superior de Investigaciones Científicas, CSIC, Madrid, Spain; CIBERNED, ISCIII, Madrid, Spain
| | - Pier Francesca Porceddu
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Via Ospedale 72, 09124 Cagliari, Italy
| | - Yousef Tizabi
- Department of Pharmacology, Howard University College of Medicine, Washington, DC, USA
| | - Giulia Costa
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Via Ospedale 72, 09124 Cagliari, Italy
| | - Micaela Morelli
- Department of Biomedical Sciences, Section of Neuropsychopharmacology, University of Cagliari, Via Ospedale 72, 09124 Cagliari, Italy; Centre of Excellence for Neurobiology of Dependence, University of Cagliari, Cagliari, Italy; National Research Council (CNR), Institute of Neuroscience, Cagliari, Italy
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Parrott AC. Why all stimulant drugs are damaging to recreational users: an empirical overview and psychobiological explanation. Hum Psychopharmacol 2015. [PMID: 26216554 DOI: 10.1002/hup.2468] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
AIMS Stimulant drugs such as nicotine and Ecstasy/3, 4-methylenedioxymethamphetamine (MDMA) are taken for positive reasons, yet their regular use leads to deficits rather than gains. This article outlines the psychobiological rationale for this paradox. METHODS The empirical literature on nicotine, cocaine, amphetamine, Ecstasy/MDMA, and mephedrone are reviewed. A theoretical explanation for why they are problematic to humans is then described. RESULTS The acute effects of central nervous system (CNS) stimulants are typically positive, with greater alertness and emotional intensity. However, in the post-drug recovery period, the opposite feelings develop, with lethargy and low moods. All recreational stimulants cause mood fluctuation, although it is most pronounced in drugs with rapid onset and comedown (e.g. nicotine and cocaine), explaining why they are the most addictive. Parallel fluctuations occur across many psychological and neurocognitive functions, with users suffering various off-drug deficits. CNS stimulants also affect the hypothalamic-pituitary-adrenal axis, impairing sleep, disrupting homeostasis, and exacerbating psychiatric distress. Neuroimaging studies reveal altered brain activity patterns in regular users. These problems are related to lifetime usage but commence in novice users. CONCLUSIONS Repetitive CNS stimulation is potentially damaging to the organism, both acutely and chronically. The review describes the various psychobiological systems through which recreational stimulant drugs impair human well-being.
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Affiliation(s)
- Andrew C Parrott
- Department of Psychology, Swansea University, Swansea, South Wales, UK
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