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Wazaify M, Al-Khateeb YM, Musleh B, Al-Smadi H, Steenkamp C. Qualitative Exploration of the Experiences of People Who Use Captagon and Therapists in Jordan. Subst Use Misuse 2024; 59:816-824. [PMID: 38263603 DOI: 10.1080/10826084.2024.2304012] [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] [Indexed: 01/25/2024]
Abstract
Background: Captagon (Fenethylline) is an amphetamine type stimulant (ATS) and one of the most popular substances of use in the Middle East. This study aims to describe and analyze the trajectory of captagon use, severity of addiction and withdrawal symptoms and its effect on quality of life from the perspectives of people who use captagon, who receive treatment as well as therapists. Methods: This study took a qualitative approach, using semi-structured, audio-recorded interviews, which were transcribed verbatim, translated to English and coded using Nvivo software for thematic analysis. Results: Data saturation was achieved after interviewing a total of 27 participants (7 therapists and 20 patients using captagon either alone or among other illicit drugs), most of which were male (n = 22). Their ages ranged between 18-48 years (median= 27). Four main themes were identified during the interviews: (1) Definition and sought effects of captagon; (2) the downside of captagon use and withdrawal symptoms associated with captagon use; (3) motivations for captagon use and to treatment; and (4) the impact of Covid-19 on captagon's use and on treatment. Conclusion: This qualitative study has illustrated for the first time the several challenges and complicating factors that people who use captagon and therapists face in Jordan. Findings call attention to implementing effective interventions to raise public's awareness of the negative impact of such use, with focus on high-risk groups, address the needs of different users and encourage the use of international treatment guidelines.
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Affiliation(s)
- Mayyada Wazaify
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
| | - Yara M Al-Khateeb
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, University of Jordan, Amman, Jordan
| | | | - Hamza Al-Smadi
- National Centre for Mental Health, Ministry of Health, Amman, Jordan
| | - Christina Steenkamp
- School of Social Sciences, Faculty of Humanities and Social Sciences, Oxford Brookes University, Oxford, UK
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2
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Manolov S, Ivanov I, Bojilov D, Nedialkov P. Synthesis, In Vitro Anti-Inflammatory Activity, and HRMS Analysis of New Amphetamine Derivatives. MOLECULES (BASEL, SWITZERLAND) 2022; 28:molecules28010151. [PMID: 36615344 PMCID: PMC9822421 DOI: 10.3390/molecules28010151] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
Herein, we report the obtaining of new hybrid molecules of amphetamine with different profens (amfens). The obtained amfens are characterized by their melting points, UV, 1H-, 13C-NMR, and HRMS spectra. A complete and detailed mass spectral analysis of the newly obtained derivatives of amphetamine with ibuprofen, flurbiprofen, ketoprofen, naproxen, and carprofen was performed. In vitro inhibition of albumin denaturation of each new compound was assessed, and they showed significant activity. The IC50 values of the obtained amphetamine-profen derivatives ranged from 92.81 to 159.87 µg/mL. This indicates that the new hybrids inherit the anti-inflammatory properties of profens. Using in silico method, the toxicity was also calculated. The obtained results are given in LD50 values. Depending on the route of administration, the amfens are less toxic compared to the standard amphetamine.
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Affiliation(s)
- Stanimir Manolov
- Department of Organic Chemistry, Faculty of Chemistry, University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Iliyan Ivanov
- Department of Organic Chemistry, Faculty of Chemistry, University of Plovdiv, 4000 Plovdiv, Bulgaria
- Correspondence: ; Tel./Fax:+359-32-261-349
| | - Dimitar Bojilov
- Department of Organic Chemistry, Faculty of Chemistry, University of Plovdiv, 4000 Plovdiv, Bulgaria
| | - Paraskev Nedialkov
- Department of Pharmacognosy, Faculty of Pharmacy, Medical University of Sofia, 1000 Sofia, Bulgaria
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3
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Guo K, Ma X, Li J, Zhang C, Wu L. Recent advances in combretastatin A-4 codrugs for cancer therapy. Eur J Med Chem 2022; 241:114660. [PMID: 35964428 DOI: 10.1016/j.ejmech.2022.114660] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 12/14/2022]
Abstract
CA4 is a potent microtubule polymerization inhibitor and vascular disrupting agent. However, the in vivo efficiency of CA4 is limited owing to its poor pharmacokinetics resulting from its high lipophilicity and low water solubility. To improve the water solubility, CA4 phosphate (CA4P) has been developed and shows potent antivascular and antitumor effects. CA4P had been evaluated as a vascular disrupting agent in previousc linical trials. However, it had been discontinued due to the lack of a meaningful improvement in progression-free survival and unfavorable partial response data. Codrug is a drug design approach to chemically bind two or more drugs to improve therapeutic efficiency or decrease adverse effects. This review describes the progress made over the last twenty years in developing CA4-based codrugs to improve the therapeutic profile and achieve targeted delivery to cancer tissues. It also discusses the existing problems and the developmental prospects of CA4 codrugs.
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Affiliation(s)
- Kerong Guo
- School of Pharmacy, Xinxiang Medical University, Xinxiang, 453003, China
| | - Xin Ma
- School of Pharmacy, Xinxiang Medical University, Xinxiang, 453003, China
| | - Jian Li
- School of Pharmacy, Xinxiang Medical University, Xinxiang, 453003, China
| | - Chong Zhang
- School of Pharmacy, Xinxiang Medical University, Xinxiang, 453003, China
| | - Liqiang Wu
- School of Pharmacy, Xinxiang Medical University, Xinxiang, 453003, China.
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4
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Shalaby AS, Bahanan AO, Alshehri MH, Elag KA. Sleep Deprivation & Amphetamine Induced Psychosis. PSYCHOPHARMACOLOGY BULLETIN 2022; 52:31-40. [PMID: 35815175 PMCID: PMC9235313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To explore the relationship between sleep deprivation and amphetamine-induced psychosis. METHODS The patient group included 78 patients with a diagnosis of amphetamine (Captagon)-induced psychosis. The control group included 49 patients with no current or past history of amphetamine (Captagon)-induced psychosis. All study subjects underwent the following: a demographic sheet, a structured clinical interview for SM-IV (SCID 1), a drug use questionnaire, a questionnaire to explore any relationship between sleep deprivation and Captagon-induced psychosis, routine medical investigation, and urine screening for detection of drugs. RESULTS The patient group showed significantly higher both regular and maximum daily doses of Captagon. Patients showed more periods of sleep deprivation with the use of Captagon in comparison to controls, especially with the increase of the Captagon dose. Patients believed that the occurrence and termination of sleep deprivation were the cause of the start and end of psychotic experiences (more so than the increase and decrease or stoppage of Captagon doses). CONCLUSION sleep deprivation plays an essential role in the development of psychotic symptoms in patients who are using Captagon.
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Affiliation(s)
- Amr Said Shalaby
- Shalaby, MD, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Department of Neuropsychiatry, Menoufia University, Egypt. Bahanan, M.B.B.CH, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Alshehri, M.B.B.CH, Eradah Complex for Mental Health and Addiction, Eradah services, Jeddah, Saudi Arabia. Elag, MD, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Department of Neuropsychiatry, Ain Shams University, Egypt
| | - Abdullah Osama Bahanan
- Shalaby, MD, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Department of Neuropsychiatry, Menoufia University, Egypt. Bahanan, M.B.B.CH, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Alshehri, M.B.B.CH, Eradah Complex for Mental Health and Addiction, Eradah services, Jeddah, Saudi Arabia. Elag, MD, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Department of Neuropsychiatry, Ain Shams University, Egypt
| | - Mishal Hasan Alshehri
- Shalaby, MD, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Department of Neuropsychiatry, Menoufia University, Egypt. Bahanan, M.B.B.CH, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Alshehri, M.B.B.CH, Eradah Complex for Mental Health and Addiction, Eradah services, Jeddah, Saudi Arabia. Elag, MD, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Department of Neuropsychiatry, Ain Shams University, Egypt
| | - Khaled Ahmed Elag
- Shalaby, MD, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Department of Neuropsychiatry, Menoufia University, Egypt. Bahanan, M.B.B.CH, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Alshehri, M.B.B.CH, Eradah Complex for Mental Health and Addiction, Eradah services, Jeddah, Saudi Arabia. Elag, MD, Eradah Complex for Mental Health and Addiction, Eradah Services, Jeddah, Saudi Arabia. Department of Neuropsychiatry, Ain Shams University, Egypt
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5
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Adami PE, Koutlianos N, Baggish A, Bermon S, Cavarretta E, Deligiannis A, Furlanello F, Kouidi E, Marques-Vidal P, Niebauer J, Pelliccia A, Sharma S, Solberg EE, Stuart M, Papadakis M. Cardiovascular effects of doping substances, commonly prescribed medications and ergogenic aids in relation to sports: a position statement of the sport cardiology and exercise nucleus of the European Association of Preventive Cardiology. Eur J Prev Cardiol 2022; 29:559-575. [PMID: 35081615 DOI: 10.1093/eurjpc/zwab198] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/30/2021] [Accepted: 11/09/2021] [Indexed: 02/06/2023]
Abstract
The use of substances and medications with potential cardiovascular effects among those practicing sports and physical activity has progressively increased in recent years. This is also connected to the promotion of physical activity and exercise as core aspects of a healthy lifestyle, which has led also to an increase in sport participation across all ages. In this context, three main users' categories can be identified, (i) professional and amateur athletes using substances to enhance their performance, (ii) people with chronic conditions, which include physical activity and sport in their therapeutic plan, in association with prescribed medications, and (iii) athletes and young individuals using supplements or ergogenic aids to integrate their diet or obtaining a cognitive enhancement effect. All the substances used for these purposes have been reported to have side effects, among whom the cardiovascular consequences are the most dangerous and could lead to cardiac events. The cardiovascular effect depends on the type of substance, the amount, the duration of use, and the individual response to the substances, considering the great variability in responses. This Position Paper reviews the recent literature and represents an update to the previously published Position Paper published in 2006. The objective is to inform physicians, athletes, coaches, and those participating in sport for a health enhancement purpose, about the adverse cardiovascular effects of doping substances, commonly prescribed medications and ergogenic aids, when associated with sport and exercise.
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Affiliation(s)
- Paolo Emilio Adami
- Health and Science Department, World Athletics, 6-8 Quai Antoine 1er, Monaco 98000, Monaco
| | - Nikolaos Koutlianos
- Sports Medicine Laboratory, Aristotle University of Thessaloniki, Thermi, AUTH DPESS, 54124, Thessaloniki, Greece
| | - Aaron Baggish
- Cardiovascular Performance Program, Massachusetts General Hospital, 55 Fruit Street Boston, MA 02114, USA
| | - Stéphane Bermon
- Health and Science Department, World Athletics, 6-8 Quai Antoine 1er, Monaco 98000, Monaco
| | - Elena Cavarretta
- Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica, 79 - 04100 - Latina (LT), Italy.,Mediterranea Cardiocentro, Via Orazio, 2, 80122, Napoli (NA), Italy
| | - Asterios Deligiannis
- Sports Medicine Laboratory, Aristotle University of Thessaloniki, Thermi, AUTH DPESS, 54124, Thessaloniki, Greece
| | - Francesco Furlanello
- Aritmologia Clinica e Sportiva, IRCCS Gruppo MultiMedica Elettrofisiologia, Via Milanese 300, 20099, Sesto San Giovanni(MI), Italy
| | - Evangelia Kouidi
- Sports Medicine Laboratory, Aristotle University of Thessaloniki, Thermi, AUTH DPESS, 54124, Thessaloniki, Greece
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital (CHUV), Rue du Bugnon 46, 1011 Lausanne, Switzerland
| | - Josef Niebauer
- Paracelsus Medical University, Strubergasse 21, 5020 Salzburg, Austria
| | - Antonio Pelliccia
- Sports Medicine and Science Institute, CONI, Largo Piero Gabrielli, 1, 00197, Rome, Italy
| | - Sanjay Sharma
- Cardiovascular Clinical Academic Group, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
| | | | - Mark Stuart
- International Testing Agency-ITA, Av. de Rhodanie 58, 1007 Lausanne, Switzerland
| | - Michael Papadakis
- Cardiovascular Clinical Academic Group, St George's, University of London, Cranmer Terrace, London SW17 0RE, UK
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6
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Physician Perspectives on Codeine Accessibility, Patterns of Use, Misuse, and Dependence in Saudi Arabia. Int J Ment Health Addict 2021. [DOI: 10.1007/s11469-021-00670-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
AbstractIn Saudi Arabia, there are concerning rates of non-compliance with pharmaceutical regulations prohibiting the pharmacy dispensing of prescription-only medications without a physician prescription. This is the first study in the Middle East which examines physicians’ perceptions regarding misuse of codeine, listed as a narcotic, controlled, and prescription-only drug. The CODEMISUSED survey was adapted to the Saudi Arabian context and pilot tested, prior to cross-sectional administration to physicians in Riyadh, Jeddah, Abha, and Jazan (n = 105). Descriptive statistics (frequencies and percentage) present physician level of agreement, neutrality, and disagreement with statements regarding codeine prescribing, patient awareness and use, online and community pharmacy availability, and dependence. The study indicates concern by physicians regarding patient intentional use of codeine to enhance mood, misuse patterns, lack of awareness around habit-forming use and iatrogenic dependence, and sourcing via illegal dispensing. It underscores the imperatives to address pharmacy compliance with pharmaceutical regulatory controls, implement enhanced pharmacovigilance, and improve awareness around safe use.
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7
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Methamphetamine-related postmortem cases in Jeddah, Saudi Arabia. Forensic Sci Int 2021; 321:110746. [PMID: 33676238 DOI: 10.1016/j.forsciint.2021.110746] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 01/13/2023]
Abstract
A more than 500% increase in the number of deaths involving methamphetamine occurred between 2016 and 2018 in Jeddah, Saudi Arabia. As such, this report employed a validated liquid chromatography tandem mass spectrometry method to quantify methamphetamine and its metabolites in bodily fluids from 47 postmortem cases in which methamphetamine was involved. The mean age of the deceased was 33 years old (median: 30, range: 16-63), and 94% were male. Methamphetamine was co-ingested with another drug in 32 of the cases (68%); however, the deaths were only due to the combined toxicity of methamphetamine and another drug in 15 of the cases (32%). Of note, 13 of these deaths (28% of all deaths) involved heroin. When methamphetamine was the sole cause of death (32% of the studied cases), the median concentrations of methamphetamine and amphetamine were 527 and 128 ng/mL. When methamphetamine was combined toxicity with another drug, the median concentrations of methamphetamine and amphetamine decreased to 161 and 53 ng/mL. When deaths were unrelated to methamphetamine, the median concentrations of methamphetamine and amphetamine were 130 and 44 ng/mL, respectively. The highest median methamphetamine concentration was found in urine (5281 ng/mL), followed by stomach contents (878 ng/mL), bile (762 ng/mL), vitreous humor (3 ng/mL), and blood (208 ng/mL). Almost 40% of the studied cases involved violence, 61% were accidental, 21% were suicides, 17% were homicides, and 2% were natural deaths. Methamphetamine is highly addictive. Increases in deaths have been seen in various countries. More awareness, education and treatment programs are required to reduce the likelihood of addiction, crimes, suicide, and other fatalities resulting from methamphetamine abuse.
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8
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Jones NS, Comparin JH. Interpol review of controlled substances 2016-2019. Forensic Sci Int Synerg 2020; 2:608-669. [PMID: 33385148 PMCID: PMC7770462 DOI: 10.1016/j.fsisyn.2020.01.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 01/23/2020] [Indexed: 12/14/2022]
Abstract
This review paper covers the forensic-relevant literature in controlled substances from 2016 to 2019 as a part of the 19th Interpol International Forensic Science Managers Symposium. The review papers are also available at the Interpol website at: https://www.interpol.int/content/download/14458/file/Interpol%20Review%20Papers%202019.pdf.
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Affiliation(s)
- Nicole S. Jones
- RTI International, Applied Justice Research Division, Center for Forensic Sciences, 3040 E. Cornwallis Road, Research Triangle Park, NC, 22709-2194, USA
| | - Jeffrey H. Comparin
- United States Drug Enforcement Administration, Special Testing and Research Laboratory, USA
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9
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Elliott SP, Holdbrook T, Brandt SD. Prodrugs of New Psychoactive Substances (NPS): A New Challenge. J Forensic Sci 2020; 65:913-920. [DOI: 10.1111/1556-4029.14268] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Revised: 11/29/2019] [Accepted: 12/17/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Simon P. Elliott
- Elliott Forensic Consulting Birmingham U.K
- Department of Analytical, Environmental and Forensic Sciences King’s College London London U.K
| | - Tanith Holdbrook
- Department of Analytical, Environmental and Forensic Sciences King’s College London London U.K
| | - Simon D. Brandt
- School of Pharmacy and Biomolecular Sciences Liverpool John Moores University Liverpool U.K
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10
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Alaryan T, Hasan TA, Eshelli M, Alzeer S. The Misuse of Prescribed Drugs During the Syrian Crisis: a Cross-sectional Study. Int J Ment Health Addict 2019. [DOI: 10.1007/s11469-019-00180-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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11
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Gokdemir MT, Giden R. Acute inferior myocardial infarction associated with the ingestion of captagon pills: A case report. Turk J Emerg Med 2019; 19:79-82. [PMID: 31065608 PMCID: PMC6495050 DOI: 10.1016/j.tjem.2018.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2018] [Revised: 05/04/2018] [Accepted: 05/06/2018] [Indexed: 11/16/2022] Open
Abstract
Phenylethylamine HCL (PEA HCL), more commonly called Captagon on the market, is a synthetic stimulant consisting of a theophylline molecule covalently bonded to an amphetamine molecule. The pathophysiology of myocardial infarction (MI) causing amphetamine-like compounds such as amphetamine and phenylethyline is not clear, this effect may be attributed to the vessel wall narrowing and destabilization of the thrombus. In the literature, some cases of acute myocardial infarction (AMI) associated with amphetamine and ephedrine abuse already been reported. To our knowledge, there is only a cases reporting AMI associated with the use of PEA commonly called Captagon. In this case, we wanted to contribute to the literature by presenting the case of a 23-year-old who developed PEA due to captagon tablet use.
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Affiliation(s)
- Mehmet Tahir Gokdemir
- Health Sciences University, Gazi Yasargil Research and Training Hospital, Emergency Medicine Department, Diyarbakır, Turkey
| | - Ramazan Giden
- Sanliurfa Research and Training Hospital, Emergency Department, Sanliurfa, Turkey
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12
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Wu N, Feng Z, He X, Kwon W, Wang J, Xie XQ. Insight of Captagon Abuse by Chemogenomics Knowledgebase-guided Systems Pharmacology Target Mapping Analyses. Sci Rep 2019; 9:2268. [PMID: 30783122 PMCID: PMC6381188 DOI: 10.1038/s41598-018-35449-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 09/10/2018] [Indexed: 12/26/2022] Open
Abstract
Captagon, known by its genetic name Fenethylline, is an addictive drug that complicates the War on Drugs. Captagon has a strong CNS stimulating effect than its primary metabolite, Amphetamine. However, multi-targets issues associated with the drug and metabolites as well as its underlying mechanisms have not been fully defined. In the present work, we applied our established drug-abuse chemogenomics-knowledgebase systems pharmacology approach to conduct targets/off-targets mapping (SP-Targets) investigation of Captagon and its metabolites for hallucination addiction, and also analyzed the cell signaling pathways for both Amphetamine and Theophylline with data mining of available literature. Of note, Amphetamine, an agonist for trace amine-associated receptor 1 (TAAR1) with enhancing dopamine signaling (increase of irritability, aggression, etc.), is the main cause of Captagon addiction; Theophylline, an antagonist that blocks adenosine receptors (e.g. A2aR) in the brain responsible for restlessness and painlessness, may attenuate the behavioral sensitization caused by Amphetamine. We uncovered that Theophylline's metabolism and elimination could be retarded due to competition and/or blockage of the CYP2D6 enzyme by Amphetamine; We also found that the synergies between these two metabolites cause Captagon's psychoactive effects to act faster and far more potently than those of Amphetamine alone. We carried out further molecular docking modeling and molecular dynamics simulation to explore the molecular interactions between Amphetamine and Theophylline and their important GPCRs targets, including TAAR1 and adenosine receptors. All of the systems pharmacology analyses and results will shed light insight into a better understanding of Captagon addiction and future drug abuse prevention.
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Affiliation(s)
- Nan Wu
- Department of Pharmaceutical Sciences and Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- National Center of Excellence for Computational Drug Abuse Research, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- Drug Discovery Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- Departments of Computational Biology and Structural Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
| | - Zhiwei Feng
- Department of Pharmaceutical Sciences and Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- National Center of Excellence for Computational Drug Abuse Research, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- Drug Discovery Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- Departments of Computational Biology and Structural Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
| | - Xibing He
- Department of Pharmaceutical Sciences and Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- National Center of Excellence for Computational Drug Abuse Research, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- Drug Discovery Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- Departments of Computational Biology and Structural Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
| | - William Kwon
- Department of Pharmaceutical Sciences and Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- National Center of Excellence for Computational Drug Abuse Research, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- Drug Discovery Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
- Departments of Computational Biology and Structural Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States
| | - Junmei Wang
- Department of Pharmaceutical Sciences and Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States.
- National Center of Excellence for Computational Drug Abuse Research, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States.
- Drug Discovery Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States.
- Departments of Computational Biology and Structural Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States.
| | - Xiang-Qun Xie
- Department of Pharmaceutical Sciences and Computational Chemical Genomics Screening Center, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States.
- National Center of Excellence for Computational Drug Abuse Research, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States.
- Drug Discovery Institute, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States.
- Departments of Computational Biology and Structural Biology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, 15261, United States.
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13
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Wenthur CJ, Zhou B, Janda KD. Vaccine-driven pharmacodynamic dissection and mitigation of fenethylline psychoactivity. Nature 2017; 548:476-479. [PMID: 28813419 PMCID: PMC5957549 DOI: 10.1038/nature23464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 07/03/2017] [Indexed: 01/09/2023]
Abstract
Fenethylline, also known as Captagon, is a synthetic psychoactive
stimulant that has recently been linked to substance use disorder and
‘pharmacoterrorism’ in the Middle East.1–4 Although fenethylline shares a common phenethylamine core
with other amphetamine-type stimulants, it additionally incorporates a
covalently-linked xanthine moiety into its parent structure.5,6
These independently-active pharmacophores are liberated during metabolism,
resulting in a structurally-diverse chemical mixture being deployed to the
central nervous system.7–9 Although
fenethylline’s psychoactive properties have been reported to differ from
other synthetic stimulants, the in vivo chemical complexity it
manifests upon ingestion has impeded efforts to unambiguously identify the
specific species responsible for these effects.10,11 Here we develop a ‘dissection through
vaccination’ approach, called DISSECTIV, to mitigate
fenethylline’s psychoactivity and show that its rapid-onset and distinct
psychoactive properties are facilitated by functional synergy between
theophylline and amphetamine. Our results demonstrate that incremental
vaccination against single chemical species within a multi-component mixture can
be used to uncover emergent properties arising from polypharmacologic activity.
We anticipate that DISSECTIV will be employed to expose unidentified active
chemical species and illuminate pharmacodynamic interactions within other
chemically complex systems, such as those found in counterfeit or illegal drug
preparations, post-metabolic tissue samples, and natural product extracts.
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Affiliation(s)
- Cody J Wenthur
- Department of Chemistry, The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, USA.,Department of Immunology, WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, USA
| | - Bin Zhou
- Department of Chemistry, The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, USA.,Department of Immunology, WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, USA
| | - Kim D Janda
- Department of Chemistry, The Skaggs Institute for Chemical Biology, The Scripps Research Institute, La Jolla, California 92037, USA.,Department of Immunology, WIRM Institute for Research and Medicine, The Scripps Research Institute, La Jolla, California 92037, USA
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14
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Mohamed K. One-Step Derivatization-Extraction Method for Rapid Analysis of Eleven Amphetamines and Cathinones in Oral Fluid by GC–MS. J Anal Toxicol 2017; 41:639-645. [DOI: 10.1093/jat/bkx046] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2016] [Accepted: 06/14/2017] [Indexed: 11/13/2022] Open
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15
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Twark C, Suzuki J. Fenethylline-Induced Psychosis, Fenethylline-Themed Paranoid Delusions, or Both? PSYCHOSOMATICS 2017; 58:561-564. [PMID: 28577859 DOI: 10.1016/j.psym.2017.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 03/24/2017] [Accepted: 03/26/2017] [Indexed: 11/15/2022]
Affiliation(s)
- Claire Twark
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Longwood Psychiatry Residency Training Program, Building for Transformative Medicine, Boston, MA.
| | - Joji Suzuki
- Division of Addiction Psychiatry, Brigham and Women's Hospital, Building for Transformative Medicine, Boston, MA
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16
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Al-Imam A, Santacroce R, Roman-Urrestarazu A, Chilcott R, Bersani G, Martinotti G, Corazza O. Captagon: use and trade in the Middle East. Hum Psychopharmacol 2017; 32. [PMID: 27766667 DOI: 10.1002/hup.2548] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 08/09/2016] [Accepted: 08/11/2016] [Indexed: 11/11/2022]
Abstract
BACKGROUND Fenetheylline, a psychostimulant drug, often branded as Captagon, is a combination of amphetamine and theophylline. Since the cessation of its legal production in 1986, counterfeited products have been produced illicitly in south-east Europe and far-east Asia. Its profitable trade has been linked to terrorist organizations, including Islamic State of Iraq and the Levant. This study aims to reach up-to-date data, concerning the Captagon e-commerce and use in the Middle East. METHODS A multi-staged and multi-lingual literature search was carried out. A list of prespecified keywords was applied across medical and paramedical databases, web and Dark web, search engines, social communication media, electronic commerce websites, media networks, and the Global Public Health Intelligence Network database. RESULTS The use of Captagon as a stimulant in terrorist settings has been marginally covered in the literature. Data can widely be retrieved from Google and AOL search engines, YouTube, and Amazon e-commerce websites, and to a lesser extent from Alibaba and eBay. On the contrary, Middle Eastern e-commerce websites yielded almost no results. Interestingly, the Dark web generated original data for Captagon e-commerce in the Middle East. CONCLUSION Further investigations are needed on the role that psychoactive drugs play in terrorist attacks and civil war zones. Unless a comprehensive methodological strategy, inclusive of unconventional methods of research, is implemented, it will not be feasible to face such a threat to humanity.
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Affiliation(s)
- Ahmed Al-Imam
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Faculty of Medicine, University of Baghdad, Baghdad, Iraq
| | - Rita Santacroce
- Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | | | - Robert Chilcott
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | | | - Giovanni Martinotti
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Department of Neuroscience, Imaging and Clinical Sciences, Gabriele D'Annunzio University of Chieti-Pescara, Chieti, Italy
| | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK.,Sapienza University of Rome, Rome, Italy
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17
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Van Hout MC, Hearne E, Wells J. Economic and conflict based rapid mass population movement into Europe: The security and public health implications for future EU drugs policy. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 38:13-15. [DOI: 10.1016/j.drugpo.2016.10.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 10/19/2016] [Accepted: 10/20/2016] [Indexed: 11/26/2022]
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18
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Aljuffali IA, Lin CF, Chen CH, Fang JY. The codrug approach for facilitating drug delivery and bioactivity. Expert Opin Drug Deliv 2016; 13:1311-25. [DOI: 10.1080/17425247.2016.1187598] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Ibrahim A. Aljuffali
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Chwan-Fwu Lin
- Department of Cosmetic Science, Chang Gung University of Science and Technology, Taoyuan, Taiwan
| | - Chun-Han Chen
- Division of General Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
- Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jia-You Fang
- Pharmaceutics Laboratory, Graduate Institute of Natural Products, Chang Gung University, Taoyuan, Taiwan
- Chinese Herbal Medicine Research Team, Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Research Center for Industry of Human Ecology, Chang Gung University of Science and Technology, Taoyuan, Taiwan
- Department of Anesthesiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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