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Zacher A, Zimmermann J, Cole DM, Friedli N, Opitz A, Baumgartner MR, Steuer AE, Verdejo-Garcia A, Stock AK, Beste C, Quednow BB. Chemical cousins with contrasting behavioural profiles: MDMA users and methamphetamine users differ in social-cognitive functions and aggression. Eur Neuropsychopharmacol 2024; 83:43-54. [PMID: 38642447 DOI: 10.1016/j.euroneuro.2024.04.010] [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: 12/07/2023] [Revised: 04/10/2024] [Accepted: 04/12/2024] [Indexed: 04/22/2024]
Abstract
Methamphetamine (METH, "Crystal Meth") and 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") share structural-chemical similarities but have distinct psychotropic profiles due to specific neurochemical actions. Previous research has suggested that their impact on social cognitive functions and social behaviour may differ significantly, however, direct comparisons of METH and MDMA users regarding social cognition and interaction are lacking. Performances in cognitive and emotional empathy (Multifaceted Empathy Test) and emotion sensitivity (Face Morphing Task), as well as aggressive social behaviour (Competitive Reaction Time Task) were assessed in samples of n = 40 chronic METH users, n = 39 chronic MDMA users and n = 86 stimulant-naïve controls (total N = 165). Self-reports and hair samples were used to obtain subjective and objective estimates of substance use patterns. METH users displayed diminished cognitive and emotional empathy towards positive stimuli, elevated punitive social behaviour regardless of provocation, and self-reported heightened trait anger relative to controls. MDMA users diverged from the control group only by exhibiting a distinct rise in punitive behaviour when faced with provocation. Correlation analyses indicated that both higher hair concentrations of MDMA and METH may be associated with reduced cognitive empathy. Moreover, greater lifetime MDMA use correlated with increased punitive behaviour among MDMA users. Our findings confirm elevated aggression and empathy deficits in chronic METH users, while chronic MDMA users only displayed more impulsive aggression. Dose-response correlations indicate that some of these deficits might be a consequence of use. Specifically, the dopaminergic mechanism of METH might be responsible for social-cognitive deficits.
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Affiliation(s)
- Amelie Zacher
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Josua Zimmermann
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, Joint Center of University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland
| | - David M Cole
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Translational Psychiatry, University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Nicole Friedli
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Antje Opitz
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Markus R Baumgartner
- Forensic Pharmacology and Toxicology, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Andrea E Steuer
- Forensic Pharmacology and Toxicology, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Antonio Verdejo-Garcia
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Clayton, Victoria, Australia
| | - Ann-Kathrin Stock
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, TU Dresden, Dresden, Germany
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland; Neuroscience Center Zurich, Joint Center of University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
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2
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Haggarty CJ, Bershad AK, Kumar MK, Lee R, de Wit H. The 3,4-methylenedioxymethamphetamine enhances early visual processing for salient socio-emotional stimuli. Eur J Neurosci 2024; 59:3224-3235. [PMID: 38637983 DOI: 10.1111/ejn.16346] [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: 02/06/2024] [Revised: 03/15/2024] [Accepted: 03/26/2024] [Indexed: 04/20/2024]
Abstract
The 3,4-methylenedioxymethamphetamine (MDMA) has long been used non-medically, and it is currently under investigation for its potential therapeutic benefits. Both uses may be related to its ability to enhance empathy, sociability, emotional processing and its anxiolytic effects. However, the neural mechanisms underlying these effects, and their specificity to MDMA compared to other stimulants, are not yet fully understood. Here, using electroencephalography (EEG), we investigated the effects of MDMA and a prototypic stimulant, methamphetamine (MA), on early visual processing of socio-emotional stimuli in an oddball emotional faces paradigm. Specifically, we examined whether MDMA or MA enhance the processing of facial expressions, compared to placebo, during the early stages of visual perception. MDMA enhanced an event-related component that is sensitive to detecting faces (N170), specifically for happy and angry expressions compared to neutral faces. MA did not affect this measure, and neither drug altered other components of the response to emotional faces. These findings provide novel insights into the neural mechanisms underlying the effects of MDMA on socio-emotional processing and may have implications for the therapeutic use of MDMA in the treatment of social anxiety and other psychiatric disorders.
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Affiliation(s)
- Connor J Haggarty
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
- Pharmacy Practice, Wayne State University, Wayne, Michigan, USA
| | - Anya K Bershad
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California, USA
| | - Mahesh K Kumar
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Royce Lee
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
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3
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Opitz A, Zimmermann J, Cole DM, Coray RC, Zachäi A, Baumgartner MR, Steuer AE, Pilhatsch M, Quednow BB, Beste C, Stock AK. Conflict monitoring and emotional processing in 3,4-methylenedioxymethamphetamine (MDMA) and methamphetamine users - A comparative neurophysiological study. Neuroimage Clin 2024; 41:103579. [PMID: 38447413 PMCID: PMC10924209 DOI: 10.1016/j.nicl.2024.103579] [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: 10/03/2023] [Revised: 02/06/2024] [Accepted: 02/07/2024] [Indexed: 03/08/2024]
Abstract
In stimulant use and addiction, conflict control processes are crucial for regulating substance use and sustaining abstinence, which can be particularly challenging in social-affective situations. Users of methamphetamine (METH, "Ice") and 3,4-methylenedioxymethamphetamine (MDMA, "Ecstasy") both experience impulse control deficits, but display different social-affective and addictive profiles. We thus aimed to compare the effects of chronic use of the substituted amphetamines METH and MDMA on conflict control processes in different social-affective contexts (i.e., anger and happiness) and investigate their underlying neurophysiological mechanisms. For this purpose, chronic but recently abstinent users of METH (n = 38) and MDMA (n = 42), as well as amphetamine-naïve healthy controls (n = 83) performed an emotional face-word Stroop paradigm, while event-related potentials (ERPs) were recorded. Instead of substance-specific differences, both MDMA and METH users showed smaller behavioral effects of cognitive-emotional conflict processing (independently of emotional valence) and selective deficits in emotional processing of anger content. Both effects were underpinned by stronger P3 ERP modulations suggesting that users of substituted amphetamines employ altered stimulus-response mapping and decision-making. Given that these processes are modulated by noradrenaline and that both MDMA and METH use may be associated with noradrenergic dysfunctions, the noradrenaline system may underlie the observed substance-related similarities. Better understanding the functional relevance of this currently still under-researched neurotransmitter and its functional changes in chronic users of substituted amphetamines is thus an important avenue for future research.
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Affiliation(s)
- Antje Opitz
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Josua Zimmermann
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - David M Cole
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Translational Psychiatry Lab, University Psychiatric Clinics Basel, University of Basel, Basel, Switzerland
| | - Rebecca C Coray
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - Anna Zachäi
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Germany
| | - Markus R Baumgartner
- Center for Forensic Hair Analytics, Institute of Forensic Medicine, University of Zurich, Zurich, Switzerland
| | - Andrea E Steuer
- Department of Forensic Pharmacology & Toxicology, Zurich Institute of Forensic Medicine, University of Zurich, 8057 Zurich, Switzerland
| | - Maximilian Pilhatsch
- Department of Psychiatry and Psychotherapy, Carl Gustav Carus University Hospital, TU Dresden, Dresden, Germany; Department of Psychiatry and Psychotherapy, Elblandklinikum, Radebeul, Germany
| | - Boris B Quednow
- Experimental and Clinical Pharmacopsychology, Department of Adult Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Switzerland; Neuroscience Center Zurich, University of Zurich and ETH Zurich, Switzerland
| | - 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; Biopsychology, Department of Psychology, School of Science, TU Dresden, Germany.
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4
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Sottile JE, Macia KS, Wickham RE, Haug NA. Development and initial validation of an MDMA/Ecstasy motives assessment. Addict Behav 2023; 136:107494. [PMID: 36162335 DOI: 10.1016/j.addbeh.2022.107494] [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: 05/16/2022] [Revised: 08/11/2022] [Accepted: 09/14/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVE MDMA/Ecstasy motives differ from those of other substances such as alcohol, cannabis, and methamphetamine. Previous literature on alcohol and cannabis use identified social, expansion, enhancement, coping, and conformism as primary motives for use. MDMA/Ecstasy users also report using the drug for increases in self-awareness and energy. The development of an MDMA/Ecstasy use motives assessment has potential to inform treatment interventions and public policy on harm reduction. METHOD An MDMA/Ecstasy use motives assessment was developed from alcohol and cannabis motives measures and qualitative feedback from MDMA/Ecstasy users. Participants included an international sample of adults (N = 1754) who completed an online questionnaire regarding their motives for using recreational MDMA/Ecstasy. RESULTS Exploratory and confirmatory factor analysis supported a 4-factor MDMA/Ecstasy motives scale. The four motive scales showed good internal consistency reliabilitySocial (α = 0.88) Expansion (α = 0.81), Coping (α = 0.82), and Energy (α = 0.75). Conformity and Enhancement did not emerge as significant factors. Analyses demonstrated convergent and discriminant validity with relevant constructs including quantity/frequency of use, MDMA use disorder, sensation seeking personality, and positive and negative consequences of use. CONCLUSIONS MDMA/Ecstasy use motives differ from those of other substances due to the distinctly stimulating, emotional, and empathic effects sought by users. By identifying salient MDMA/Ecstasy motives, this study highlights the unique aspects of recreational MDMA/Ecstasy use. This research has utility for informing clinical practice and contributing to public health harm reduction efforts.
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Affiliation(s)
- James E Sottile
- Department of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304 USA
| | - Kathryn S Macia
- National Center for PTSD, VA Palo Alto Health Care System, 795 Willow Road, Menlo Park, CA 94025 USA
| | - Robert E Wickham
- Department of Psychological Sciences, Northern Arizona University, S San Francisco Street, Flagstaff, AZ 86011 USA
| | - Nancy A Haug
- Department of Psychology, Palo Alto University, 1791 Arastradero Road, Palo Alto, CA 94304 USA.
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5
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Sarris J, Pinzon Rubiano D, Day K, Galvão-Coelho NL, Perkins D. Psychedelic medicines for mood disorders: current evidence and clinical considerations. Curr Opin Psychiatry 2022; 35:22-29. [PMID: 34855694 DOI: 10.1097/yco.0000000000000759] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW Despite advances in treatment modalities for mood disorders over recent decades, further therapeutic options are still required. Increased research is occurring, with the pursuit of psychedelic-based pharmacotherapies for a range of mood disorders and other conditions. RECENT FINDINGS Serotonergic psychedelics have been found to modulate brain networks underlying various psychiatric disorders, as well promoting neurogenesis and neuroplasticity. Randomized placebo-controlled trials have found psilocybin with psychological support effective at treating depression, including treatment-resistant depression; with emergent research also signalling N,N-dimethyltryptamine/ayahuasca also as a potential option for the treatment of depression. Lysergic acid diethylamide has been found to have anxiolytic effects, whereas 3,4-methylenedioxymethamphetamine (MDMA) has been used effectively to treat post-traumatic stress disorder (PTSD), with Phase III clinical trial evidence. Microdosing of psychedelics is a growing phenomenon that has shown benefits in some preclinical data; however, a recent self-directed controlled trial reported no evidence of improved mood. SUMMARY Current research with medicinal psychedelics, usually as an adjunct to psychotherapy, has shown encouraging results in treating mood disorders. However, there are challenges regarding blinding and sample sizes remain small, and there have been no definitive Phase III studies (aside from MDMA for PTSD). Further work exploring novel formulations, interface with pharmacogenomics and the microbiome, and inflammatory pathways can be advised.
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Affiliation(s)
- Jerome Sarris
- Psychae Institute, Melbourne, Victoria
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales
- Florey Institute of Neuroscience and Mental Health, Parkville
- The Melbourne Clinic Professorial Unit, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
| | | | | | - Nicole L Galvão-Coelho
- NICM Health Research Institute, Western Sydney University, Westmead, New South Wales
- Laboratory of Hormone Measurement, Department of Physiology and Behavior
- Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Daniel Perkins
- Psychae Institute, Melbourne, Victoria
- University of Melbourne
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia
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Li L, Zhang LZ, He ZX, Ma H, Zhang YT, Xun YF, Yuan W, Hou WJ, Li YT, Lv ZJ, Jia R, Tai FD. Dorsal raphe nucleus to anterior cingulate cortex 5-HTergic neural circuit modulates consolation and sociability. eLife 2021; 10:67638. [PMID: 34080539 PMCID: PMC8213405 DOI: 10.7554/elife.67638] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 06/02/2021] [Indexed: 02/06/2023] Open
Abstract
Consolation is a common response to the distress of others in humans and some social animals, but the neural mechanisms underlying this behavior are not well characterized. By using socially monogamous mandarin voles, we found that optogenetic or chemogenetic inhibition of 5-HTergic neurons in the dorsal raphe nucleus (DR) or optogenetic inhibition of serotonin (5-HT) terminals in the anterior cingulate cortex (ACC) significantly decreased allogrooming time in the consolation test and reduced sociability in the three-chamber test. The release of 5-HT within the ACC and the activity of DR neurons were significantly increased during allogrooming, sniffing, and social approaching. Finally, we found that the activation of 5-HT1A receptors in the ACC was sufficient to reverse consolation and sociability deficits induced by the chemogenetic inhibition of 5-HTergic neurons in the DR. Our study provided the first direct evidence that DR-ACC 5-HTergic neural circuit is implicated in consolation-like behaviors and sociability.
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Affiliation(s)
- Laifu Li
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China.,College of Life Sciences, Nanyang Normal University, Nanyang, China
| | - Li-Zi Zhang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Zhi-Xiong He
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Huan Ma
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Yu-Ting Zhang
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Yu-Feng Xun
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Wei Yuan
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China.,Provincial Key Laboratory of Acupuncture and Medications, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Wen-Juan Hou
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Yi-Tong Li
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Zi-Jian Lv
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Rui Jia
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
| | - Fa-Dao Tai
- Institute of Brain and Behavioral Sciences, College of Life Sciences, Shaanxi Normal University, Xi'an, China
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7
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Marazziti D, Avella MT, Ivaldi T, Palermo S, Massa L, Vecchia AD, Basile L, Mucci F. Neuroenhancement: State of the Art and Future Perspectives. CLINICAL NEUROPSYCHIATRY 2021; 18:137-169. [PMID: 34909030 PMCID: PMC8629054 DOI: 10.36131/cnfioritieditore20210303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Pharmacological neuroenhancement refers to the non-medical use of prescription drugs, alcohol, illegal drugs, or the so-called soft enhancers for the purpose of improving cognition, mood, pro-social behavior, or work and academic performance. This phenomenon is undoubtedly more frequent than previously supposed especially amongst university students. The aim of the present paper was to carefully review and comment on the available literature on neuroenhancement, according to Prisma guidelines. The results showed a great use of all prescribed drugs (benzodiazepines, antidepressants, antipsychotics, nootropic compounds, and especially stimulants) as neuroenhancers amongst healthy subjects, although probably the real prevalence is underestimated. The use of illicit drugs and soft enhancers is similarly quite common. Data on the improvement of cognition by other compounds, such as oxytocin and pheromones, or non-pharmacological techniques, specifically deep brain stimulation and transcranial magnetic stimulation, are still limited. In any case, if it is true that human beings are embedded by the desire to overcome the limits of their intrinsic nature, neuroenhancement practices put into question the concept of authenticity. Therefore, the problem appears quite complex and requires to be deepened and analyzed with no prejudice, although within an ethical conceptual frame.
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Affiliation(s)
- Donatella Marazziti
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
- Unicamillus-Saint Camillus International University of Health Sciences, Rome, Italy
| | - Maria Teresa Avella
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Tea Ivaldi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Stefania Palermo
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Lucia Massa
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Alessandra Della Vecchia
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Lucia Basile
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Italy
| | - Federico Mucci
- Department of Biotechnology, Chemistry and Pharmacy, University of Siena, Italy
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Oeri HE. Beyond ecstasy: Alternative entactogens to 3,4-methylenedioxymethamphetamine with potential applications in psychotherapy. J Psychopharmacol 2021; 35:512-536. [PMID: 32909493 PMCID: PMC8155739 DOI: 10.1177/0269881120920420] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The last two decades have seen a revival of interest in the entactogen 3,4-methylenedioxy-N-methylamphetamine (MDMA) as an adjunct to psychotherapy, particularly for the treatment of post-traumatic stress disorder. While clinical results are highly promising, and MDMA is expected to be approved as a treatment in the near future, it is currently the only compound in its class of action that is being actively investigated as a medicine. This lack of alternatives to MDMA may prove detrimental to patients who do not respond well to the particular mechanism of action of MDMA or whose treatment calls for a modification of MDMA's effects. For instance, patients with existing cardiovascular conditions or with a prolonged history of stimulant drug use may not fit into the current model of MDMA-assisted psychotherapy, and could benefit from alternative drugs. This review examines the existing literature on a host of entactogenic drugs, which may prove to be useful alternatives in the future, paying particularly close attention to any neurotoxic risks, neuropharmacological mechanism of action and entactogenic commonalities with MDMA. The substances examined derive from the 1,3-benzodioxole, cathinone, benzofuran, aminoindane, indole and amphetamine classes. Several compounds from these classes are identified as potential alternatives to MDMA.
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Affiliation(s)
- Hans Emanuel Oeri
- Hans Emanuel Oeri, University of Victoria,
3800 Finnerty Rd, Victoria, British Columbia V8P 5C2, Canada.
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9
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Basedow LA, Kuitunen-Paul S, Wiedmann MF, Roessner V, Golub Y. Self-reported PTSD is associated with increased use of MDMA in adolescents with substance use disorders. Eur J Psychotraumatol 2021; 12:1968140. [PMID: 34603636 PMCID: PMC8480619 DOI: 10.1080/20008198.2021.1968140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Adolescent patients with a substance use disorder (SUD) often fulfil the criteria for a co-occurring post-traumatic stress disorder (PTSD). However, it is not clear if these dual-diagnosed adolescents present with unique levels of substance use and how their substance use relates to PTSD symptom clusters. OBJECTIVE To investigate substance use in adolescents with co-occurring PTSD and SUD. Additionally, we explored how the use of specific substances is related to specific PTSD symptom clusters. METHOD We recruited n = 121 German adolescent SUD patients, in three groups: no history of traumatic events (TEs) (n = 35), TEs but not PTSD (n = 48), probable PTSD (n = 38). All groups were administered a trauma questionnaire and were asked to report their past-month substance use. RESULTS Adolescents with probable PTSD and SUD report a higher frequency of MDMA use than adolescents with no PTSD and no TE (PTSD vs. noTE: U = 510.5, p = .016; PTSD vs. TE: U = 710.0, p = .010). The use of MDMA was more frequent in adolescents with avoidance symptoms (X2 (1) = 6.0, p = .014). Participants report using substances at a younger age (PTSD vs. noTE: U = 372.0, p = .001; PTSD vs. TE: U = 653.5, p = .022) and PTSD symptom onset was on average 2.2 years earlier than first MDMA use (t (26) = -2.89, p = .008). CONCLUSIONS Adolescent SUD patients with probable PTSD are more likely to use MDMA than SUD patients without PTSD. The use of MDMA was associated with reported avoidance symptoms. The first age of MDMA use is initiated after PTSD onset. It is unclear whether the association of MDMA use with avoidance symptoms is due to efforts to reduce these symptoms or a result of regular MDMA use.
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Affiliation(s)
- Lukas Andreas Basedow
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Sören Kuitunen-Paul
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Melina Felicitas Wiedmann
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Veit Roessner
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
| | - Yulia Golub
- Department Of Child And Adolescent Psychiatry, Faculty Of Medicine, Technische Universität Dresden, Dresden, Germany
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10
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Crespi BJ. Comparative psychopharmacology of autism and psychotic-affective disorders suggests new targets for treatment. Evol Med Public Health 2019; 2019:149-168. [PMID: 31548888 PMCID: PMC6748779 DOI: 10.1093/emph/eoz022] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 08/07/2019] [Indexed: 12/13/2022] Open
Abstract
The first treatments showing effectiveness for some psychiatric disorders, such as lithium for bipolar disorder and chlorpromazine for schizophrenia, were discovered by accident. Currently, psychiatric drug design is seen as a scientific enterprise, limited though it remains by the complexity of brain development and function. Relatively few novel and effective drugs have, however, been developed for many years. The purpose of this article is to demonstrate how evolutionary biology can provide a useful framework for psychiatric drug development. The framework is based on a diametrical nature of autism, compared with psychotic-affective disorders (mainly schizophrenia, bipolar disorder and depression). This paradigm follows from two inferences: (i) risks and phenotypes of human psychiatric disorders derive from phenotypes that have evolved along the human lineage and (ii) biological variation is bidirectional (e.g. higher vs lower, faster vs slower, etc.), such that dysregulation of psychological traits varies in two opposite ways. In this context, the author review the evidence salient to the hypothesis that autism and psychotic-affective disorders represent diametrical disorders in terms of current, proposed and potential psychopharmacological treatments. Studies of brain-derived neurotrophic factor, the PI3K pathway, the NMDA receptor, kynurenic acid metabolism, agmatine metabolism, levels of the endocannabinoid anandamide, antidepressants, anticonvulsants, antipsychotics, and other treatments, demonstrate evidence of diametric effects in autism spectrum disorders and phenotypes compared with psychotic-affective disorders and phenotypes. These findings yield insights into treatment mechanisms and the development of new pharmacological therapies, as well as providing an explanation for the longstanding puzzle of antagonism between epilepsy and psychosis. Lay Summary: Consideration of autism and schizophrenia as caused by opposite alterations to brain development and function leads to novel suggestions for pharmacological treatments.
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Affiliation(s)
- Bernard J Crespi
- Department of Biological Sciences, Simon Fraser University, 8888 University Drive, Burnaby, BC V5A 1S6, Canada
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11
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Preller KH, Vollenweider FX. Modulation of Social Cognition via Hallucinogens and "Entactogens". Front Psychiatry 2019; 10:881. [PMID: 31849730 PMCID: PMC6902301 DOI: 10.3389/fpsyt.2019.00881] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 11/07/2019] [Indexed: 01/30/2023] Open
Abstract
Social cognition is a fundamental ability in human everyday lives. Deficits in social functioning also represent a core aspect of many psychiatric disorders. Yet, despite its significance, deficits in social cognition skills are insufficiently targeted by current treatments. Hallucinogens and entactogens have been shown to have the potential to modulate social processing. This article reviews the literature on the influence of hallucinogens and entactogens on social processing in controlled experimental studies in humans and elucidates the underlying neurobiological and neuropharmacological mechanisms. Furthermore, it identifies current knowledge gaps and derives implications for hallucinogen-assisted treatment approaches as well as the development of novel medication for trans-diagnostic impairments in social cognition.
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Affiliation(s)
- Katrin H Preller
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
| | - Franz X Vollenweider
- Neuropsychopharmacology and Brain Imaging, Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital for Psychiatry Zurich, Zurich, Switzerland
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