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Byrska B, Stanaszek R. Chemical composition of Ecstasy tablets seized in Poland between 2005 and 2020. Forensic Toxicol 2024:10.1007/s11419-024-00691-3. [PMID: 39017813 DOI: 10.1007/s11419-024-00691-3] [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: 12/11/2023] [Accepted: 05/30/2024] [Indexed: 07/18/2024]
Abstract
PURPOSE The most commonly associated substance found in Ecstasy tablets is MDMA (3,4-methylenedioxymethamphetamine). In our study, we showed how the composition of psychoactive ingredients in Ecstasy tablets seized on the drug market in Poland has changed in the years 2005-2020. METHODS The study material consisted of nearly 20,000 single Ecstasy tablets seized by representatives of law enforcement (the police, prosecutors) from 2005 to 2020 and analysed by the Institute of Forensic Research, Krakow, Poland. The analysis of the tablets was carried out by gas chromatography-mass spectrometry (GC-MS), high-performance liquid chromatography with diode array detection (HPLC-DAD) and ultra-high-performance liquid chromatography with photodiode array detection (UHPLC-PDA). RESULTS Currently, new types of MDMA tablets are introduced onto the market, available in various colours and shapes. Our study showed that tablets sold on the street as Ecstasy have variable purity and sometimes contain little or no MDMA. The mean content of MDMA in one tablet seized in 2005-2011 decreased from 90 to 50 mg. In 2013, Ecstasy tablets with a very high MDMA content (average 195 mg per tablet) appeared on the market, but in the next 2 years, the MDMA content decreased again. From 2016, the average MDMA content began to rise again, ranging from 60 to 280 mg. CONCLUSION Tablets sold as Ecstasy also contained completely different psychoactive substances, including new psychoactive substances (NPS) (found in almost 20% of all examined tablets sold as Ecstasy) belonging to different chemical groups or their dangerous combinations (i.e. phenylethylamines, piperazines, tryptamines, cathinones, arylalkylamines, arylcyclohexylamines and piperidines). Such a large variety of psychoactive substances in Ecstasy tablets is associated with a high risk for users unaware of their composition.
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Affiliation(s)
- Bogumiła Byrska
- Professor Jan Sehn Institute of Forensic Research, Krakow, Poland.
| | - Roman Stanaszek
- Professor Jan Sehn Institute of Forensic Research, Krakow, Poland
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2
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Hachicha I, Lahdhiri MH, Bouraoui R, Matri KE, Trojet S, Chaker N, Limaiem R. Presumed ecstasy-induced peripheral retinal hemorrhage. J Fr Ophtalmol 2024:104165. [PMID: 38580531 DOI: 10.1016/j.jfo.2024.104165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 02/07/2024] [Indexed: 04/07/2024]
Affiliation(s)
- I Hachicha
- Department of ophthalmology B, Institut Hédi-Raies d'ophtalmologie de Tunis, boulevard du 9-Avril 1938, 1006 Tunis, Tunisia; Faculté de médecine de Tunis, université Tunis, El Manar, Tunis, Tunisia.
| | - M H Lahdhiri
- Department of ophthalmology B, Institut Hédi-Raies d'ophtalmologie de Tunis, boulevard du 9-Avril 1938, 1006 Tunis, Tunisia; Faculté de médecine de Tunis, université Tunis, El Manar, Tunis, Tunisia
| | - R Bouraoui
- Department of ophthalmology B, Institut Hédi-Raies d'ophtalmologie de Tunis, boulevard du 9-Avril 1938, 1006 Tunis, Tunisia; Oculogenetic laboratory LR14SP01, Tunis, Tunisia; Faculté de médecine de Tunis, université Tunis, El Manar, Tunis, Tunisia
| | - K El Matri
- Department of ophthalmology B, Institut Hédi-Raies d'ophtalmologie de Tunis, boulevard du 9-Avril 1938, 1006 Tunis, Tunisia; Oculogenetic laboratory LR14SP01, Tunis, Tunisia; Faculté de médecine de Tunis, université Tunis, El Manar, Tunis, Tunisia
| | - S Trojet
- Faculté de médecine de Tunis, université Tunis, El Manar, Tunis, Tunisia
| | - N Chaker
- Department of ophthalmology B, Institut Hédi-Raies d'ophtalmologie de Tunis, boulevard du 9-Avril 1938, 1006 Tunis, Tunisia; Oculogenetic laboratory LR14SP01, Tunis, Tunisia; Faculté de médecine de Tunis, université Tunis, El Manar, Tunis, Tunisia
| | - R Limaiem
- Department of ophthalmology B, Institut Hédi-Raies d'ophtalmologie de Tunis, boulevard du 9-Avril 1938, 1006 Tunis, Tunisia; Oculogenetic laboratory LR14SP01, Tunis, Tunisia; Faculté de médecine de Tunis, université Tunis, El Manar, Tunis, Tunisia
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3
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Alexander-Savino CV, Mirowski GW, Culton DA. Mucocutaneous Manifestations of Recreational Drug Use. Am J Clin Dermatol 2024; 25:281-297. [PMID: 38217568 DOI: 10.1007/s40257-023-00835-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/04/2023] [Indexed: 01/15/2024]
Abstract
Recreational drug use is increasingly common in the dermatology patient population and is often associated with both general and specific mucocutaneous manifestations. Signs of substance use disorder may include changes to general appearance, skin, and mucosal findings associated with particular routes of drug administration (injection, insufflation, or inhalation) or findings specific to a particular drug. In this review article, we provide an overview of the mucocutaneous manifestations of illicit drug use including cocaine, methamphetamine, heroin, hallucinogens, marijuana, and common adulterants to facilitate the identification and improved care of these patients with the goal being to connect this patient population with appropriate resources for treatment.
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Affiliation(s)
- Carolina V Alexander-Savino
- State University of New York Upstate Medical University, Syracuse, NY, USA
- Department of Dermatology, University of North Carolina at Chapel Hill, 410 Market Street, Suite 400, Chapel Hill, NC, 27516, USA
| | - Ginat W Mirowski
- Department of Dermatology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Oral Pathology, Medicine, Radiology, Indiana University School of Dentistry, Indianapolis, IN, USA
| | - Donna A Culton
- Department of Dermatology, University of North Carolina at Chapel Hill, 410 Market Street, Suite 400, Chapel Hill, NC, 27516, USA.
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Makunts T, Dahill D, Jerome L, de Boer A, Abagyan R. Concomitant medications associated with ischemic, hypertensive, and arrhythmic events in MDMA users in FDA adverse event reporting system. Front Psychiatry 2023; 14:1149766. [PMID: 37275981 PMCID: PMC10233020 DOI: 10.3389/fpsyt.2023.1149766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 04/18/2023] [Indexed: 06/07/2023] Open
Abstract
3,4-Methylenedioxymethamphetamine (MDMA) is currently being investigated as an adjunctive treatment to therapy for posttraumatic stress and other anxiety related disorders in clinical trials. Within the next few years MDMA-assisted therapy is projected for approval by regulatory authorities. MDMA's primary mechanism of action includes modulation of monoamine signaling by increasing release and inhibiting reuptake of serotonin, norepinephrine, and, to a lesser extent, dopamine. This pharmacology affects sympathomimetic physiology. In controlled trials, special attention has been given to cardiovascular adverse events (AEs), because transient increases in heart rate and blood pressure have been observed during the MDMA-assisted therapy sessions. Finding and quantifying the potential drivers of cardiac AEs in clinical trials is difficult since only a relatively small number of participants have been included in these studies, and a limited set of allowed concomitant drugs has been studied. In this study a more diverse set of reports from the FDA Adverse Event Reporting System was surveyed. We found 17 cases of cardiovascular AEs, in which the individuals had taken one or more substances in addition to MDMA. Interestingly, all of those concomitant medications and illicit substances, including opioids, stimulants, anticholinergics, and amphetamines, had been previously associated with cardiovascular AEs. Furthermore, in none of the reports MDMA was marked as the primary suspect.
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Affiliation(s)
- Tigran Makunts
- MAPS Public Benefit Corporation, San Jose, CA, United States
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, San Diego, CA, United States
| | - Diane Dahill
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Lisa Jerome
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | | | - Ruben Abagyan
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, San Diego, CA, United States
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5
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Kessler L, Hopkins A, Bahrke J, Kunstman K. An Overview of Adolescent Psychostimulant Use. Pediatr Ann 2023; 52:e170-e177. [PMID: 37159061 DOI: 10.3928/19382359-20230307-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Adolescence marks a period of significant neural maturation and development of lifelong habits, including the potential use of recreational psychostimulant drugs. Increased prevalence of drug adulteration and fatalities related to drug overdose pose new challenges for individuals who use drugs recreationally. As the prevalence of recreational psychostimulant use drastically increases during young adulthood, pediatric and adolescent health care providers can play a crucial role in the lifelong well-being of their patients by identifying those with risk factors for consequences associated with substance use at an early age. This article discusses the epidemiology, pharmacology, clinical manifestations, complications, and common methods of use for three types of psychostimulant drugs-amphetamines, methamphetamine, and 3,4-Methylenedioxymethamphetamine. This article aims to provide pediatric and adolescent health care providers with practical knowledge to effectively perform substance use screening, brief intervention, and referral to treatment with the goal of reducing drug-related morbidity and mortality among the adolescent age group. [Pediatr Ann. 2023;52(5):170-e177.].
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6
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Pierce ZP, Black JM. The Neurophysiology Behind Trauma-Focused Therapy Modalities Used to Treat Post-Traumatic Stress Disorder Across the Life Course: A Systematic Review. TRAUMA, VIOLENCE & ABUSE 2023; 24:1106-1123. [PMID: 34866515 DOI: 10.1177/15248380211048446] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This review presents the current state of understanding of trauma-informed modalities in light of current research in neuroscience, analyzing which brain structures and processes are impacted by these modalities. Studies included in the present review met the inclusion criteria of 1) addressing post-traumatic stress disorder (PTSD) in a specific population, 2) treatment of PTSD using any of the evidence-based trauma-informed modalities considered in this review, and 3) presenting functional magnetic resonance imagery (fMRI) data, derived from BOLD signals and voxel-compression maps, of brain structures impacted by these trauma-informed modalities. Articles for this review were collated through PubMed and MEDLINE, using key terms in descending order, such as 'childhood trauma', 'adolescent trauma', and 'adulthood trauma', to 'PTSD', 'fMRI', and so on, depending on the modality in question. Based on these criteria and research methods, 37 studies remained for inclusion in the present review. Among a number of critical findings, this review demonstrates that eye movement desensitization and reprocessing (EMDR) and mindfulness therapy effectively deactivate hindbrain regions implicated in the downregulation of autonomic nervous system (ANS) hyperarousal. This review also shows that trauma-focused cognitive behavioral therapy (TF-CBT) and EMDR activate the hippocampus, anterior cingulate cortex (ACC), medial prefrontal cortex (mPFC), and orbitofrontal cortex (OFC)-areas that are implicated in crucial cognitive, affective, and behavioral processes that aid trauma survivors in navigating their challenges.
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Affiliation(s)
- Zachary P Pierce
- School of Social Work, 6019Boston College, Chestnut Hill, MA
- The Cell to Society Laboratory, School of Social Work, 6019Boston College, Chestnut Hill, MA
| | - Jessica M Black
- School of Social Work, 6019Boston College, Chestnut Hill, MA
- The Cell to Society Laboratory, School of Social Work, 6019Boston College, Chestnut Hill, MA
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7
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Van Echelpoel R, Parrilla M, Sleegers N, Shanmugam ST, van Nuijs AL, Slosse A, Van Durme F, De Wael K. Validated portable device for the qualitative and quantitative electrochemical detection of MDMA ready for on-site use. Microchem J 2023. [DOI: 10.1016/j.microc.2023.108693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2023]
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8
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Jones G, Lipson J, Wang E. Examining associations between MDMA/ecstasy and classic psychedelic use and impairments in social functioning in a U.S. adult sample. Sci Rep 2023; 13:2466. [PMID: 36774449 PMCID: PMC9922292 DOI: 10.1038/s41598-023-29763-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: 07/29/2022] [Accepted: 02/09/2023] [Indexed: 02/13/2023] Open
Abstract
Impairment in social functioning is a common source of morbidity across many mental health disorders, yet there is a dearth of effective and easily implemented interventions to support social functioning. MDMA/ecstasy and classic psychedelics (psilocybin, LSD, peyote, mescaline) represent two potential treatments for impairments in social functioning, as evidence suggests these compounds may be supportive for alleviating social difficulties. Using a nationally representative sample of U.S. adults from the National Survey on Drug Use and Health (2015-2019) (N = 214,505), we used survey-weighted multivariable ordinal and logistic regression to examine the associations between lifetime use of the aforementioned compounds and impairments in social functioning in the past year. Lifetime MDMA/ecstasy use was associated with lowered odds of three of our four social impairment outcomes: difficulty dealing with strangers (aOR 0.92), difficulty participating in social activities (aOR 0.90), and being prevented from participating in social activities (aOR 0.84). Lifetime mescaline use was also associated with lowered odds of difficulty dealing with strangers (aOR 0.85). All other substances either shared no relationship with impairments in social functioning or conferred increased odds of our outcomes. Future experimental studies can assess whether these relationships are causal.
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Affiliation(s)
- Grant Jones
- Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA, 02138, USA.
| | - Joshua Lipson
- Teachers College, Columbia University, New York, USA
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9
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McGrane IR, Ramsbacher NC, Rook WC, Omar FA. Effects of 3,4-methylenedioxymethamphetamine and methamphetamine on motor vehicle driving performance: A systematic review of experimental and observational studies. J Forensic Sci 2023; 68:22-34. [PMID: 36411495 DOI: 10.1111/1556-4029.15179] [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: 09/07/2022] [Revised: 10/29/2022] [Accepted: 11/15/2022] [Indexed: 11/23/2022]
Abstract
Methamphetamine (METH) and 3,4-methylenedioxymethamphetamine (MDMA) are common drugs of abuse and driving under their influence may occur in 1 million people yearly in the United States. This systematic review fills the currently unmet need in understanding the effects of METH and MDMA on motor vehicle driving performance (MVP) and provides insight into the forensic community. A PubMed search on September 24, 2020, for experimental and observational studies, which evaluated the impact of METH and MDMA on MVP was performed. After a review of 208 abstracts, 103 were considered potentially interesting and full texts were obtained. After the exclusion of non-English articles, review articles, single case reports, and articles which did not evaluate METH or MDMA on MVP, a total of nine experimental studies, 10 traditional observational studies, and 35 case series were included. The clinical rigor of experimental studies was evaluated using the Jadad scale. Experimental studies often demonstrated no significant MVP safety signals for METH or MDMA use, which was contrary to the overwhelming MVP safety risks found in observational studies. Common driving behaviors while using METH or MDMA include: errors in judgment, traveling at high speeds, failure to stop, merging inappropriately, lane weaving, and crashes. Limitations of experimental studies that led to dissimilar MVP outcomes from observational studies include: the common use of driving simulators, as opposed to actual driving examinations, and doses of METH or MDMA administered may not be representative of blood concentrations seen in observational studies. This systematic review has no funding source and was not registered.
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Affiliation(s)
- Ian R McGrane
- Skaggs School of Pharmacy, College of Health, University of Montana, Missoula, Montana, USA.,Department of Pharmacy, Providence St. Patrick Hospital, Missoula, Montana, USA
| | - Nathan C Ramsbacher
- Department of Pharmacy, Providence St. Patrick Hospital, Missoula, Montana, USA
| | - William C Rook
- Department of Pharmacy, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Faddy A Omar
- Department of Pharmacy, Holy Rosary Healthcare, Miles City, Montana, USA
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10
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Lyubomirsky S. Toward a New Science of Psychedelic Social Psychology: The Effects of MDMA (Ecstasy) on Social Connection. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2022; 17:1234-1257. [PMID: 35536567 DOI: 10.1177/17456916211055369] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Psychedelic science has generated hundreds of compelling published studies yet with relatively little impact on mainstream psychology. I propose that social psychologists have much to gain by incorporating psychoactive substances into their research programs. Here I use (±)-3,4-methylenedioxymethamphetamine (MDMA) as an example because of its documented ability in experiments and clinical trials to promote bonding, love, and warmth. Social connection is a fundamental human need, yet researchers still possess few tools to effectively and durably boost it. MDMA allows investigators to isolate the psychological mechanisms-as well as brain pathways-underlying felt social connection and thus reveal what should be targeted in future (nondrug) studies. Accordingly, I introduce a conceptual model that presents the proximal psychological mechanisms stimulated by MDMA (lowered fear, increased sociability, more chemistry), as well as its potential long-term impacts (improved relationships, reduced loneliness, stronger therapeutic alliances). Finally, I discuss further questions (e.g., whether using MDMA for enhancing connection can backfire) and promising research areas for building a new science of psychedelic social psychology. In sum, psychopharmacological methods can be a useful approach to illuminate commonly studied social-psychological processes, such as connectedness, prejudice, or self, as well as inform interventions to directly improve people's lives.
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Pélissier-Alicot AL, Kintz P, Ameline A, Sastre C, Baillif-Couniou V, Leonetti G. Soumission chimique impliquant la MDMA : à propos d’un cas inhabituel. TOXICOLOGIE ANALYTIQUE ET CLINIQUE 2022. [DOI: 10.1016/j.toxac.2022.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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12
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Sottile RJ, Vida T. A proposed mechanism for the MDMA-mediated extinction of traumatic memories in PTSD patients treated with MDMA-assisted therapy. Front Psychiatry 2022; 13:991753. [PMID: 36311515 PMCID: PMC9596814 DOI: 10.3389/fpsyt.2022.991753] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a devastating psychiatric disorder afflicting millions of people around the world. Characterized by severe anxiety, intrusive thoughts, pervasive nightmares, an assortment of somatic symptoms, associations with severe long-term health problems, and an elevated risk of suicide, as much as 40-70% of patients suffer from refractory disease. 3,4-Methylenedioxy-methamphetamine (MDMA), like classic psychedelics such as psilocybin, have been used to enhance the efficacy of psychotherapy almost since their discovery, but due to their perceived potential for abuse and inclusion on USFDA (United States Food and Drug Administration) schedule 1, research into the mechanism by which they produce improvements in PTSD symptomology has been limited. Nevertheless, several compelling rationales have been explored, with the pro-social effects of MDMA thought to enhance therapeutic alliance and thus facilitate therapist-assisted trauma processing. This may be insufficient to fully explain the efficacy of MDMA in the treatment of psychiatric illness. Molecular mechanisms such as the MDMA mediated increase of brain-derived neurotrophic factor (BDNF) availability in the fear memory learning pathways combined with MDMA's pro-social effects may provide a more nuanced explanation for the therapeutic actions of MDMA.
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Affiliation(s)
- Robert J Sottile
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV, United States
| | - Thomas Vida
- Department of Medical Education, Kirk Kerkorian School of Medicine at UNLV, University of Nevada Las Vegas, Las Vegas, NV, United States
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Renzi F, Reitano E, Franca D, Chiara O, Cimbanassi S. Trauma, alcohol and drugs misuse in car and motorcycle drivers: a prevalence study in a level one trauma center. Updates Surg 2021; 74:1129-1136. [PMID: 34515980 PMCID: PMC9213368 DOI: 10.1007/s13304-021-01131-2] [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: 04/21/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
Alcohol and drugs misuse represents an important social problem. There is no agreement about influence of ethanol and drugs on trauma severity and clinical course. The aim of this study was to investigate the impact of alcohol and drugs abuse on road related trauma managed to our Level I Trauma Center. Data of 1067 car or motorcycle drivers consecutively admitted in a 5 years period were retrospectively analyzed. The sample was divided into two groups: patients with alcohol and/or drugs misuse and patients without detectable plasmatic levels or not screened because no clinical suspicion of these substance. Demographic data, mechanism of trauma, severity of injury, daily and season time of trauma distribution, alcohol and drugs levels and outcomes were retrieved. Alcohol or drugs misuse were detected in 242 patients. Heavy alcohols levels were the 62.3%. Among drugs cannabis was the most detected substance. These patients were significantly younger than the overall study population (p = 0.011), with a higher ISS (p = 0.012) a lower RTS (p = 0.047), a lower GCS (p = 0.005) and an higher head injuries severity (p = 0.030). Regarding time distribution, Saturday was the day with the highest percentage of trauma associated with substance misuse (21%). Alcohol/drugs misuse plays a very important role in the epidemiology of road related trauma. Despite the higher severity of trauma scores and the higher incidence of severe head injuries in patients with alcohol or drugs consumption, there were no effects of this substances on mortality of injured patients involved in road crashes.
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Affiliation(s)
- Federica Renzi
- General Surgery and Trauma Team, ASST Niguarda, Piazza Ospedale Maggiore 3Milano, 20162, Milan, Italy
| | - Elisa Reitano
- Division of General Surgery, Department of Translational Medicine, Maggiore Della Carità Hospital, University of Eastern Piedmont, Corso Giuseppe Mazzini 18, Novara, Italy
| | - Davanzo Franca
- Milan Poison Control Centre, ASST Grande Ospedale Metropolitano Niguarda, Piazza dell'Ospedale Maggiore 3, 20162, Milan, Italy
| | - Osvaldo Chiara
- General Surgery and Trauma Team, University of Milan, ASST Niguarda, Piazza Ospedale Maggiore 3Milano, 20162, Milan, Italy.
| | - Stefania Cimbanassi
- General Surgery and Trauma Team, ASST Niguarda, Piazza Ospedale Maggiore 3Milano, 20162, Milan, Italy
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Ecstasy-Induced Malignant Hyperthermia with Fatal Outcome: A Case Report. ACTA MEDICA MARTINIANA 2021. [DOI: 10.2478/acm-2021-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
3,4-methylenedioxymetamphetamine (MDMA), also known as “ecstasy”, “tulips”, or “Molly”, is an increasingly used “recreational drug” particularly among teenagers and young adults along with the widespread conviction that MDMA is a “safe drug”. The reason for this substance being abused is a desire for closeness to other people, develop a greater tolerance of their views and feelings, and even to touch them physically. According to these effects MDMA is classified also as an “empatogenic” or “entactogenic”. Although MDMA is used for the above-mentioned socially acceptable purposes, in many individuals the drug usage is followed with side-effects varying from mild to severe, potentially even life-threatening. One of the most significant complication of MDMA intoxication is hyper-thermia in the consumer. Authors presented a case of MDMA toxicity with severe hyperthermia (42 ºC) with a fatal outcome to the ecstasy-influenced subject. The aim of this article is to describe the effects of ecstasy, the “recreational drug” widely used in local pubs, dance clubs, and during open air festivals, even in the Slovak Republic.
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Jîtcă G, Ősz BE, Tero-Vescan A, Vari CE. Psychoactive Drugs-From Chemical Structure to Oxidative Stress Related to Dopaminergic Neurotransmission. A Review. Antioxidants (Basel) 2021; 10:381. [PMID: 33806320 PMCID: PMC8000782 DOI: 10.3390/antiox10030381] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/24/2021] [Accepted: 03/01/2021] [Indexed: 12/26/2022] Open
Abstract
Nowadays, more and more young people want to experience illegal, psychoactive substances, without knowing the risks of exposure. Besides affecting social life, psychoactive substances also have an important effect on consumer health. We summarized and analyzed the published literature data with reference to the mechanism of free radical generation and the link between chemical structure and oxidative stress related to dopaminergic neurotransmission. This review presents data on the physicochemical properties, on the ability to cross the blood brain barrier, the chemical structure activity relationship (SAR), and possible mechanisms by which neuronal injuries occur due to oxidative stress as a result of drug abuse such as "bath salts", amphetamines, or cocaine. The mechanisms of action of ingested compounds or their metabolites involve intermediate steps in which free radicals are generated. The brain is strongly affected by the consumption of such substances, facilitating the induction of neurodegenerative diseases. It can be concluded that neurotoxicity is associated with drug abuse. Dependence and oxidative stress are linked to inhibition of neurogenesis and the onset of neuronal death. Understanding the pathological mechanisms following oxidative attack can be a starting point in the development of new therapeutic targets.
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Affiliation(s)
- George Jîtcă
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (G.J.); (C.E.V.)
| | - Bianca E. Ősz
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (G.J.); (C.E.V.)
| | - Amelia Tero-Vescan
- Department of Biochemistry, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania;
| | - Camil E. Vari
- Department of Pharmacology and Clinical Pharmacy, Faculty of Pharmacy, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania; (G.J.); (C.E.V.)
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Abstract
Ecstasy use is commonly combined with ethanol consumption. While combination drug use in general is correlated with a higher risk for toxicity, the risk of the specific combination of ecstasy (3,4-methylenedioxymethamphetamine (MDMA)) and ethanol is largely unknown. Therefore, we have reviewed the literature on changes in MDMA pharmacokinetics and pharmacodynamics due to concurrent ethanol exposure in human, animal and in vitro studies. MDMA pharmacokinetics appear unaffected: the MDMA blood concentration after concurrent exposure to MDMA and ethanol was comparable to lone MDMA exposure in multiple human placebo-controlled studies. In contrast, MDMA pharmacodynamics were affected: locomotor activity increased and body temperature decreased after concurrent exposure to MDMA and ethanol compared to lone MDMA exposure. Importantly, these additional ethanol effects were consistently observed in multiple animal studies. Additional ethanol effects have also been reported on other pharmacodynamic aspects, but are inconclusive due to a low number of studies or due to inconsistent findings. These investigated pharmacodynamic aspects include monoamine brain concentrations, neurological (psychomotor function, memory, anxiety, reinforcing properties), cardiovascular, liver and endocrine effects. Although only a single or a few studies were available investigating these aspects, most studies indicated an aggravation of MDMA-induced effects upon concurrent ethanol exposure. In summary, concurrent ethanol exposure appears to increase the risk for MDMA toxicity. Increased toxicity is due to an aggravation of MDMA pharmacodynamics, while MDMA pharmacokinetics is largely unaffected. Although a significant attenuation of the MDMA-induced increase of body temperature was observed in animal studies, its relevance for human exposure remains unclear.
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Affiliation(s)
- Eefje Vercoulen
- Department of Drug Monitoring and Policy, Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands
| | - Laura Hondebrink
- Dutch Poisons Information Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
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17
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Overview of the major classes of new psychoactive substances, psychoactive effects, analytical determination and conformational analysis of selected illegal drugs. OPEN CHEM 2021. [DOI: 10.1515/chem-2021-0196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Abstract
The misuse of psychoactive substances is attracting a great deal of attention from the general public. An increase use of psychoactive substances is observed among young people who do not have enough awareness of the harmful effects of these substances. Easy access to illicit drugs at low cost and lack of effective means of routine screening for new psychoactive substances (NPS) have contributed to the rapid increase in their use. New research and evidence suggest that drug use can cause a variety of adverse psychological and physiological effects on human health (anxiety, panic, paranoia, psychosis, and seizures). We describe different classes of these NPS drugs with emphasis on the methods used to identify them and the identification of their metabolites in biological specimens. This is the first review that thoroughly gives the literature on both natural and synthetic illegal drugs with old known data and very hot new topics and investigations, which enables the researcher to use it as a starting point in the literature exploration and planning of the own research. For the first time, the conformational analysis was done for selected illegal drugs, giving rise to the search of the biologically active conformations both theoretically and using lab experiments.
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18
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Makunts T, Jerome L, Abagyan R, de Boer A. Reported Cases of Serotonin Syndrome in MDMA Users in FAERS Database. Front Psychiatry 2021; 12:824288. [PMID: 35140642 PMCID: PMC8820588 DOI: 10.3389/fpsyt.2021.824288] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 12/28/2021] [Indexed: 11/13/2022] Open
Abstract
3,4-Methylenedioxymethamphetamine (MDMA), is investigated as a treatment for post-traumatic stress disorder and other anxiety-related conditions in multiple placebo-controlled and open label studies. MDMA-assisted therapy is projected for approval by the United States Food and Drug Administration (FDA) and other regulatory agencies worldwide within the next few years. MDMA is a monoamine releaser and uptake inhibitor affecting serotonin, potentially increasing the risk of serotonin syndrome (SS). No instances of SS have occurred in clinical trials. The relatively small number of patients in controlled trials warranted a survey of FDA Adverse Event Reporting System data for the occurrence of SS in a larger database. We found 20 SS cases in people exposed to MDMA, all of which had also taken one or more substances with serotonergic properties in addition to MDMA, including amphetamines, stimulants, and opioids. There were no cases of SS associated with MDMA where MDMA was the sole reported compound taken.
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Affiliation(s)
- Tigran Makunts
- MAPS Public Benefit Corporation, San Jose, CA, United States.,Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, San Diego, CA, United States
| | - Lisa Jerome
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Ruben Abagyan
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego, San Diego, CA, United States
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19
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Đogatović N, Potkonjak E, Račić V, Milićević M, Abdulaj D, Kozomara B. 3,4-methylenedioxymethamphetamine (MDMA)-induced macular haemorrhage: A case report. SCRIPTA MEDICA 2021. [DOI: 10.5937/scriptamed52-27259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
A case of 28-year-old female patient with retinal haemorrhage after taking 3,4-methylenedioxymethamphetamine (ecstasy, MDMA) and having a sexual intercourse is described. Ecstasy is a drug that is often consumed by young people. It leaves various consequences on the human body. Retinal haemorrhage in the eye caused by ecstasy has been described before. Like in this case, the experience in spontaneous resolving of the MDMA-induced retinal haemorrhage is favourable.
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20
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Hossein-Zadeh N, Bagheri M, Abdi Rad I, Lozeie M, Nasir-Zadeh M. Zinc Protects against MDMA-Induced Apoptosis of Sertoli Cells in Mouse via Attenuation of Caspase-3. INTERNATIONAL JOURNAL OF FERTILITY & STERILITY 2020; 14:223-227. [PMID: 33098390 PMCID: PMC7604711 DOI: 10.22074/ijfs.2020.44410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Accepted: 05/26/2020] [Indexed: 11/04/2022]
Abstract
Background 3,4-Methylenedioxymethamphetamine (MDMA) disrupts function of the endocrine system and different organs such as heart, blood vessels, kidney, liver and nervous systems. This revision was conducted to evaluate impact of MDMA on apoptosis and Zinc in the MDMA-induced apoptosis of cultured Sertoli cells by measuring Caspase-3 gene expression. Materials and Methods In this experimental study, Sertoli cells were incubated with MDMA (0, 0.5, 1, 3 and 5 mM), Zinc (0, 8, 16, 32, 64 μM) and Zinc (8 μM) prior to adding MDMA (5 mM) for 24 and 48 hours. MTT assay was used for evaluating impacts of these conditions on the viability of Sertoli cells. Caspase-3 gene expression level was detected using quantitative reverse transcription PCR (qRT-PCR) in all of the tested groups. Results Finding showed that cellular viability was decreased and level of Caspase-3 mRNA was increased in MDMA treated cells. Additionally, pre-treatment with Zinc (8 μM) attenuated MDMA-induced apoptosis and down-regulated caspase-3. The mean of caspase-3 mRNA level (fold change ± SE) was 3.98 ± 1.18, 0.31 ± 0.28, and 1.72 ± 0.28 in respectively MDMA (5 mM), Zinc (8 μM), and Zinc+MDMA groups vs. control group. The mean of Caspase-3 mRNA (fold change) was not statistically different in the tested groups (P>0.05), unless MDMA (5 mM) group (P=0.008). Conclusion We suggest that MDMA toxicity could be involved in apoptosis of Sertoli cells. In addition, Zinc could reduce MDMA-induced apoptosis by down-regulation of Caspase-3 mRNA levels.
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Affiliation(s)
| | - Morteza Bagheri
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran. Electronic Address:
| | - Isa Abdi Rad
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran
| | - Marziyeh Lozeie
- Department of Genetic, Tabriz Branch, Islamic Azad University, Tabriz, Iran
| | - Mahdieh Nasir-Zadeh
- Cellular and Molecular Research Center, Cellular and Molecular Medicine Institute, Urmia University of Medical Sciences, Urmia, Iran
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21
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Noseda R, Schmid Y, Scholz I, Liakoni E, Liechti ME, Dargan PI, Wood DM, Dines AM, Yates C, Heyerdahl F, Hovda KE, Giraudon I, Ceschi A, Anand L, Anseeuw K, Badaras R, Bonnici J, Brvar M, Burke R, Caganova B, Eyer F, Galicia M, Geith S, Gillebeert J, Grenc D, Gorozia K, Jaffal K, Jürgens G, Konstari J, Kutubidze S, Laubner G, Liguts V, Lyphout C, Mégarbane B, Miró Ò, Moughty A, O'Connor N, Paasma R, Perez JO, Perminas M, Persett PS, Põld K, Puiguriguer J, Radenkova-Saeva J, Rulisek J, Sopirala R, Stašinskis R, Surkus J, Toth I, Vallersnes OM, Vigorita F, Waldman W, Waring WS, Zacharov S. MDMA-related presentations to the emergency departments of the European Drug Emergencies Network plus (Euro-DEN Plus) over the four-year period 2014–2017. Clin Toxicol (Phila) 2020; 59:131-137. [DOI: 10.1080/15563650.2020.1784914] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Roberta Noseda
- Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
| | - Yasmin Schmid
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Irene Scholz
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Evangelia Liakoni
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- Institute of Pharmacology, University of Bern, Bern, Switzerland
| | - Matthias E. Liechti
- Division of Clinical Pharmacology and Toxicology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Paul I. Dargan
- Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, UK
- Clinical Toxicology, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - David M. Wood
- Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, UK
- Clinical Toxicology, Faculty of Life Sciences and Medicine, King’s College London, London, UK
| | - Alison M. Dines
- Clinical Toxicology, Guy’s and St Thomas’ NHS Foundation Trust and King’s Health Partners, London, UK
| | - Christopher Yates
- Emergency Department and Clinical Toxicology Unit, Hospital Universitari Son Espases, Mallorca, Spain
| | - Fridtjof Heyerdahl
- Prehospital Division, Oslo University Hospital, Oslo, Norway
- The Norwegian Air Ambulance Foundation, Bodo, Norway
| | - Knut E. Hovda
- The Norwegian CBRNE Centre of Medicine, Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | - Isabelle Giraudon
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Lisbon, Portugal
| | - Alessandro Ceschi
- Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland
- Department of Clinical Pharmacology and Toxicology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Biomedical Sciences, University of Southern Switzerland, Lugano, Switzerland
| | - Lukasz Anand
- Department of Clinical Toxicology, Medical University of Gdansk, Poland
| | - Kurt Anseeuw
- Department of Emergency Medicine, ZNA Stuivenberg, Antwerp, Belgium
| | | | | | - Miran Brvar
- Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Rachel Burke
- Emergency Department, Mater Misericordiae University Hospital, Dublin 7, Republic of Ireland
| | - Blazena Caganova
- National Toxicological Information Centre, University Hospital, Bratislava, Slovakia
| | - Florian Eyer
- Department of Clinical Toxicology, Klinikum Rechts der Isar, Technical University of Munich, Germany
| | | | - Stefanie Geith
- Department of Clinical Toxicology, Klinikum Rechts der Isar, Technical University of Munich, Germany
| | - Johan Gillebeert
- Department of Emergency Medicine, ZNA Stuivenberg, Antwerp, Belgium
| | - Damjan Grenc
- Centre for Clinical Toxicology and Pharmacology, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ketevan Gorozia
- Archangel St. Michael Multiprofile Clinical Hospital, Tbilisi, Georgia
| | - Karim Jaffal
- Department of Medical and Toxicological Critical Care, Lariboisiere Hospital, INSERM UMRS-1144, Paris-Diderot University, Paris, France
| | - Gesche Jürgens
- Zealand University Hospital Roskilde, Clinical Pharmacology Unit, Roskilde, Denmark
| | | | - Soso Kutubidze
- Archangel St. Michael Multiprofile Clinical Hospital, Tbilisi, Georgia
| | - Gabija Laubner
- Republic Vilnius University Hospital, Vilnius, Lithuania
| | | | | | - Bruno Mégarbane
- Department of Medical and Toxicological Critical Care, Lariboisiere Hospital, INSERM UMRS-1144, Paris-Diderot University, Paris, France
| | - Òscar Miró
- Emergency Department, Hospital Clınic, University of Barcelona, Catalonia, Spain
| | - Adrian Moughty
- Emergency Department, Mater Misericordiae University Hospital, Dublin 7, Republic of Ireland
| | - Niall O'Connor
- Department of Emergency Medicine, Our Lady of Lourdes Hospital, Drogheda, County Louth, Republic of Ireland
| | | | - Juan Ortega Perez
- Clinical Toxicology Unit, Emergency Department, Hospital Son Espases, Palma de Mallorca, Balearic Island, Spain
| | - Marius Perminas
- Hospital of Lithuanian University of Health Sciences (LSMU), Kauno klinikos, Kaunus, Lithuania
| | - Per Sverre Persett
- Department of Acute Medicine, Medical Division, Oslo University Hospital, Norway
| | - Kristiina Põld
- Emergency Medicine Department, North-Estonia Medical Centre, Tallinn, Estonia
| | - Jordi Puiguriguer
- Clinical Toxicology Unit, Emergency Department, Hospital Son Espases, Palma de Mallorca, Balearic Island, Spain
| | | | - Jan Rulisek
- Department of Anesthesia and Intensive Care, 1st Faculty of Medicine, Charles University and General University Hospital, U Nemocnice 2, 120 00 Prague 2, Czech Republic
| | - Radhika Sopirala
- Department of Emergency Medicine, Our Lady of Lourdes Hospital, Drogheda, County Louth, Republic of Ireland
| | | | - Jonas Surkus
- Hospital of Lithuanian University of Health Sciences (LSMU), Kauno klinikos, Kaunus, Lithuania
| | | | - Odd Martin Vallersnes
- Department of General Practice, University of Oslo, Oslo, Norway
- Oslo Accident and Emergency Outpatient Clinic, City of Oslo Health Agency, Oslo, Norway
| | | | - Wojciech Waldman
- Department of Clinical Toxicology, Medical University of Gdansk, Poland
- Pomeranian Centre of Toxicology, Gdansk, Poland
| | - W. Stephen Waring
- Acute Medical Unit, York Teaching Hospitals NHS Foundation Trust, York, UK
| | - Sergej Zacharov
- Toxicological Information Centre, Department of Occupational Medicine, 1st Faculty of Medicine, Charles University and General University Hospital, Na Bojisti 1, 120 00 Prague 2, Czech Republic
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22
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Abstract
Objective To investigate the manifestations and incidence of headaches caused by heroin
in Chinese women. Methods This was a survey study conducted from 29 June to 3 July 2015 with women
attending the Shanxi Drug Rehabilitation Centre for Women (China). All study
subjects were newly admitted and had not begun their drug rehabilitation.
Demographic characteristics, heroin usage and headache episodes within the
previous 3 months were surveyed, especially the presence of a headache
within 2 hours of heroin use. Details of the severity, location, premonitory
symptoms and characteristics of headaches were recorded. Results Of the 90 heroin-dependent patients, 74 experienced headache attacks within 2
hours of heroin use, and the headaches subsided within 72 hours of
discontinuation of heroin use. Most heroin-induced headaches were similar to
migraines and manifested as pulsating pain in 54 patients (51/74, 68.9%);
bilateral pain was reported by 46 patients (46/74, 62.2%). Approximately
half of the patients with heroin-induced headaches also reported
accompanying symptoms of nausea, vomiting, and light and sound
sensitivity. Conclusions Heroin-induced headache may eventually be listed as a new class of headache
in the International Classification of Headache Disorders.
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Affiliation(s)
- Li Li
- Department of Neurology, Chinese PLA General Hospital, Beijing, China.,Department of Neurology, Jincheng General Hospital, Jincheng, Shan Xi Province, China
| | - Shengyuan Yu
- Department of Neurology, Chinese PLA General Hospital, Beijing, China
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23
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Cajanding RJM. MDMA-Associated Liver Toxicity: Pathophysiology, Management, and Current State of Knowledge. AACN Adv Crit Care 2020; 30:232-248. [PMID: 31462520 DOI: 10.4037/aacnacc2019852] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
3,4-Methylenedioxymethamphetamine (MDMA, ecstasy) has become a popular recreational drug of abuse among young adults, partly because of the belief that it is relatively safe compared with other drugs with the same stimulant and hallucinogenic effects. However, MDMA use has been associated with a wide spectrum of organ toxicities, with the liver being severely affected by its deleterious effects. This article discusses the essential pharmacology of MDMA and describes the effects MDMA has on various organ systems of the body, with particular focus on the liver. The putative mechanisms by which MDMA can cause liver damage are explored, with emphasis on patient-related factors that explain why some individuals are more susceptible than others to damage from MDMA. The incidence of hepatotoxicity related to MDMA use is presented, and the nursing management of patients who develop acute liver failure due to MDMA overuse is explored in light of current evidence.
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Affiliation(s)
- Ruff Joseph Macale Cajanding
- Ruff Joseph Macale Cajanding is Charge Nurse, Adult Critical Care Unit, 6th Floor, King George V Building, St. Bartholomew's Hospital, Barts Health NHS Trust, 2 King Edward Street, London EC1A 1HQ, United Kingdom
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24
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Bahji A, Forsyth A, Groll D, Hawken ER. Efficacy of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy for posttraumatic stress disorder: A systematic review and meta-analysis. Prog Neuropsychopharmacol Biol Psychiatry 2020; 96:109735. [PMID: 31437480 DOI: 10.1016/j.pnpbp.2019.109735] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 06/27/2019] [Accepted: 08/10/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) is a common psychiatric condition that can develop following a traumatic experience. PTSD is associated with significant disability, a large economic burden, and despite the range of therapies to treat PTSD, response to antidepressants is limited. A growing body of clinical research suggests the efficacy of 3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy in individuals with treatment-refractory PTSD. AIM To assess the effectiveness and safety of MDMA-assisted psychotherapy for reducing symptoms of PTSD, a systematic review and meta-analysis was undertaken. METHODS Six online databases were searched from inception to December 2018. Reference lists of relevant articles were manually searched as well as electronic sources of ongoing trials and conference proceedings. Researchers active in the subject were also contacted. Eligible studies included randomized and quasi-randomized clinical trials using MDMA-assisted psychotherapy for PTSD in comparison with other medications, placebo or no medication (supportive care). We used standard methodological procedures expected by the Cochrane Collaboration. Two authors assessed studies for inclusion and extracted data. Using random-effects meta-analysis with Cochrane's Review Manager 5.3, we obtained standardized mean differences [SMD] and rate ratios [RR] for reduction in PTSD symptomatology. RESULTS A total of 5 trials met inclusion criteria, totaling 106 participants (average age: 35-40 years, 70% female). Studies were rated as moderate in quality. MDMA-assisted psychotherapy demonstrated a high rate of clinical response (RR = 3.47, 95% CI: 1.70, 7.06), remission (RR = 2.63, 95% CI: 1.37, 5.02), with a large effect size at reducing the symptoms of PTSD (SMD = 1.30, 95% CI: 0.66, 1.94). Available evidence indicates that MDMA was well-tolerated, with few serious adverse events reported across studies. CONCLUSIONS MDMA-assisted psychotherapy appears to be a potentially safe, effective, and durable treatment for individuals with chronic, treatment-refractory PTSD. However, future studies involving larger samples and longer durations of treatment and follow-up are warranted-and underway.
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Affiliation(s)
- Anees Bahji
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
| | - Ashleigh Forsyth
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Providence Care Hospital, Kingston, Ontario, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Emily R Hawken
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada; Providence Care Hospital, Kingston, Ontario, Canada
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25
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Liang Q, Yuan T, Cao X, He H, Yang J, Yuan J. Assessing the severity of methamphetamine use disorder beyond the subjective craving report: the role of an attention bias test. Gen Psychiatr 2019; 32:e100019. [PMID: 31179431 PMCID: PMC6551440 DOI: 10.1136/gpsych-2018-100019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/20/2018] [Accepted: 12/24/2018] [Indexed: 12/03/2022] Open
Abstract
Background Methamphetamine (MA) is one of the most commonly abused illicit psychostimulant drugs and MA use disorder constitutes a universal health concern across the world. Despite many intervention approaches to MA use disorder, the indicator of addiction severity is mainly limited to subjective craving score to drug-related cues, which is influenced by many factors such as social approval and self-masking. Aim The present study investigates whether self-reported craving for drug use in response to MA cues is a reliable indicator for addiction severity in MA users, and then tests the validity of the cue-induced attention bias test in addiction severity assessment. Methods Fifty-two male MA users completed the cue-induced craving test and attention bias task, and were required to report clinical characteristics of addiction severity. For the attention bias test, subjects were required to discriminate the letter superimposed onto MA use-related or neutral scenes. The reaction time delay during MA-use condition relative to neutral condition was used as an index of the attention bias. Results The results showed that 24 of the 52 MA users rated non-zero in cue-induced craving test, and they showed a significant attention bias to drug-related pictures. However, the other 28 users who rated zero in cue-induced craving evaluation showed a similar attention bias to drug-related cues. In addition, the attention bias to MA use-related cues was significantly and positively correlated with the clinical indexes of addiction severity, but the relationship was absent between subjective craving evaluation and the indexes of addiction severity. Conclusion These results suggest that attention bias to MA cues may be a more reliable indicator than experiential craving report, especially when subjective craving is measured in the compulsory rehabilitation centre.
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Affiliation(s)
- Qiongdan Liang
- The Laboratory for Affect Cognition and Regulation (ACRLab), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China.,Department of Psychology, Tsinghua University, Beijing, China
| | - Tifei Yuan
- Shanghai Mental Health Center, Shanghai Jiaotong University, Shanghai, China
| | - Xinyu Cao
- Da Lian Shan Institute of Addiction Rehabilitation, Nanjing, China
| | - Hao He
- Da Lian Shan Institute of Addiction Rehabilitation, Nanjing, China
| | - Jiemin Yang
- The Laboratory for Affect Cognition and Regulation (ACRLab), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China
| | - Jiajin Yuan
- The Laboratory for Affect Cognition and Regulation (ACRLab), Key Laboratory of Cognition and Personality of Ministry of Education (SWU), Faculty of Psychology, Southwest University, Chongqing, China
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26
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MDMA alone affects sensorimotor and prepulse inhibition responses in mice and rats: tips in the debate on potential MDMA unsafety in human activity. Forensic Toxicol 2018. [DOI: 10.1007/s11419-018-0444-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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27
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Janušonis S, Detering N. A stochastic approach to serotonergic fibers in mental disorders. Biochimie 2018; 161:15-22. [PMID: 30056260 DOI: 10.1016/j.biochi.2018.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 07/24/2018] [Indexed: 01/09/2023]
Abstract
Virtually all brain circuits are physically embedded in a three-dimensional matrix of fibers that release 5-hydroxytryptamine (5-HT, serotonin). The density of this matrix varies across brain regions and cortical laminae, and it is altered in some mental disorders, including Major Depressive Disorder and Autism Spectrum Disorder. We investigate how the regional structure of the serotonergic matrix depends on the stochastic behavior of individual serotonergic fibers and introduce a new framework for the quantitative analysis of this behavior. In particular, we show that a step-wise random walk, based on the von Mises-Fisher probability distribution, can provide a realistic and mathematically concise description of these fibers. We also consider other stochastic models, including the fractional Brownian motion. The proposed approach seeks to advance the current understanding of the ascending reticular activating system (ARAS) and may also support future theory-guided therapeutic approaches.
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Affiliation(s)
- Skirmantas Janušonis
- Department of Psychological and Brain Sciences, University of California, Santa Barbara, CA, 93106-9660, USA.
| | - Nils Detering
- Department of Statistics and Applied Probability, University of California, Santa Barbara, CA, 93106-3110, USA
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28
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Liang Q, Lin J, Yang J, Li X, Chen Y, Meng X, Yuan J. Intervention Effect of Repetitive TMS on Behavioral Adjustment After Error Commission in Long-Term Methamphetamine Addicts: Evidence From a Two-Choice Oddball Task. Neurosci Bull 2018; 34:449-456. [PMID: 29340869 PMCID: PMC5960444 DOI: 10.1007/s12264-018-0205-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 10/27/2017] [Indexed: 01/09/2023] Open
Abstract
Behavioral adjustment plays an important role in the treatment and relapse of drug addiction. Nonetheless, few studies have examined behavioral adjustment and its plasticity following error commission in methamphetamine (METH) dependence, which is detrimental to human health. Thus, we investigated the behavioral adjustment performance following error commission in long-term METH addicts and how it varied with the application of repetitive transcranial magnetic stimulation (rTMS) of the left dorsolateral prefrontal cortex (DLPFC). Twenty-nine male long-term METH addicts (for > 3 years) were randomly assigned to high-frequency (10 Hz, n = 15) or sham (n = 14) rTMS of the left DLPFC during a two-choice oddball task. Twenty-six age-matched, healthy male adults participated in the two-choice oddball task pretest to establish normal performance for comparison. The results showed that 10 Hz rTMS over the left DLPFC significantly decreased the post-error slowing effect in response times of METH addicts. In addition, the 10 Hz rTMS intervention remarkably reduced the reaction times during post-error trials but not post-correct trials. While the 10 Hz rTMS group showed a more pronounced post-error slowing effect than the healthy participants during the pretest, the post-error slowing effect in the posttest of this sample was similar to that in the healthy participants. These results suggest that high-frequency rTMS over the left DLPFC is a useful protocol for the improvement of behavioral adjustment after error commission in long-term METH addicts.
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Affiliation(s)
- Qiongdan Liang
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Jia Lin
- Da Lian Shan Institute of Addiction Rehabilitation, Nanjing, China
| | - Jiemin Yang
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | - Xiang Li
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China
| | | | - Xianxin Meng
- School of Education, Nanyang Normal University, Nanyang, China
| | - Jiajin Yuan
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, 400715, China.
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Abstract
Sociologists and political scientists examining the social construction of public anxiety surrounding drug use in the United States have argued that racial minorities are the targets of the harshest drug laws while middle-class whites are shielded. In this article, I provide further evidence that middle-class, white drug users are shielded from harsh punishment by analyzing the process through which U.S. legislators and policy makers decide which drug users need punishment and which deserve protection and treatment. Analyzing transcripts from federal Congressional hearings, I examine the rhetoric of legislators and stakeholder witnesses concerning the use of 3,4-methylenedioxymethamphetamine (MDMA) by middle-class whites. Building on the social construction literature, I use social identity theory to demonstrate how legislators within Congressional hearings create in- and out-groups in order to categorize different drug users and dealers. My analysis of Congressional hearing language concerning white MDMA use demonstrates that Congressional speakers use rhetoric to convince committee members and the wider public that middle-class, white drug users are different from drug users of color and that the appropriate policy response is education and treatment rather than punishment. My findings highlight how middle-class, white drug users are characterized differently from drug users of color, providing further evidence that U.S. drug policy has historically favored middle-class, white drug users.
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Abstract
BACKGROUND Ecstasy is a widely used psychoactive drug that users often take because they experience positive effects such as increased euphoria, sociability, elevated mood, and heightened sensations. Ecstasy use is not harmless and several immediate and long term side effects have been identified. Lifetime ecstasy use is likely to be partly influenced by genetic factors, but no twin study has determined the heritability. Here, we apply a classical twin design to a large sample of twins and siblings to estimate the heritability of lifetime ecstasy use. METHODS The sample comprised 8500 twins and siblings aged between 18 and 45 years from 5402 families registered at the Netherlands Twin Registry. In 2013-2014 participants filled out a questionnaire including a question whether they had ever used ecstasy. We used the classical twin design to partition the individual differences in liability to ecstasy use into that due to genetic, shared environmental, and residual components. RESULTS Overall, 10.4% of the sample had used ecstasy during their lifetime, with a somewhat higher prevalence in males than females. Twin modelling indicated that individual differences in liability to lifetime ecstasy use are for 74% due to genetic differences between individuals, whereas shared environmental and residual factors explain a small proportion of its liability (5% and 21%, respectively). Although heritability estimates appeared to be higher for females than males, this difference was not significant. CONCLUSIONS Lifetime ecstasy use is a highly heritable trait, which indicates that some people are genetically more vulnerable to start using ecstasy than others.
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Cadoni C, Pisanu A, Simola N, Frau L, Porceddu PF, Corongiu S, Dessì C, Sil A, Plumitallo A, Wardas J, Di Chiara G. Widespread reduction of dopamine cell bodies and terminals in adult rats exposed to a low dose regimen of MDMA during adolescence. Neuropharmacology 2017; 123:385-394. [DOI: 10.1016/j.neuropharm.2017.06.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 06/01/2017] [Accepted: 06/07/2017] [Indexed: 11/16/2022]
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Duman B, Sedes N, Baskak B. Additive Effects of Former Methylenedioxymethamphetamine and Cannabis Use on Subclinical Psychotic Symptoms. Noro Psikiyatr Ars 2017; 54:38-42. [PMID: 28566957 DOI: 10.5152/npa.2017.16964] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 04/15/2016] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Methylenedioxymethamphetamine (MDMA) is an amphetamine-derived psychostimulant, usually known as "ecstasy." The long-term neuropsychological effects of MDMA are examined in several studies with conflicting results. The most common findings reported are depression, anxiety, and memory and attention deficits. In addition to acute psychotic reactions observed after MDMA use, serotonergic and dopaminergic toxicities may increase the psychosis risk in the long-term. Cannabis usage among MDMA users is very high. The aim of this study was, therefore, to examine the additive effects of cannabis and MDMA on subclinical psychotic symptoms (SPS). METHODS Here, 131 healthy controls (hC), 54 former cannabis and MDMA users (C&M), and 46 former cannabis users (C) were evaluated for SPS. The definition of former user was based on the Munich Composite International Diagnostic Interview. The SPS scores were assessed by using the Schizotypal Personality Questionnaire (SPQ). The relationship between substance-free periods and total MDMA exposure with SPS was also examined. RESULTS The C&M group had higher levels of SPS than both C and hC groups. This is true not only for the total SPQ scores but both positive and negative schizotypy scores as well as cognitive-perceptual, disorganized, and interpersonal schizotypy scores aligned hierarchically in the 3 study groups (C&M>C>hC). The total MDMA exposure was positively correlated and MDMA-free period was negatively correlated with the SPS score. CONCLUSION We found that the former use of cannabis and MDMA is associated with marked elevation in SPS. Moreover, the exposure amount of MDMA and MDMA-free periods are important determinants of SPS. The longer the cannabis and ecstasy free periods, the larger is the waning of SPS.
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Affiliation(s)
- Berker Duman
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Nilay Sedes
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
| | - Bora Baskak
- Department of Psychiatry, Ankara University School of Medicine, Ankara, Turkey
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Lozano-Torres B, Pascual L, Bernardos A, Marcos MD, Jeppesen JO, Salinas Y, Martínez-Máñez R, Sancenón F. Pseudorotaxane capped mesoporous silica nanoparticles for 3,4-methylenedioxymethamphetamine (MDMA) detection in water. Chem Commun (Camb) 2017; 53:3559-3562. [DOI: 10.1039/c7cc00186j] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
MDMA, a principal ecstasy component, is detected by using pseudorotaxane-capped mesoporous silica nanoparticles.
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Affiliation(s)
- Beatriz Lozano-Torres
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM). Universitat Politécnica de Valencia
- Universitat de Valencia
- Spain
- Departamento de Química
- Universidad Politécnica de Valencia
| | - Lluís Pascual
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM). Universitat Politécnica de Valencia
- Universitat de Valencia
- Spain
- Departamento de Química
- Universidad Politécnica de Valencia
| | - Andrea Bernardos
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM). Universitat Politécnica de Valencia
- Universitat de Valencia
- Spain
- Departamento de Química
- Universidad Politécnica de Valencia
| | - María D. Marcos
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM). Universitat Politécnica de Valencia
- Universitat de Valencia
- Spain
- Departamento de Química
- Universidad Politécnica de Valencia
| | - Jan O. Jeppesen
- Department of Physics
- Chemistry
- and Pharmacy
- University of Southern Denmark
- Odense M
| | - Yolanda Salinas
- Institute of Polymer Chemistry (ICP)
- Johannes Kepler University Linz
- 4040 Linz
- Austria
| | - Ramón Martínez-Máñez
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM). Universitat Politécnica de Valencia
- Universitat de Valencia
- Spain
- Departamento de Química
- Universidad Politécnica de Valencia
| | - Félix Sancenón
- Instituto Interuniversitario de Investigación de Reconocimiento Molecular y Desarrollo Tecnológico (IDM). Universitat Politécnica de Valencia
- Universitat de Valencia
- Spain
- Departamento de Química
- Universidad Politécnica de Valencia
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Abstract
Classic hallucinogens share pharmacology as serotonin 5-HT2A, 5-HT2B, and 5-HT2C receptor agonists. Unique among most other Schedule 1 drugs, they are generally non-addictive and can be effective tools in the treatment of addiction. Mechanisms underlying these attributes are largely unknown. However, many preclinical studies show that 5-HT2C agonists counteract the addictive effects of drugs from several classes, suggesting this pharmacological property of classic hallucinogens may be significant. Drawing from a comprehensive analysis of preclinical behavior, neuroanatomy, and neurochemistry studies, this review builds rationale for this hypothesis, and also proposes a testable, neurobiological framework. 5-HT2C agonists work, in part, by modulating dopamine neuron activity in the ventral tegmental area-nucleus accumbens (NAc) reward pathway. We argue that activation of 5-HT2C receptors on NAc shell, GABAergic, medium spiny neurons inhibits potassium Kv1.x channels, thereby enhancing inhibitory activity via intrinsic mechanisms. Together with experiments that show that addictive drugs, such as cocaine, potentiate Kv1.x channels, thereby suppressing NAc shell GABAergic activity, this hypothesis provides a mechanism by which classic hallucinogen-mediated stimulation of 5-HT2C receptors could thwart addiction. It also provides a potential reason for the non-addictive nature of classic hallucinogens.
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Affiliation(s)
- Clinton E Canal
- Center for Drug Discovery, Department of Pharmaceutical Sciences, Northeastern University, Boston, USA
| | - Kevin S Murnane
- Department of Pharmaceutical Sciences, Mercer University College of Pharmacy, Mercer University Health Sciences Center, Atlanta, USA
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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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Spadari M, Batisse A, Guerlais M, Boucher A, Daveluy A, Le Boisselier R, Gibaja V, Eiden C, Lepelley M, Roussin A, Deheul S, Frauger E, Debruyne D. Les aspects actuels de l’usage de l’ecstasy/MDMA en France. Therapie 2016; 71:553-562. [DOI: 10.1016/j.therap.2016.05.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/02/2016] [Indexed: 10/21/2022]
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Betzler F, Viohl L, Romanczuk-Seiferth N. Decision-making in chronic ecstasy users: a systematic review. Eur J Neurosci 2016; 45:34-44. [PMID: 27859780 DOI: 10.1111/ejn.13480] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 11/09/2016] [Accepted: 11/10/2016] [Indexed: 11/30/2022]
Abstract
Different cognitive impairments have been reported as a result of long-term MDMA/ecstasy use. Increased impulsivity and altered decision-making have been shown to be associated with the development and maintenance of addictive disorders pointing toward the necessity to understand a potential impairment of decision-making due to MDMA use. Thus, assessing the long-term effects of MDMA is crucial in order to evaluate its controversially discussed therapeutic use. The aim of this systematic review was to summarize the scientific literature on potential effects of chronic MDMA use on higher order decision-making processes in humans. Therefore, a systematic search for controlled trials relevant to the topic has been performed. Only studies using specific tasks on decision-making were included that involved subjects in the drug-free interval with drug-naïve, and/or polydrug control groups. A total of 12 studies could be identified that met the inclusion criteria, all of which were cross-sectional studies. The findings on decision-making disturbances in MDMA users were heterogeneous. Seven studies reported increased risky decisions, whereas five studies did not find MDMA-specific influences on decision-making. Increased impulsivity was observed both in MDMA groups and in (poly)drug control groups in almost all studies. Thus, the current state of research does not allow for the conclusion that long-term use of MDMA affects decision-making behavior in general. More detailed specifications as well as further investigations of the relevant processes are needed. Significant tendencies toward risky decision-making among long-term MDMA use have been observed, but need to be confirmed by studies using a longitudinal design.
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Affiliation(s)
- Felix Betzler
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Leonard Viohl
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
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Luo M, Li Y, Zhong W. Do dorsal raphe 5-HT neurons encode “beneficialness”? Neurobiol Learn Mem 2016; 135:40-49. [DOI: 10.1016/j.nlm.2016.08.008] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/15/2016] [Accepted: 08/17/2016] [Indexed: 10/21/2022]
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Jeanne G, Purper-Ouakil D, Rigole H, Franc N. [New patterns of substance use and abuse among French adolescents, a knowledge synthesis]. Encephale 2016; 43:346-353. [PMID: 27720453 DOI: 10.1016/j.encep.2016.05.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 05/23/2016] [Accepted: 05/25/2016] [Indexed: 10/20/2022]
Abstract
AIM There have been significant changes in adolescent consumption habits over the past fifteen years. New molecules have been synthesized, new devices created and a number of products have increased in popularity; and as a result clinicians sometimes lack information. We chose to focus on this population because of its vulnerability, as adolescents show low sensitivity to long-term outcomes of their actions and may be easily influenced by peers as regards experimentation of new drugs. The most consumed products by adolescents in France are tobacco, alcohol and cannabis with the physiological effects and consumption patterns of these drugs well documented. The purpose of this review is to identify and describe other products that are frequently used by adolescents to get high, to increase performance, for purposes of self-medication or because of peer pressure. We summarized the current scientific evidence regarding drug availability, physical and chemical properties, pharmacodynamics and adverse effects. METHOD A literature review was conducted from 2000 to 2015 based on Pudmed, Google Scholar and governmental websites, using the following keyword alone or in combination: "adolescent", "new", "misuse", "abuse", "toxicity", "pharmacology" "cocaine", "MDMA", "inhalant", "poppers", "magic mushroom", "psilocybin", "designer drug", "legal high", "smart drug", "cathinone", "mephedrone", "cannabinoid", "prescription drug", "codeine", "opioid", "methylphenidate", "cough syrup", "purple drank". RESULTS New products, including synthetic cannabis, cathinone or purple drank seem to be the most dangerous. They are easily accessible and may lead to short-term severe or lethal complications. Other substances do not pose a major short-term health risk by themselves. However, their consumption may be an indication of other unhealthy risk behaviors, such as prescription drug use, which may be related to psychiatric comorbidity. Unfortunately, we do not have enough data to determine the long-term consequences of the use of these substances. Moreover, these products have a strong addictive potential and may be a risk factor for other addictions. For this reason, increased supervision is justified, both for surveillance and reduction of harm. CONCLUSION Taking care of an adolescent with substance abuse can be difficult. Updated information regarding these new substances and the particular danger they pose to adolescent health is needed. Informed clinicians can provide up to date and accurate information to the patient and family, assess potential risk factors and comorbidities, and provide appropriate support. Furthermore, because of the high prevalence of substance abuse in the adolescent population, systematic screening of adolescent consumption habit is useful to avoid or anticipate complications. Often, problematic substance consumption behaviors are signs of more complicated psychological or psychiatric issues. Substance abuse behaviors will often disappear over time but they can also become a major problem as the adolescent moves into adulthood. If problems persist, consultation with an addiction specialist may be warranted.
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Affiliation(s)
- G Jeanne
- Service de médecine psychologique pour l'enfant et l'adolescent (MPEA), CHU Saint-Éloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France.
| | - D Purper-Ouakil
- Service de médecine psychologique pour l'enfant et l'adolescent (MPEA), CHU Saint-Éloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - H Rigole
- Service de médecine interne et addictologie, CHU Saint-Éloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France
| | - N Franc
- Service de médecine psychologique pour l'enfant et l'adolescent (MPEA), CHU Saint-Éloi, 80, avenue Augustin-Fliche, 34090 Montpellier, France.
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Kuiper M, Hendrikx S, Koehler PJ. Headache and Tremor: Co-occurrences and Possible Associations. Tremor Other Hyperkinet Mov (N Y) 2015; 5:285. [PMID: 26175954 PMCID: PMC4472994 DOI: 10.7916/d8p55mkx] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Accepted: 05/12/2015] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Tremor and headache are two of the most prevalent neurological conditions. This review addresses possible associations between various types of tremor and headache, and provides a differential diagnosis for patients presenting with both tremor and headache. METHODS Data were identified by searching MEDLINE in February 2015, with the terms "tremor" and terms representing the primary headache syndromes. RESULTS Evidence for an association between migraine and essential tremor is conflicting. Other primary headaches are not associated with tremor. Conditions that may present with both tremor and headache include cervical dystonia, infectious diseases, hydrocephalus, spontaneous cerebrospinal fluid leaks, space-occupying lesions, and metabolic disease. Furthermore, both can be seen as a side effect of medication and in the use of recreational drugs. DISCUSSION No clear association between primary headaches and tremor has been found. Many conditions may feature both headache and tremor, but rarely as core clinical symptoms at presentation.
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Shelton CP, Rosini JM. Multisystem Organ Failure and Death Resulting From Ingestion of "Molly" (3,4-Methylenedioxymethamphetamine). J Emerg Nurs 2015; 41:447-50. [PMID: 26078261 DOI: 10.1016/j.jen.2015.05.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Gage SH, Hickman M, Heron J, Munafò MR, Lewis G, Macleod J, Zammit S. Associations of cannabis and cigarette use with depression and anxiety at age 18: findings from the Avon Longitudinal Study of Parents and Children. PLoS One 2015; 10:e0122896. [PMID: 25875443 PMCID: PMC4395304 DOI: 10.1371/journal.pone.0122896] [Citation(s) in RCA: 61] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 02/24/2015] [Indexed: 01/17/2023] Open
Abstract
Introduction Substance use is associated with common mental health disorders, but the causal effect of specific substances is uncertain. We investigate whether adolescent cannabis and cigarette use is associated with incident depression and anxiety, while attempting to account for confounding and reverse causation. Methods We used data from ALSPAC, a UK birth cohort study, to investigate associations between cannabis or cigarettes (measured at age 16) and depression or anxiety (measured at age 18), before and after adjustment for pre-birth, childhood and adolescent confounders. Our imputed sample size was 4561 participants. Results Both cannabis (unadjusted OR 1.50, 95% CI 1.26, 1.80) and cigarette use (OR 1.37, 95% CI 1.16, 1.61) increased the odds of developing depression. Adjustment for pre-birth and childhood confounders partly attenuated these relationships though strong evidence of association persisted for cannabis use. There was weak evidence of association for cannabis (fully adjusted OR 1.30, 95% CI 0.98, 1.72) and insufficient evidence for association for cigarette use (fully adjusted OR = 0.97, 95% CI 0.75, 1.24) after mutually adjusting for each other, or for alcohol or other substance use. Neither cannabis nor cigarette use were associated with anxiety after adjustment for pre-birth and childhood confounders. Conclusions Whilst evidence of association between cannabis use and depression persisted after adjusting for pre-term and childhood confounders, our results highlight the difficulties in trying to estimate and interpret independent effects of cannabis and tobacco on psychopathology. Complementary methods are required to robustly examine effects of cannabis and tobacco on psychopathology.
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Affiliation(s)
- Suzanne H. Gage
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- United Kingdom Centre for Tobacco Control Studies, University of Bristol, Bristol, United Kingdom
- * E-mail:
| | - Matthew Hickman
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Jon Heron
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Marcus R. Munafò
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom
- United Kingdom Centre for Tobacco Control Studies, University of Bristol, Bristol, United Kingdom
| | - Glyn Lewis
- Mental Health Sciences Unit, University College London, London, United Kingdom
| | - John Macleod
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
| | - Stanley Zammit
- School of Social and Community Medicine, University of Bristol, Bristol, United Kingdom
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, United Kingdom
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