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Wall MB, Harding R, Ertl N, Barba T, Zafar R, Sweeney M, Nutt DJ, Rabiner EA, Erritzoe D. Neuroimaging and the Investigation of Drug-Drug Interactions Involving Psychedelics. Neurosci Insights 2024; 19:26331055241286518. [PMID: 39386147 PMCID: PMC11462571 DOI: 10.1177/26331055241286518] [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: 05/18/2024] [Accepted: 09/09/2024] [Indexed: 10/12/2024] Open
Abstract
Psychedelic therapies are an emerging class of treatments in psychiatry with great potential, however relatively little is known about their interactions with other commonly used psychiatric medications. As psychedelic therapies become more widespread and move closer to the clinic, they likely will need to be integrated into existing treatment models which may include one or more traditional pharmacological therapies, meaning an awareness of potential drug-drug interactions will become vital. This commentary outlines some of the issues surrounding the study of drug-drug interactions of this type, provides a summary of some of the relevant key results to date, and charts a way forward which relies crucially on multimodal neuroimaging investigations. Studies in humans which combine Positron Emission Tomography (PET) and functional Magnetic Resonance Imaging (fMRI), plus ancillary measures, are likely to provide the most comprehensive assessment of drug-drug interactions involving psychedelics and the relevant effects at multiple levels of the drug response (molecular, functional, and clinical).
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Affiliation(s)
- Matthew B Wall
- Invicro, London, UK
- Faculty of Medicine, Imperial College London, London UK
- Centre for Psychedelic research and Neuropsychopharmacology, Imperial College London, UK
| | - Rebecca Harding
- Clinical Psychopharmacology Unit, Faculty of Brain Sciences, University College London, UK
| | - Natalie Ertl
- Invicro, London, UK
- Centre for Psychedelic research and Neuropsychopharmacology, Imperial College London, UK
| | - Tommaso Barba
- Centre for Psychedelic research and Neuropsychopharmacology, Imperial College London, UK
| | - Rayyan Zafar
- Faculty of Medicine, Imperial College London, London UK
- Centre for Psychedelic research and Neuropsychopharmacology, Imperial College London, UK
| | - Mark Sweeney
- Faculty of Medicine, Imperial College London, London UK
- Centre for Psychedelic research and Neuropsychopharmacology, Imperial College London, UK
| | - David J Nutt
- Faculty of Medicine, Imperial College London, London UK
- Centre for Psychedelic research and Neuropsychopharmacology, Imperial College London, UK
| | | | - David Erritzoe
- Faculty of Medicine, Imperial College London, London UK
- Centre for Psychedelic research and Neuropsychopharmacology, Imperial College London, UK
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Ferri BG, de Novais CO, Rojas VCT, Estevam ES, Dos Santos GJM, Cardoso RR, Nogueira ESC, Oliveira PF, de Barros WA, de Fátima Â, Vilela Giusti FC, Giusti-Paiva A. Psychedelic 25H-NBOMe attenuates post-sepsis depression in rats. Neurosci Lett 2024; 834:137845. [PMID: 38821202 DOI: 10.1016/j.neulet.2024.137845] [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: 04/09/2024] [Revised: 05/11/2024] [Accepted: 05/28/2024] [Indexed: 06/02/2024]
Abstract
Sepsis-associated encephalopathy, which manifests in severe cognitive and depressive symptoms, is directly linked to neuroinflammation. Our study investigates the efficacy of 25H-NBOMe, a phenethylamine, in alleviating these symptoms, potentially offering an innovative treatment for post-sepsis depression. Wistar rats, weighing between 250-300 g, were subjected to cecal ligation and puncture (CLP) surgery to induce sepsis. Depressive-like behaviors were assessed using the forced swim test (FST) on either day 7 or 14 post-surgery, to establish the presence of depressive symptoms. The impact of 25H-NBOMe treatment was then evaluated, focusing on the head-twitch response (HTR), performance in the FST, and GFAP expression in the prefrontal cortex. Treatment with 25H-NBOMe resulted in significant behavioral changes, demonstrated by decreased immobility and increased swimming times in the FST, along with a rise in the HTR. These outcomes indicate a reduction in depressive-like symptoms post-sepsis and the psychoactive effects of the compound. Furthermore, a notable decrease in GFAP expression in the study highlights the compound's impact on mitigating sepsis-induced astrogliosis. This study demonstrates the effectiveness of 25H-NBOMe, a psychedelic in the phenethylamine class, in treating post-sepsis depression and reducing astrogliosis. However, the psychedelic nature of 25H-NBOMe calls for further investigation into similar compounds with less psychoactive impact, crucial for advancing treatment options for neuropsychiatric symptoms following sepsis.
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Affiliation(s)
- Barbara G Ferri
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil; Laboratório de Neuroimunomodulação do Departamento de Ciências Fisiológicas do Instituto de Ciências Biomédicas, Unidade Educacional Santa Clara, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Cintia O de Novais
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil; Laboratório de Neuroimunomodulação do Departamento de Ciências Fisiológicas do Instituto de Ciências Biomédicas, Unidade Educacional Santa Clara, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Viviana C T Rojas
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, Instituto de Ciências Biomédicas, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil; Laboratório de Neuroimunomodulação do Departamento de Ciências Fisiológicas do Instituto de Ciências Biomédicas, Unidade Educacional Santa Clara, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Elisa S Estevam
- Laboratório de Neuroimunomodulação do Departamento de Ciências Fisiológicas do Instituto de Ciências Biomédicas, Unidade Educacional Santa Clara, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Gabriel J M Dos Santos
- Laboratório de Neuroimunomodulação do Departamento de Ciências Fisiológicas do Instituto de Ciências Biomédicas, Unidade Educacional Santa Clara, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Rayner R Cardoso
- Laboratório de Neuroimunomodulação do Departamento de Ciências Fisiológicas do Instituto de Ciências Biomédicas, Unidade Educacional Santa Clara, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Ester S C Nogueira
- Departamento de Biologia Celular e do Desenvolvimento do Instituto de Ciências Biomédicas, Unidade Educacional Santa Clara, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Pollyanna F Oliveira
- Laboratório de Genética Humana do Instituto de Ciências da Natureza, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Wellington A de Barros
- Grupo de Estudos em Química Orgânica e Biológica (GEQOB), Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ângelo de Fátima
- Grupo de Estudos em Química Orgânica e Biológica (GEQOB), Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | | | - Alexandre Giusti-Paiva
- Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
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Ilyin NP, Nabiullin AD, Kozlova AD, Kupriyanova OV, Shevyrin VA, Gloriozova T, Filimonov D, Lagunin A, Galstyan DS, Kolesnikova TO, Mor MS, Efimova EV, Poroikov V, Yenkoyan KB, de Abreu MS, Demin KA, Kalueff AV. Chronic Behavioral and Neurochemical Effects of Four Novel N-Benzyl-2-phenylethylamine Derivatives Recently Identified as "Psychoactive" in Adult Zebrafish Screens. ACS Chem Neurosci 2024; 15:2006-2017. [PMID: 38683969 DOI: 10.1021/acschemneuro.4c00017] [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] [Indexed: 05/02/2024] Open
Abstract
Potently affecting human and animal brain and behavior, hallucinogenic drugs have recently emerged as potentially promising agents in psychopharmacotherapy. Complementing laboratory rodents, the zebrafish (Danio rerio) is a powerful model organism for screening neuroactive drugs, including hallucinogens. Here, we tested four novel N-benzyl-2-phenylethylamine (NBPEA) derivatives with 2,4- and 3,4-dimethoxy substitutions in the phenethylamine moiety and the -F, -Cl, and -OCF3 substitutions in the ortho position of the phenyl ring of the N-benzyl moiety (34H-NBF, 34H-NBCl, 24H-NBOMe(F), and 34H-NBOMe(F)), assessing their behavioral and neurochemical effects following chronic 14 day treatment in adult zebrafish. While the novel tank test behavioral data indicate anxiolytic-like effects of 24H-NBOMe(F) and 34H-NBOMe(F), neurochemical analyses reveal reduced brain norepinephrine by all four drugs, and (except 34H-NBCl) - reduced dopamine and serotonin levels. We also found reduced turnover rates for all three brain monoamines but unaltered levels of their respective metabolites. Collectively, these findings further our understanding of complex central behavioral and neurochemical effects of chronically administered novel NBPEAs and highlight the potential of zebrafish as a model for preclinical screening of small psychoactive molecules.
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Affiliation(s)
- Nikita P Ilyin
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Arslan D Nabiullin
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
| | - Anna D Kozlova
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Olga V Kupriyanova
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan 420008, Russia
- Kazan State Medical University, Kazan 420012, Russia
| | - Vadim A Shevyrin
- Institute of Chemical Engineering, Ural Federal University, 19 Mira Str. ,Ekaterinburg 620002, Russia
| | - Tatyana Gloriozova
- Institute of Biomedical Chemistry, Pogodinskaya str., 10, bldg. 8 ,Moscow 119121, Russia
| | - Dmitry Filimonov
- Institute of Biomedical Chemistry, Pogodinskaya str., 10, bldg. 8 ,Moscow 119121, Russia
| | - Alexey Lagunin
- Institute of Biomedical Chemistry, Pogodinskaya str., 10, bldg. 8 ,Moscow 119121, Russia
| | - David S Galstyan
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Tatiana O Kolesnikova
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
- Neuroscience Laboratory, Cobrain Center, Yerevan State Medical University after Mkhitar Heratsi, Yerevan 0025, Armenia
| | - Mikael S Mor
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Evgeniya V Efimova
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Vladimir Poroikov
- Institute of Biomedical Chemistry, Pogodinskaya str., 10, bldg. 8 ,Moscow 119121, Russia
| | - Konstantin B Yenkoyan
- Neuroscience Laboratory, Cobrain Center, Yerevan State Medical University after Mkhitar Heratsi, Yerevan 0025, Armenia
- Biochemistry Department, Yerevan State Medical University after Mkhitar Heratsi, Yerevan 0025, Armenia
| | - Murilo S de Abreu
- Graduate Program in Health Sciences, Federal University of Health Sciences of Porto Alegre, Porto Alegre 900050, Brazil
| | - Konstantin A Demin
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Allan V Kalueff
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
- Neurobiology Program, Sirius University of Science and Technology, Sochi 354340, Russia
- Suzhou Key Laboratory of Neurobiology and Cell Signalling, Department of Biological Sciences, School of Science, Xi'an Jiaotong-Liverpool University, Suzhou 215123, China
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Kim YJ, Kook WA, Ma SX, Lee BR, Ko YH, Kim SK, Lee Y, Lee JG, Lee S, Kim KM, Lee SY, Jang CG. The novel psychoactive substance 25E-NBOMe induces reward-related behaviors via dopamine D1 receptor signaling in male rodents. Arch Pharm Res 2024; 47:360-376. [PMID: 38551761 DOI: 10.1007/s12272-024-01491-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 03/20/2024] [Indexed: 04/26/2024]
Abstract
Novel psychoactive substances (NPSs) are new psychotropic drugs designed to evade substance regulatory policies. 25E-NBOMe (2-(4-ethyl-2,5-dimethoxyphenyl)-N-(2-methoxybenzyl)ethanamine) has recently been identified as an NPS, and its recreational misuse has been reported to be rapidly increasing. However, the psychopharmacological effects and mechanisms of 25E-NBOMe have not been studied. We examined the abuse potential of 25E-NBOMe using the conditioned place preference in male mice and self-administration paradigms in male rats. Additionally, immunoblot assay, enzyme-linked immunosorbent assay, and microdialysis were used to determine the molecular effects of 25E-NBOMe in the nucleus accumbens (NAc). Our data demonstrated that 25E-NBOMe induces conditioned place preference, and the dopaminergic signaling in the NAc mediates these. Following 25E-NBOMe administration, expression of dopamine transporter and dopamine D1 receptor (D1DR) were enhanced in the NAc of male mice, and NAc dopamine levels were reduced in both male mice and rats. Induction of intracellular dopaminergic pathways, DARPP32, and phosphorylation of CREB in the NAc of male mice was also observed. Significantly, pharmacological blockade of D1DR or chemogenetic inhibition of D1DR-expressing medium spiny neurons in the NAc attenuated 25E-NBOMe-induced conditioned place preference in male mice. We also examined the hallucinogenic properties of 25E-NBOMe using the head twitch response test in male mice and found that this behavior was mediated by serotonin 2A receptor activity. Our findings demonstrate that D1DR signaling may govern the addictive potential of 25E-NBOMe. Moreover, our study provides new insights into the potential mechanisms of substance use disorder and the improvement of controlled substance management.
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Affiliation(s)
- Young-Jung Kim
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Wun-A Kook
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Shi-Xun Ma
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Bo-Ram Lee
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Yong-Hyun Ko
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Seon-Kyung Kim
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Youyoung Lee
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Jae-Gyeong Lee
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Sooyeun Lee
- Analytical Toxicology Laboratory, College of Pharmacy, Keimyung University, Daegu, 42601, Republic of Korea
| | - Kyeong-Man Kim
- Pharmacology Laboratory, College of Pharmacy, Chonnam National University, Gwangju, 81186, Republic of Korea
| | - Seok-Yong Lee
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea
| | - Choon-Gon Jang
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon, 16419, Republic of Korea.
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Emerick T, Marshall T, Martin TJ, Ririe D. Perioperative considerations for patients exposed to hallucinogens. Reg Anesth Pain Med 2024:rapm-2023-104851. [PMID: 38359966 PMCID: PMC11324860 DOI: 10.1136/rapm-2023-104851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 08/23/2023] [Indexed: 02/17/2024]
Abstract
Hallucinogen exposure in patients in the perioperative period presents challenges for anesthesiologists and other anesthesia providers. Acute and chronic exposure to these substances can cause physiological impacts that can affect the function of anesthetic and analgesic medications used during perioperative care. The objective of this narrative review is to educate readers on the wide array of hallucinogens and psychedelics that may influence the perioperative management of patients exposed to these substances. A narrative review of the literature surrounding hallucinogens and psychedelics was completed. Hallucinogens and psychedelics are quite varied in their mechanisms of action and therefore present a variety of perioperative implications and perioperative considerations. Many of these substances increase serotonin levels or act directly at serotonergic receptors. However, there are other relevant actions that may include varied mechanisms from N-methyl-D-aspartate receptor antagonism to stimulation of muscarinic receptors. With hallucinogen exposure rates on the rise, understanding the effects of hallucinogens is important for optimizing management and reducing risks perioperatively for patients with acute or chronic exposure.
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Affiliation(s)
- Trent Emerick
- Department of Anesthesiology and Perioperative Medicine, Chronic Pain Division, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA
| | - Tetyana Marshall
- Department of Anesthesiology and Perioperative Medicine, UPMC, Pittsburgh, Pennsylvania, USA
| | - Thomas Jeff Martin
- Pain Mechanisms Lab, Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Doug Ririe
- Pain Mechanisms Lab, Department of Anesthesiology, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
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Miller E, Bojovic V, Maddren O, Rao P, Adesina D, Petrenko A, Ponton R. Psychedelic Drug Microdosing Practices: A Qualitative Online Exploration. J Psychoactive Drugs 2024:1-10. [PMID: 38247351 DOI: 10.1080/02791072.2024.2304554] [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: 04/19/2023] [Accepted: 12/12/2023] [Indexed: 01/23/2024]
Abstract
"Microdosing," defined as the consumption of small, sub-hallucinogenic quantities of psychedelic drugs, has gained recent popularity. Microdosing is a relatively new concept, therefore no scientific recommendations exist on how to prepare and consume microdoses. Many consumers obtain microdosing information online. Few studies have investigated the content of this information; thus, the present study aimed to do so by collecting a large set of online microdosing information. A qualitative approach was taken to compile and characterize online microdosing information. Medical databases, video websites, online forums, drug-specific websites and forums, search engines, and social media websites were searched. A total of 174 unique resources were found, detailing the types of substances, preparation methods, doses, schedules, and safety strategies used by people who microdose. Future research is recommended to further explore how people prepare microdoses through in-person interviews and sample collection.
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Affiliation(s)
- Estelle Miller
- Faculty of Medical and Health Sciences, School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Vida Bojovic
- Faculty of Medical and Health Sciences, School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Olivia Maddren
- Faculty of Medical and Health Sciences, School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Prashant Rao
- Faculty of Medical and Health Sciences, School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Dami Adesina
- Faculty of Medical and Health Sciences, School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Anastasia Petrenko
- Faculty of Medical and Health Sciences, School of Pharmacy, The University of Auckland, Auckland, New Zealand
| | - Rhys Ponton
- Faculty of Medical and Health Sciences, School of Pharmacy, The University of Auckland, Auckland, New Zealand
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Gukasyan N, Narayan SK. Menstrual Changes and Reversal of Amenorrhea Induced by Classic Psychedelics: A Case Series. J Psychoactive Drugs 2024; 56:50-55. [PMID: 36682064 DOI: 10.1080/02791072.2022.2157350] [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: 06/02/2022] [Revised: 08/30/2022] [Accepted: 09/23/2022] [Indexed: 01/23/2023]
Abstract
There has been little research on the effects of psychedelics on menstrual and reproductive function, though anecdotal evidence suggests that these compounds may have striking effects on menstrual function in at least a subset of users. Social media and word of mouth were used to seek out individuals who had a history of changes in menstrual function following psychedelic use. Case histories were elicited from three respondents following informed consent. A literature search on the effects of classic psychedelics and related compounds was completed. Three women ranging from 27 to 34 years of age were interviewed and reported three distinct phenomena following the use of classic psychedelics: 1) resumption of menses following amenorrhea, 2) early onset of menses, in particular when psychedelics were used in the mid to late luteal period, and 3) improved menstrual regularity in a woman with irregular cycles who was eventually diagnosed with polycystic ovarian syndrome. The mechanisms behind these effects remain unclear, though they may be mediated via direct or indirect effects of 5-HT2A agonism on the hypothalamic-pituitary-gonadal axis. Although phenomena related to menstrual and reproductive function have been largely overlooked in the psychedelic literature to date, these effects may have therapeutic utility and warrant further study.
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Affiliation(s)
- Natalie Gukasyan
- Department of Psychiatry and Behavioral Sciences, Center for Psychedelic and Consciousness Research, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sasha K Narayan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Walsh CA, Gorfinkel L, Shmulewitz D, Stohl M, Hasin DS. Use of Lysergic Acid Diethylamide by Major Depression Status. JAMA Psychiatry 2024; 81:89-96. [PMID: 37819655 PMCID: PMC10568444 DOI: 10.1001/jamapsychiatry.2023.3867] [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] [Received: 05/05/2023] [Accepted: 08/08/2023] [Indexed: 10/13/2023]
Abstract
Importance Renewed interest in the clinical potential of hallucinogens may lead people with depression to a generally more positive view of the use of lysergic acid diethylamide (LSD). Therefore, past-year LSD use among people with depression may be increasing in prevalence. Objective To assess time trends in the prevalence of past-year nonmedical LSD use by past-year major depression status and the variation in this association by sociodemographic characteristics. Design, Setting, and Participants This survey study used pooled publicly available data from 478 492 adults aged 18 years or older who were administered the National Survey on Drug Use and Health from 2008 through 2019. Statistical analysis was conducted from December 2022 to June 2023. Main Outcome and Measures Past-year major depression diagnoses per criteria from the DSM-IV were analyzed. Logistic regression models examined whether time trends in past-year nonmedical LSD use differed between adults with vs without past-year depression, adjusting for sociodemographic characteristics. Secondary analyses examined whether the trends in LSD use by depression status differed between sociodemographic subgroups. Results The analytic sample included 478 492 adults, of whom 51.8% were female, 56.1% were younger than 50 years, 11.7% were Black, 15.1% were Hispanic, 65.8% were White, and 7.5% were another race. Weighted interview response rates ranged from 64.9% to 75.6% during the study time frame. From 2008 to 2019, past-year use of LSD increased significantly more among adults with major depression (2008 prevalence, 0.5%; 2019 prevalence, 1.8%; prevalence difference [PD], 1.3% [95% CI, 1.0%-1.6%]) compared with adults without major depression (2008 prevalence, 0.2%; 2019 prevalence, 0.8%; PD, 0.6% [95% CI, 0.5%-0.7%]) (difference in difference, 0.8% [95% CI, 0.5%-1.1%]). This difference was particularly pronounced among young adults aged 34 years or younger (PD among those aged 18-25 years with depression, 3.3% [95% CI, 2.5%-4.2%]; PD among those aged 26-34 years with depression, 2.7% [95% CI, 1.6%-3.8%]) and individuals with incomes less than $75 000 per year (PD among those with income <$20 000, 1.9% [95% CI, 1.3%-2.6%]; PD among those with income $20 000-$49 999, 1.5% [95% CI, 1.0%-2.1%]; PD among those with income $50 000-$74 999, 1.3% [95% CI, 0.7%-2.0%]). Conclusions and Relevance This study suggests that, from 2008 to 2019, there was a disproportionate increase in the prevalence of past-year LSD use among US adults with past-year depression. Among those with depression, this increase was particularly strong among younger adults and those with lower household incomes. Among individuals with depression who also report LSD use, clinicians should discuss potential strategies for mitigating harm and maximizing benefits in medically unsupervised settings.
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Affiliation(s)
- Claire A. Walsh
- Department of Translational Epidemiology, New York State Psychiatric Institute, New York
| | - Lauren Gorfinkel
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Dvora Shmulewitz
- Department of Translational Epidemiology, New York State Psychiatric Institute, New York
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
| | - Malki Stohl
- Department of Translational Epidemiology, New York State Psychiatric Institute, New York
| | - Deborah S. Hasin
- Department of Translational Epidemiology, New York State Psychiatric Institute, New York
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
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9
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Wojtas A, Gołembiowska K. Molecular and Medical Aspects of Psychedelics. Int J Mol Sci 2023; 25:241. [PMID: 38203411 PMCID: PMC10778977 DOI: 10.3390/ijms25010241] [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: 11/17/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/12/2024] Open
Abstract
Psychedelics belong to the oldest psychoactive drugs. They arouse recent interest due to their therapeutic applications in the treatment of major depressive disorder, substance use disorder, end-of-life anxiety,= and anxiety symptoms, and obsessive-compulsive disorder. In this review, the current state of preclinical research on the mechanism of action, neurotoxicity, and behavioral impact of psychedelics is summarized. The effect of selective 5-HT2A receptor agonists, 25I- and 25B-NBOMe, after acute and repeated administration is characterized and compared with the effects of a less selective drug, psilocybin. The data show a significant effect of NBOMes on glutamatergic, dopaminergic, serotonergic, and cholinergic neurotransmission in the frontal cortex, striatum, and nucleus accumbens. The increases in extracellular levels of neurotransmitters were not dose-dependent, which most likely resulted from the stimulation of the 5-HT2A receptor and subsequent activation of the 5-HT2C receptors. This effect was also observed in the wet dog shake test and locomotor activity. Chronic administration of NBOMes elicited rapid development of tolerance, genotoxicity, and activation of microglia. Acute treatment with psilocybin affected monoaminergic and aminoacidic neurotransmitters in the frontal cortex, nucleus accumbens, and hippocampus but not in the amygdala. Psilocybin exhibited anxiolytic properties resulting from intensification of GABAergic neurotransmission. The data indicate that NBOMes as selective 5-HT2A agonists exert a significant effect on neurotransmission and behavior of rats while also inducing oxidative DNA damage. In contrast to NBOMes, the effects induced by psilocybin suggest a broader therapeutic index of this drug.
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Affiliation(s)
| | - Krystyna Gołembiowska
- Unit II, Department of Pharmacology, Maj Institute of Pharmacology Polish Academy of Sciences, 12 Smętna Street, 31-343 Kraków, Poland;
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Cruz SL, Bencomo-Cruz M, Medina-Mora ME, Vázquez-Quiroz F, Fleiz-Bautista C. First drug-checking study at an electronic festival and fentanyl detection in the central region of Mexico. Harm Reduct J 2023; 20:174. [PMID: 38053148 PMCID: PMC10698886 DOI: 10.1186/s12954-023-00905-8] [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: 04/05/2023] [Accepted: 11/17/2023] [Indexed: 12/07/2023] Open
Abstract
BACKGROUND Perception of drug adulteration has increased in Mexico, but there is little research on adulterants and toxicity. The aim of this study was to identify drug composition in an electronic music outdoor festival nearby Mexico City. METHODS The participants completed a questionnaire with demographic data, harm reduction strategies, drug-use patterns, history, and the drug they expected to find. We took a small sample of each substance and prepared it for drug checking. A two-section drug testing station was placed within the grounds of the festival. Interaction with participants occurred at the front part. Drug checking was conducted at the rear part. The service was free of charge, voluntary and confidential. Forty persons aged 22 to 48 years participated (mode = 28), of which 92.5% were male, most (82.5%) were single. Through the Substance Analysis Program of "ReverdeSer Collective," we conducted the testing with the attendants that provided 51 drug samples, following ethical and biosafety protocols. We used colorimetry, Fourier Transform Infrared Spectroscopy, and fentanyl immunoassay strips for sample analysis. RESULTS Substances of choice among attendants were psychostimulants (MDMA and other amphetamine-like drugs) and hallucinogens. Most samples contained what the users expected plus adulterants. Main adulterants were methylene-dioxy-ethyl-amphetamine, methylene-dioxy-propyl-amphetamine, hydroxyamphetamine, and the selective serotonin reuptake inhibitor venlafaxine. Fentanyl was present in 2 out of 4 cocaine samples and in 14 of the 22 confirmed MDMA samples. CONCLUSIONS Some of the adulterants found pose serious health risks, especially fentanyl, amphetamine-like substances, and venlafaxine. Therefore, it is urgent to monitor these adulterants at electronic music festivals and to implement prevention, treatment, and harm reduction public policies. Naloxone distribution and drug-assisted therapies should be part of government programs in Mexico.
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Affiliation(s)
- Silvia L Cruz
- Department of Pharmacobiology, Center for Research and Advanced Studies (Cinvestav), Mexico City, Mexico
- Opioids Working Group. Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
| | - Miguel Bencomo-Cruz
- Substance Analysis Program-Deliberar A. C. and ReverdeSer Collective A. C., Mexico City, Mexico
| | - María E Medina-Mora
- Opioids Working Group. Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico
- Faculty of Psychology Director, National Autonomous University of Mexico, Mexico City, Mexico
- National Institute of Psychiatry Ramon de la Fuente Muñiz (INPRFM), Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, 14370, Mexico City, Mexico
| | - Fabiola Vázquez-Quiroz
- National Institute of Psychiatry Ramon de la Fuente Muñiz (INPRFM), Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, 14370, Mexico City, Mexico
| | - Clara Fleiz-Bautista
- Opioids Working Group. Global Studies Seminar, Faculty of Medicine, National Autonomous University of Mexico (UNAM), Mexico City, Mexico.
- National Institute of Psychiatry Ramon de la Fuente Muñiz (INPRFM), Calzada México-Xochimilco 101 Col. San Lorenzo Huipulco, 14370, Mexico City, Mexico.
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Ferri BG, de Novais CO, Bonani RS, de Barros WA, de Fátima Â, Vilela FC, Giusti-Paiva A. Psychoactive substances 25H-NBOMe and 25H-NBOH induce antidepressant-like behavior in male rats. Eur J Pharmacol 2023; 955:175926. [PMID: 37479015 DOI: 10.1016/j.ejphar.2023.175926] [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: 04/18/2023] [Revised: 06/18/2023] [Accepted: 07/17/2023] [Indexed: 07/23/2023]
Abstract
Ring-substituted phenethylamines are believed to induce psychedelic effects primarily by interacting with 5-hydroxytryptamine 2 (5-HT2A) receptors in the brain. We assessed the effect of the psychedelic substances 25H-NBOMe and 25H-NBOH on the depressive-like behavior of male adult rats. Naive Wistar rats were divided into groups to assess the effects of different doses (0.1 mg/kg, 1 mg/kg, and 3 mg/kg) of 25H-NBOMe and 25H-NBOH. The substances were administered intraperitoneally and the hallucinogenic properties were evaluated using the head twitch response test (HTR). Additionally, we assessed their locomotor activity in the open field test (OFT) and depressive-like behavior in the forced swimming test (FST). Our data demonstrated that all doses of synthetic psychedelic substances evaluated exhibited hallucinogenic effects. Interestingly, we observed that both 25H-NBOMe and 25H-NBOH produced a significantly greater motivation to escape in the FST, compared to the control group. Furthermore, we found no significant differences in locomotor activity during the OFT, except for the dose of 3 mg/kg, which induced a reduction in locomotion. This study provides new insights into a potential psychedelic substance, specifically by demonstrating the previously unknown antidepressant properties of a single dose of both 25H-NBOMe and 25H-NBOH. These findings contribute to the ongoing progress of experimental psychiatry toward developing safe and effective clinical practices in the field of psychedelics research.
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Affiliation(s)
- Barbara G Ferri
- Programa de Pós-Graduação Multicêntrico Em Ciências Fisiológicas (PPGMCF), Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Cintia O de Novais
- Programa de Pós-Graduação Multicêntrico Em Ciências Fisiológicas (PPGMCF), Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Raquel S Bonani
- Instituto de Ciências Biomédicas, Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Wellington A de Barros
- Instituto de Química da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ângelo de Fátima
- Instituto de Química da Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Fabiana C Vilela
- Programa de Pós-Graduação Em Biociências (PPGB), Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil
| | - Alexandre Giusti-Paiva
- Programa de Pós-Graduação Multicêntrico Em Ciências Fisiológicas (PPGMCF), Universidade Federal de Alfenas (Unifal-MG), Alfenas, MG, Brazil; Departamento de Ciências Fisiológicas, Centro de Ciências Biológicas da Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
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12
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Lee JG, Hur KH, Hwang SB, Lee S, Lee SY, Jang CG. Designer Drug, 25D-NBOMe, Has Reinforcing and Rewarding Effects through Change of a Dopaminergic Neurochemical System. ACS Chem Neurosci 2023; 14:2658-2666. [PMID: 37463338 DOI: 10.1021/acschemneuro.3c00196] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023] Open
Abstract
2-(2,5-Dimethoxy-4-methylphenyl)-N-(2-methoxybenzyl)_ethanamine (25D-NBOMe), an analogue of the 2C family, is a newly synthesized psychoactive substance. It acts as an agonist at the 5-HT2A receptor and has a similar mechanism to that of NBOMe compounds. However, the pharmacological mechanism for its rewarding and reinforcing effects has not been revealed. In the present study, intravenous self-administration (IVSA) test and conditioned place preference (CPP) test were performed to investigate whether 25D-NBOMe has abuse potential. We also evaluated the effects of 25D-NBOMe on neurochemical changes using western blot analysis and microdialysis. The IVSA test revealed increased self-administration in 25D-NBOMe (0.03 mg/kg)-treated rats. In addition, the CPP test revealed rewarding effects in 25D-NBOMe (1 mg/kg)-treated mice. In the neurochemical studies, 25D-NBOMe treatment affected the expression of dopamine (DA) receptor D1 (DRD1), DA receptor D2 (DRD2), tyrosine hydroxylase, DA transporter (DAT), and phospho-DAT (p-DAT) in the nucleus accumbens (NAc). In addition, microdialysis revealed that treatment with progressively increasing doses (1, 3, and 10 mg/kg) of 25D-NBOMe increased the extracellular levels of DA, 3,4-dihydroxyphenylacetic acid, and homovanillic acid in the rat NAc. Taken together, our results show the abuse potential and neurochemical changes related to addictive behavior after administration of 25D-NBOMe.
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Affiliation(s)
- Jae-Gyeong Lee
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Kwang-Hyun Hur
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Su-Bin Hwang
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Sooyeun Lee
- Department of Analytical Toxicology, College of Pharmacy, Keimyung University, Daegu 42601, Republic of Korea
| | - Seok-Yong Lee
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
| | - Choon-Gon Jang
- Department of Pharmacology, School of Pharmacy, Sungkyunkwan University, Suwon 16419, Republic of Korea
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Cassiano LMG, Oliveira MDS, de Barros WA, de Fátima Â, Coimbra RS. Neurotoxic effects of hallucinogenic drugs 25H-NBOMe and 25H-NBOH in organotypic hippocampal cultures. Heliyon 2023; 9:e17720. [PMID: 37449113 PMCID: PMC10336585 DOI: 10.1016/j.heliyon.2023.e17720] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 04/26/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction NBOMes and NBOHs are psychoactive drugs derived from phenethylamines and have hallucinogenic effects due to their strong agonism to serotonin 5-HT2A receptors. Although cases of toxicity associated with the recreational use of substituted phenethylamines are frequently reported, there is a lack of information on the possible neurotoxic effects of NBOMe and NBOH in the brain hippocampus, a major neurogenesis region. Objectives This study aimed at assessing the phenotypic and molecular effects of prolonged exposure of the hippocampus to the drugs 25H-NBOMe and 25H-NBOH. Methods The ex vivo organotypic culture model of hippocampal slices (OHC) was used to investigate, by immunofluorescence and confocal microscopy, and transcriptome analyses, the mechanisms associated with the neurotoxicity of 25H-NBOMe and 25H-NBOH. Results Reduction in the density of mature neurons in the OHCs occurred after two and seven days of exposure to 25H-NBOMe and 25H-NBOH, respectively. After the withdrawal of 25H-NBOMe, the density of mature neurons in the OHCs stabilized. In contrast, up to seven days after 25H-NBOH removal from the culture medium, progressive neuron loss was still observed in the OHCs. Interestingly, the exposure to 25H-NBOH induced progenitor cell differentiation, increasing the density of post-mitotic neurons in the OHCs. Corroborating these findings, the functional enrichment analysis of differentially expressed genes in the OHCs exposed to 25H-NBOH revealed the activation of WNT/Beta-catenin pathway components associated with neurogenesis. During and after the exposure to 25H-NBOMe or 25H-NBOH, gene expression patterns related to the activation of synaptic transmission and excitability of neurons were identified. Furthermore, activation of signaling pathways and biological processes related to addiction and oxidative stress and inhibition of the inflammatory response were observed after the period of drug exposure. Conclusion 25H-NBOMe and 25H-NBOH disrupt the balance between neurogenesis and neuronal death in the hippocampus and, although chemically similar, have distinct neurotoxicity mechanisms.
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Affiliation(s)
- Larissa Marcely Gomes Cassiano
- Neurogenômica, Imunopatologia, Instituto René Rachou, Fiocruz, Belo Horizonte, MG, 30190-002, Brazil
- Programa de Pós-Graduação em Bioquímica e Imunologia, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Marina da Silva Oliveira
- Neurogenômica, Imunopatologia, Instituto René Rachou, Fiocruz, Belo Horizonte, MG, 30190-002, Brazil
| | - Wellington Alves de Barros
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Ângelo de Fátima
- Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, 31270-901, Brazil
| | - Roney Santos Coimbra
- Neurogenômica, Imunopatologia, Instituto René Rachou, Fiocruz, Belo Horizonte, MG, 30190-002, Brazil
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14
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Rodrigues CHP, Mariotto LS, Castro JS, Peruquetti PH, Silva-Junior NC, Bruni AT. Acute, chronic, and post-mortem toxicity: a review focused on three different classes of new psychoactive substances. Forensic Toxicol 2023; 41:187-212. [PMID: 36604359 DOI: 10.1007/s11419-022-00657-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/22/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE New psychoactive substances (NPS) are not controlled under the Single Convention on Narcotic Drugs of 1961 or the 1971 Convention, but they may pose a public health threat. Knowledge of the main properties and toxicological effects of these substances is lacking. According to the current Drugs Law (Law n. 11.343/2006), the Brazilian Surveillance Agency issues directives for forbidden substances in Brazil, and structural classes of synthetic cannabinoids, cathinones, and phenylethylamines are considered illicit drugs. Considering that data on these controlled substances are scattered, the main objective of this work was to collect and organize data to generate relevant information on the toxicological properties of NPS. METHODS We carried out a literature review collecting information on the acute, chronic, and post-mortem toxicity of these classes of NSP. We searched info in five scientific databases considering works from 2017 to 2021 and performed a statistical evaluation of the data. RESULTS Results have shown a general lack of studies in this field given that many NPS have not had their toxicity evaluated. We observed a significant difference in the volume of data concerning acute and chronic/post-mortem toxicity. Moreover, studies on the adverse effects of polydrug use are scarce. CONCLUSIONS More in-depth information about the main threats involving NPS use are needed.
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Affiliation(s)
- Caio H P Rodrigues
- Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil
- INCT Forense - Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil
| | - Lívia S Mariotto
- Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil
- INCT Forense - Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil
| | - Jade S Castro
- Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil
- INCT Forense - Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil
| | - Paulo H Peruquetti
- Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil
| | - Newton C Silva-Junior
- Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil
- INCT Forense - Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil
| | - Aline T Bruni
- Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil.
- INCT Forense - Department of Chemistry, Faculty of Philosophy, Science and Letters at Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, 14040-901, Brazil.
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Palamar JJ, Le A. Prevalence of self-reported adverse effects associated with drug use among nightclub and festival attendees, 2019-2022. DRUG AND ALCOHOL DEPENDENCE REPORTS 2023; 7:100149. [PMID: 37025564 PMCID: PMC10070077 DOI: 10.1016/j.dadr.2023.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 02/18/2023] [Accepted: 03/20/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND Research investigating adverse effects from drug use has focused extensively on poisonings and mortality. This study focuses on drug-related adverse effects not necessarily resulting in hospitalization or death among a population known for high prevalence of party drug use-electronic dance music (EDM) nightclub and festival attendees. METHODS Adults entering EDM venues were surveyed in 2019-2022 (n = 1952). Those reporting past-month use of a drug were asked whether they had experienced a harmful or very unpleasant effect after use. We examined 20 drugs and drug classes with a particular focus on alcohol, cannabis, cocaine, and ecstasy. Prevalence and correlates of adverse effects were estimated. RESULTS Almost half (47.6%) of adverse effects involved alcohol and 19.0% involved cannabis. 27.6% of those using alcohol reported an adverse effect, while 19.5%, 15.0%, and 14.9% of participants reported an effect from use of cocaine, ecstasy, and cannabis, respectively. Use of less prevalent drugs, such as NBOMe, methamphetamine, fentanyls, and synthetic cathinones, tended to be associated with higher prevalence of adverse effects. The most consistent risk factor was younger age, while past-month use of a greater number of drugs was often a protective factor against adverse effects. For most drugs, taking too much was the most common perceived reason for the adverse effect, and visiting a hospital after use was most prevalent among those experiencing an adverse effect from cocaine (11.0%). CONCLUSIONS Adverse drug effects are common in this population and results can inform prevention and harm reduction in this population and the general population.
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Affiliation(s)
- Joseph J. Palamar
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, Room 1752, New York, NY 10016, USA
| | - Austin Le
- New York University Grossman School of Medicine, Department of Population Health, 180 Madison Avenue, Room 1752, New York, NY 10016, USA
- New York University College of Dentistry, New York, NY, USA
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Herian M, Świt P. 25X-NBOMe compounds - chemistry, pharmacology and toxicology. A comprehensive review. Crit Rev Toxicol 2023; 53:15-33. [PMID: 37115704 DOI: 10.1080/10408444.2023.2194907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Recently, a growing number of reports have indicated a positive effect of hallucinogenic-based therapies in different neuropsychiatric disorders. However, hallucinogens belonging to the group of new psychoactive substances (NPS) may produce high toxicity. NPS, due to their multi-receptors affinity, are extremely dangerous for the human body and mental health. An example of hallucinogens that have been lately responsible for many severe intoxications and deaths are 25X-NBOMes - N-(2-methoxybenzyl)-2,5-dimethoxy-4-substituted phenethylamines, synthetic compounds with strong hallucinogenic properties. 25X-NBOMes exhibit a high binding affinity to serotonin receptors but also to dopamine, adrenergic and histamine receptors. Apart from their influence on perception, many case reports point out systemic and neurological poisoning with these compounds. In humans, the most frequent side effects are tachycardia, anxiety, hypertension and seizures. Moreover, preclinical studies confirm that 25X-NBOMes cause developmental impairments, cytotoxicity, cardiovascular toxicity and changes in behavior of animals. Metabolism of NBOMes seems to be very complex and involves many metabolic pathways. This fact may explain the observed high toxicity. In addition, many analytical methods have been applied in order to identify these compounds and their metabolites. The presented review summarized the current knowledge about 25X-NBOMes, especially in the context of toxicity.
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Affiliation(s)
- Monika Herian
- Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Paweł Świt
- Institute of Chemistry, Faculty of Science and Technology, University of Silesia, Katowice, Poland
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Tang ZH, Yu ZP, Li Q, Zhang XQ, Muhetaer K, Wang ZC, Xu P, Shen HW. The effects of serotonergic psychedelics in synaptic and intrinsic properties of neurons in layer II/III of the orbitofrontal cortex. Psychopharmacology (Berl) 2023; 240:1275-1285. [PMID: 37071130 DOI: 10.1007/s00213-023-06366-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/06/2023] [Indexed: 04/19/2023]
Abstract
RATIONALE Serotonergic psychedelics show promise in the treatment of psychiatric disorders, including obsessive-compulsive disorder. Dysfunction of the orbitofrontal cortex (OFc) has been implicated in the pathophysiology of compulsive behavior, which might be a key region for the efficacy of psychedelics. However, the effects of psychedelics on the neural activities and local excitation/inhibition (E/I) balance in the OFc are unclear. OBJECTIVES This study aimed to investigate how 25C-NBOMe, a substituted phenethylamine psychedelic, regulated the synaptic and intrinsic properties of neurons in layer II/III of the OFc. METHODS Acute brain slices containing the OFc of adult male Sprague Dawley rats were used for ex vivo whole-cell recording. The synaptic and intrinsic properties of neurons were monitored using voltage and current clamps, respectively. Electrically evoked action potential (eAP) was used to measure synaptic-driven pyramidal activity. RESULTS 25C-NBOMe enhanced spontaneous neurotransmission at glutamatergic synapses but diminished that in GABAergic synapses through the 5-HT2A receptor. 25C-NBOMe also increased both evoked excitatory currents and evoked action potentials. Moreover, 25C-NBOMe promoted the excitability of pyramidal neurons but not fast-spiking neurons. Either inhibiting G protein-gated inwardly rectifying potassium channels or activating protein kinase C significantly obstructed the facilitative effect of 25C-NBOMe on the intrinsic excitability of pyramidal neurons. CONCLUSIONS This work reveals the multiple roles of 25C-NBOMe in modulating synaptic and neuronal function in the OFc, which collectively promotes local E/I ratios.
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Affiliation(s)
- Zi-Hang Tang
- Department of Physiology and Pharmacology, School of Medicine, Ningbo University, 818 Fenghua Rd, Ningbo, Zhejiang, 315211, People's Republic of China
| | - Zhi-Peng Yu
- Department of Physiology and Pharmacology, School of Medicine, Ningbo University, 818 Fenghua Rd, Ningbo, Zhejiang, 315211, People's Republic of China
- Faculty of Electrical Engineering and Computer Science, Ningbo University, 818 Fenghua Rd, Ningbo, Zhejiang, 315211, People's Republic of China
| | - Qiong Li
- Department of Physiology and Pharmacology, School of Medicine, Ningbo University, 818 Fenghua Rd, Ningbo, Zhejiang, 315211, People's Republic of China
| | - Xiao-Qin Zhang
- Department of Physiology and Pharmacology, School of Medicine, Ningbo University, 818 Fenghua Rd, Ningbo, Zhejiang, 315211, People's Republic of China
| | - Kadeliya Muhetaer
- Department of Physiology and Pharmacology, School of Medicine, Ningbo University, 818 Fenghua Rd, Ningbo, Zhejiang, 315211, People's Republic of China
| | - Zheng-Chun Wang
- Department of Physiology and Pharmacology, School of Medicine, Ningbo University, 818 Fenghua Rd, Ningbo, Zhejiang, 315211, People's Republic of China
| | - Peng Xu
- Key Laboratory of Drug Monitoring and Control, Drug Intelligence and Forensic Center, Ministry of Public Security, Beijing, 100093, People's Republic of China
| | - Hao-Wei Shen
- Department of Physiology and Pharmacology, School of Medicine, Ningbo University, 818 Fenghua Rd, Ningbo, Zhejiang, 315211, People's Republic of China.
- Key Laboratory of Addiction Research of Zhejiang Province, Ningbo Kangning Hospital, Ningbo, Zhejiang, 315010, People's Republic of China.
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Gerostamoulos D, Glowacki L, Pricone M, Crump K, Di Rago M, Joubert S, Lynch MJ, Woodford NW, Drummer OH. Fatal Intoxications from a Combination of 4-Fluoroamphetamine and 25C-NBOMe. J Anal Toxicol 2023; 47:191-196. [PMID: 35975553 DOI: 10.1093/jat/bkac059] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 08/05/2022] [Accepted: 08/15/2022] [Indexed: 11/12/2022] Open
Abstract
Six fatalities have occurred from the ingestion of a combination of new psychoactive substances (NPSs), 4-fluoroamphetamine (4FA) and 2-(4-chloro-2,5-dimethoxyphenyl)-N-[(2-methoxyphenyl)methyl]ethanamine (25C-NBOMe) over a 9-month period. Four of these fatalities (one older female and three young males) were from direct adverse effects of drugs, and one each from a fall while being intoxicated and during restraint. All cases were subject to full postmortem examinations that included collection of femoral blood. The four drug-caused fatalities had postmortem blood concentrations for 4FA and 25C-NBOMe of 330-682 ng/L (median 417) and 1.4-12 ng/mL (median 4.3), respectively. The other two cases (both young males) where death was considered to have been caused indirectly by drug intoxication had 4FA and 25C-NBOMe postmortem concentrations of 21 and 123 ng/mL, and 1.8 and 4.5 ng/mL, respectively. None of these cases showed concentrations of drugs that suggested use of high recreational doses. In one drug-caused death, capsules and a brown powder obtained from the scene were found to contain a mixture of these two NPSs. With the exception of one drug-caused death, other drugs were detected; however, the effects of the two NPSs together were regarded as the primary triggers for the deaths. There were no consistent symptoms or pathology in these cases; however, agitation/aggression was observed in two cases prior to their collapse, with seizures in possibly three cases. Pulmonary and/or cerebral edema was noted in three cases. Potentially significant natural disease (a mildly enlarged heart) was only observed in one drug-caused case. These cases illustrate a possible increased risk of sudden death with this combination of drugs, both of which can elevate serotonin concentrations as well as act as strong stimulants. These cases also illustrate the difficulty in detecting NPS in cases where no prior information is available that might suggest their use.
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Affiliation(s)
- Dimitri Gerostamoulos
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
- Department of Forensic Medicine, Monash University, School of Public Health and Preventive Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Linda Glowacki
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Maria Pricone
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Kerryn Crump
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Matthew Di Rago
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
- Department of Forensic Medicine, Monash University, School of Public Health and Preventive Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Samantha Joubert
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Matthew J Lynch
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
- Department of Forensic Medicine, Monash University, School of Public Health and Preventive Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Noel W Woodford
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
- Department of Forensic Medicine, Monash University, School of Public Health and Preventive Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
| | - Olaf H Drummer
- Victorian Institute of Forensic Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
- Department of Forensic Medicine, Monash University, School of Public Health and Preventive Medicine, 65 Kavanagh Street, Southbank, Victoria 3006, Australia
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19
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Oh HA, Yoo JH, Kim YJ, Han KS, Woo DH. 4-EA-NBOMe, an amphetamine derivative, alters glutamatergic synaptic transmission through 5-HT 1A receptors on cortical neurons from SpragueDawley rat and pyramidal neurons from C57BL/6 mouse. Neurotoxicology 2023; 95:144-154. [PMID: 36738894 DOI: 10.1016/j.neuro.2023.02.001] [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: 09/07/2022] [Revised: 01/20/2023] [Accepted: 02/01/2023] [Indexed: 02/05/2023]
Abstract
New psychoactive substances (NPSs) are compounds designed to mimic illegal recreational drugs. In particular, there are difficulties in legal restrictions because there is no fast NPS detection method to suppress the initial spread of NPS with criminal records; thus, they expose the public to serious health threats, including toxicity and dependence. However, the effects of NPSs on the brain and the related cellular mechanisms are well unknown. One of the recently emerging drugs is 4-ethylamphetamine-NBOMe (4-EA-NBOMe), a member of the 2 C phenylalanine family with a similar structure to methamphetamine (methA). In this study, we tested the effect of methA analogs on the glutamatergic synaptic transmission on primary cultured cortical neurons of SpragueDawley (SD) rats and C57BL/6 mice, and also layer 2/3 pyramidal neurons of the medial prefrontal cortex (mPFC) of C57BL/6 mice. We found that acute treatment with 4-EA-NBOMe inhibits spontaneous excitatory postsynaptic currents (EPSCs) and that withdrawal after chronic inhibition by 4-EA-NBOMe augments glutamatergic synaptic transmission. These modifications of synaptic responses are mediated by 5-HT1A receptors. These findings suggest that 4-EA-NBOMe directly affects the central nervous system by changing the efficacy of glutamatergic synaptic transmission.
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Affiliation(s)
- Hyun-A Oh
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, KRICT, Daejeon 34114, South Korea
| | - Jae Hong Yoo
- Department of Biological Sciences, Chungnam National University, Daejeon 34134 South Korea
| | - Ye-Ji Kim
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, KRICT, Daejeon 34114, South Korea; Human and Environmental Toxicology, University of Science and Technology, Daejeon 34114, South Korea
| | - Kyung-Seok Han
- Department of Biological Sciences, Chungnam National University, Daejeon 34134 South Korea.
| | - Dong Ho Woo
- Department of Advanced Toxicology Research, Korea Institute of Toxicology, KRICT, Daejeon 34114, South Korea; Human and Environmental Toxicology, University of Science and Technology, Daejeon 34114, South Korea.
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20
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Belouin SJ, Averill LA, Henningfield JE, Xenakis SN, Donato I, Grob CS, Berger A, Magar V, Danforth AL, Anderson BT. Policy considerations that support equitable access to responsible, accountable, safe, and ethical uses of psychedelic medicines. Neuropharmacology 2022; 219:109214. [PMID: 35973601 PMCID: PMC9536012 DOI: 10.1016/j.neuropharm.2022.109214] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/24/2022] [Accepted: 08/05/2022] [Indexed: 11/23/2022]
Abstract
There is mounting evidence suggesting psychedelic and entactogen medicines (namely psilocybin and 3,4-methylenedioxymethamphetamine [MDMA]), in conjunction with proper psychosocial support, hold the potential to provide safe, rapid acting, and robust clinical improvements with durable effects. In the US, both psilocybin and MDMA have been granted Breakthrough Therapy designations by the US Food and Drug Administration and may potentially receive full FDA approval with similar regulatory considerations occurring in multiple countries. At the same time, regulatory changes are poised to increase access to legal or decriminalized psychedelic use in various non-medical settings. This review provides a brief discussion on the historical use of psychedelic medicines, the status of the empirical evidence, and numerous significant policy considerations that must be thoughtfully addressed regarding standards-of-practice, consumer protection, engagement of communities, safeguarding access for all, and developing data standards, which supports the responsible, accountable, safe, and ethical uses of these medicines in clinical, faith-based, and other contexts. We provide suggestions for how public health and harm reduction can be supported through a public-private partnership that engages a community of stakeholders from various disciplines in the co-creation and dissemination of best practices and public policies.
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Affiliation(s)
- Sean J Belouin
- United States Public Health Service, Germantown, MD, USA; Substance Abuse and Mental Health Services Administration (SAMHSA), Rockville, MD, USA; Pain and Palliative Care, NIH Clinical Research Center, Bethesda, MD, USA.
| | - Lynnette A Averill
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA; US Department of Veterans Affairs, Michael E. DeBakey Veterans Administration Medical Center, Houston, TX, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; US Department of Veterans Affairs, National Center for PTSD - Clinical Neurosciences Division, Orange, CT, USA; Reason for Hope, New York, NY, USA
| | - Jack E Henningfield
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Research, Health Policy and Abuse Liability, Pinney Associates, Bethesda, MD, USA
| | - Stephen N Xenakis
- Reason for Hope, New York, NY, USA; United States Army, Hallandale Beach, FL, USA; Uniformed Services University of the Health Sciences (UHSUS), Bethesda, MD, USA
| | - Ingrid Donato
- Office of Prevention Innovation, Center for Substance Abuse Prevention, SAMHSA, Rockville, MD, USA
| | - Charles S Grob
- David Geffen School of Medicine at University of California (UCLA), Los Angeles, CA, USA; Division of Child and Adolescent Psychiatry, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Ann Berger
- Pain and Palliative Care, NIH Clinical Research Center, Bethesda, MD, USA
| | - Veronica Magar
- Gender, Equity and Human Rights, World Health Organization (WHO), Geneva, Switzerland
| | - Alicia L Danforth
- The Lundquist Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Brian T Anderson
- University of California San Francisco (UCSF) Department of Psychiatry & Behavioral Sciences, San Francisco, CA, USA; University of California Berkeley Center for the Science of Psychedelics, Berkeley, CA, USA
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21
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Šíchová K, Syrová K, Kofroňová E, Pinterova‐Leca N, Vejmola Č, Nykodemová J, Palivec P, Olejníková L, Danda H, Jorratt P, Adam Š, Hiep BQ, Štefková‐Mazochová K, Končická M, Kuchař M, Páleníček T. Pharmacokinetics, systemic toxicity, thermoregulation and acute behavioural effects of 25CN‐NBOMe. Addict Biol 2022; 27:e13216. [DOI: 10.1111/adb.13216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/07/2022] [Accepted: 07/14/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Klára Šíchová
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
| | - Kateřina Syrová
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
- Third Faculty of Medicine Charles University Prague Czech Republic
| | - Edita Kofroňová
- Forensic Laboratory of Biologically Active Compounds, Department of Chemistry of Natural Compounds University of Chemistry and Technology Prague Czech Republic
| | - Nikola Pinterova‐Leca
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
| | - Čestmír Vejmola
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
- Third Faculty of Medicine Charles University Prague Czech Republic
| | - Jitka Nykodemová
- Forensic Laboratory of Biologically Active Compounds, Department of Chemistry of Natural Compounds University of Chemistry and Technology Prague Czech Republic
| | - Petr Palivec
- Forensic Laboratory of Biologically Active Compounds, Department of Chemistry of Natural Compounds University of Chemistry and Technology Prague Czech Republic
| | - Lucie Olejníková
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
| | - Hynek Danda
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
- Third Faculty of Medicine Charles University Prague Czech Republic
| | - Pascal Jorratt
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
- Third Faculty of Medicine Charles University Prague Czech Republic
| | - Šafanda Adam
- First Faculty of Medicine, Institute of Pathology Charles University Prague Czech Republic
| | - Bui Quang Hiep
- First Faculty of Medicine, Institute of Pathology Charles University Prague Czech Republic
| | | | - Markéta Končická
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
| | - Martin Kuchař
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
- Forensic Laboratory of Biologically Active Compounds, Department of Chemistry of Natural Compounds University of Chemistry and Technology Prague Czech Republic
| | - Tomáš Páleníček
- Psychedelics Research Centre National Institute of Mental Health Klecany Czech Republic
- Third Faculty of Medicine Charles University Prague Czech Republic
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22
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Kopra EI, Ferris JA, Rucker JJ, McClure B, Young AH, Copeland CS, Winstock AR. Adverse experiences resulting in emergency medical treatment seeking following the use of lysergic acid diethylamide (LSD). J Psychopharmacol 2022; 36:956-964. [PMID: 35672900 PMCID: PMC9353972 DOI: 10.1177/02698811221099650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Recreational lysergic acid diethylamide (LSD) use is growing in popularity amid increasing research interest on psychedelics and their possible therapeutic potential yet; the potent psychotropic effects of LSD may result in adverse reactions and behaviour. AIMS This study aimed to investigate the 12-month incidence and nature of LSD-related adverse experiences resulting in emergency medical treatment (EMT) seeking in an international sample of people reporting LSD use. METHODS We use data from the 2017 Global Drug Survey - a large anonymous online survey on patterns of drug use conducted between November 2016 and January 2017. RESULTS Out of 10,293 past-year LSD users, 102 (1.0%) reported seeking EMT, with a per-event risk estimate of 0.2%. Younger age, comorbid mental health conditions and higher frequency of use were associated with increased risk of EMT seeking. The most common symptoms were psychological, including anxiety, panic and confusion, with the most common explanatory factors cited by respondents being poor 'setting' and 'mindset'. Most responders reported feeling back to normal within 24 h, but 11 participants experienced persistent issues after 4 weeks. CONCLUSION The results suggest that LSD is a relatively safe drug in recreational settings. Adverse reactions are typically short-lived, self-limiting and psychological in nature. Sub-optimal set and setting were commonly reported as suspected contributory factors. Within clinical settings, patient screening, preparatory sessions and supervision should reduce these acute risks considerably.
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Affiliation(s)
- Emma I Kopra
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology & Neuroscience, King’s College London,
London, UK,Emma I Kopra, Department of Psychological
Medicine, Institute of Psychiatry, Psychology & Neuroscience, King’s College
London, 16 De Crespigny Park, London SE5 8AF, UK.
| | - Jason A Ferris
- Centre for Health Services Research,
Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - James J Rucker
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology & Neuroscience, King’s College London,
London, UK,South London and Maudsley NHS
Foundation Trust, London, UK
| | | | - Allan H Young
- Department of Psychological Medicine,
Institute of Psychiatry, Psychology & Neuroscience, King’s College London,
London, UK,South London and Maudsley NHS
Foundation Trust, London, UK
| | - Caroline S Copeland
- Institute of Pharmaceutical Science,
Faculty of Life Sciences and Medicine, King’s College London, London, UK,National Programme of Substance Abuse
Deaths, Population Health Research Institute, St George’s, University of London,
London, UK
| | - Adam R Winstock
- Institute of Epidemiology and Health
Care, University College London, London, UK,Global Drug Survey, London, UK
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23
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Gampfer TM, Wagmann L, Pulver B, Westphal F, Flockerzi V, Meyer MR. A simplified strategy to assess the cytotoxicity of new psychoactive substances in HepG2 cells using a high content screening assay - Exemplified for nine compounds. Toxicology 2022; 476:153258. [PMID: 35842060 DOI: 10.1016/j.tox.2022.153258] [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: 05/21/2022] [Revised: 06/27/2022] [Accepted: 07/11/2022] [Indexed: 10/17/2022]
Abstract
New psychoactive substances (NPS) are an issue of global concern posing a serious threat to the healthcare systems. Consumption of some NPS has been associated with toxic effects on the liver amongst others. However, data concerning their (cyto-)toxicity are usually not available. For a straightforward assessment of their cytotoxic potential, a simplified strategy measuring six different cytotoxicity indicating parameters simultaneously by a high content screening assay (HCSA) was developed. Its applicability was further investigated using nine NPS from heterogeneous chemical classes. HepG2 cells were incubated with NPS for 48 h at a low and high concentration (7.81 and 125 µM), respectively. To study metabolism-mediated effects on their cytotoxicity, cells were additionally incubated with the unspecific cytochrome (CYP) P450 inhibitor 1-aminobenzotriazole. Four fluorescence dyes were used to monitor cell count, nuclear size, and nuclear intensity (all Hoechst33342), mitochondrial membrane potential (TMRM), cytoplasmic calcium levels (CAL-520), and plasma membrane integrity (TOTO-3). Amongst the investigated NPS, ephylone, CUMYL-CBMICA, and dibutylone showed a strong cytotoxic potential, affecting two parameters at 7.81 µM. 5-MeO-MiPT showed moderate effects by impairing one parameter at 7.81 and one at 125 µM. Furthermore, at the high concentration of 5-MeO-MiPT, an effect of metabolism on cytotoxicity was observed. The HCSA confirmed the cytotoxic potential of ephylone and 5-MeO-MiPT, as the investigated concentrations were in the range of their published blood concentrations which induced liver damages after intake. The mitochondrial membrane potential was the parameter with the highest sensitivity and thus considered as suitable "cytobiomarker". In turn, parameters showing a high variability or unexpected effects such as cytosolic calcium levels and plasma membrane integrity might be omitted in the future. Even though 5-MeO-MiPT showed metabolism-based effects, HepG2 are known to have limited metabolic activity compared to cell lines such as HepaRG. Therefore, in further experiments cell lines with higher CYP-expression needs to be included and findings compared. Nevertheless, the simplified HCSA-based strategy allowed to screen NPS from diverse chemical groups for a first assessment of the cytotoxic properties of the parent compound. This information is crucial for a thorough risk assessment of NPS not only for public health authorities.
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Affiliation(s)
- Tanja M Gampfer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany
| | - Lea Wagmann
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany
| | - Benedikt Pulver
- State Bureau of Criminal Investigation Schleswig-Holstein, Forensic Science Institute, Kiel, Germany; Institute of Forensic Medicine, Forensic Toxicology, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Herrmann Staudinger Graduate School, University of Freiburg, Freiburg, Germany
| | - Folker Westphal
- State Bureau of Criminal Investigation Schleswig-Holstein, Forensic Science Institute, Kiel, Germany
| | - Veit Flockerzi
- Department of Experimental and Clinical Pharmacology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany
| | - Markus R Meyer
- Department of Experimental and Clinical Toxicology, Institute of Experimental and Clinical Pharmacology and Toxicology, Center for Molecular Signaling (PZMS), Saarland University, Homburg, Germany.
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24
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Demin KA, Kupriyanova OV, Shevyrin VA, Derzhavina KA, Krotova NA, Ilyin NP, Kolesnikova TO, Galstyan DS, Kositsyn YM, Khaybaev AAS, Seredinskaya MV, Dubrovskii Y, Sadykova RG, Nerush MO, Mor MS, Petersen EV, Strekalova T, Efimova EV, Kuvarzin SR, Yenkoyan KB, Bozhko DV, Myrov VO, Kolchanova SM, Polovian AI, Galumov GK, Kalueff AV. Acute behavioral and Neurochemical Effects of Novel N-Benzyl-2-Phenylethylamine Derivatives in Adult Zebrafish. ACS Chem Neurosci 2022; 13:1902-1922. [PMID: 35671176 DOI: 10.1021/acschemneuro.2c00123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Hallucinogenic drugs potently affect brain and behavior and have also recently emerged as potentially promising agents in pharmacotherapy. Complementing laboratory rodents, the zebrafish (Danio rerio) is a powerful animal model organism for screening neuroactive drugs, including hallucinogens. Here, we test a battery of ten novel N-benzyl-2-phenylethylamine (NBPEA) derivatives with the 2,4- and 3,4-dimethoxy substitutions in the phenethylamine moiety and the -OCH3, -OCF3, -F, -Cl, and -Br substitutions in the ortho position of the phenyl ring of the N-benzyl moiety, assessing their acute behavioral and neurochemical effects in the adult zebrafish. Overall, substitutions in the Overall, substitutions in the N-benzyl moiety modulate locomotion, and substitutions in the phenethylamine moiety alter zebrafish anxiety-like behavior, also affecting the brain serotonin and/or dopamine turnover. The 24H-NBOMe(F) and 34H-NBOMe(F) treatment also reduced zebrafish despair-like behavior. Computational analyses of zebrafish behavioral data by artificial intelligence identified several distinct clusters for these agents, including anxiogenic/hypolocomotor (24H-NBF, 24H-NBOMe, and 34H-NBF), behaviorally inert (34H-NBBr, 34H-NBCl, and 34H-NBOMe), anxiogenic/hallucinogenic-like (24H-NBBr, 24H-NBCl, and 24H-NBOMe(F)), and anxiolytic/hallucinogenic-like (34H-NBOMe(F)) drugs. Our computational analyses also revealed phenotypic similarity of the behavioral activity of some NBPEAs to that of selected conventional serotonergic and antiglutamatergic hallucinogens. In silico functional molecular activity modeling further supported the overlap of the drug targets for NBPEAs tested here and the conventional serotonergic and antiglutamatergic hallucinogens. Overall, these findings suggest potent neuroactive properties of several novel synthetic NBPEAs, detected in a sensitive in vivo vertebrate model system, the zebrafish, raising the possibility of their potential clinical use and abuse.
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Affiliation(s)
- Konstantin A Demin
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia.,Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Olga V Kupriyanova
- Institute of Fundamental Medicine and Biology, Kazan Volga Region Federal University, Kazan 420008, Russia.,Kazan State Medical University, Kazan 420012, Russia
| | - Vadim A Shevyrin
- Institute of Chemistry and Technology, Ural Federal University, 19 Mira Str., Ekaterinburg 620002, Russia
| | - Ksenia A Derzhavina
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia.,Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Nataliya A Krotova
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia.,Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Nikita P Ilyin
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia.,Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Tatiana O Kolesnikova
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia.,Neurobiology Program, Sirius University of Science and Technology, Sochi 354340, Russia
| | - David S Galstyan
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia.,Laboratory of Preclinical Bioscreening, Granov Russian Research Center of Radiology and Surgical Technologies, Ministry of Healthcare of Russian Federation, Pesochny 197758, Russia
| | - Yurii M Kositsyn
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | | | - Maria V Seredinskaya
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Yaroslav Dubrovskii
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia.,Institute of Chemistry, St. Petersburg State University, St. Petersburg 199034, Russia.,St. Petersburg State Chemical Pharmaceutical University, St. Petersburg 197022, Russia
| | | | - Maria O Nerush
- Almazov National Medical Research Centre, St. Petersburg 197341, Russia
| | - Mikael S Mor
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Elena V Petersen
- Moscow Institute of Physics and Technology, Moscow 141701, Russia
| | | | - Evgeniya V Efimova
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Savelii R Kuvarzin
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia
| | - Konstantin B Yenkoyan
- Neuroscience Laboratory, COBRAIN Center, M. Heratsi Yerevan State Medical University, Yerevan AM 0025, Armenia.,COBRAIN Scientific Educational Center for Fundamental Brain Research, Yerevan AM 0025, Armenia
| | | | | | | | | | | | - Allan V Kalueff
- Institute of Translational Biomedicine, St. Petersburg State University, St. Petersburg 199034, Russia.,Almazov National Medical Research Centre, St. Petersburg 197341, Russia.,Ural Federal University, Ekaterinburg 620075, Russia.,Granov Russian Research Center of Radiology and Surgical Technologies, Ministry of Healthcare of Russian Federation, Pesochny 197758, Russia.,Moscow Institute of Physics and Technology, Moscow 141701, Russia.,COBRAIN Scientific Educational Center for Fundamental Brain Research, Yerevan AM 0025, Armenia.,Scientific Research Institute of Neuroscience and Medicine, Novosibirsk, 630117, Russia
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25
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Mallaroni P, Mason NL, Vinckenbosch FRJ, Ramaekers JG. The use patterns of novel psychedelics: experiential fingerprints of substituted phenethylamines, tryptamines and lysergamides. Psychopharmacology (Berl) 2022; 239:1783-1796. [PMID: 35487983 PMCID: PMC9166850 DOI: 10.1007/s00213-022-06142-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 04/06/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Novel psychedelics (NPs) are an expanding set of compounds, presenting new challenges for drug policy and opportunities for clinical research. Unlike their classical derivatives, little is known regarding their use profiles or their subjective effects. AIMS The purpose of this study was to compile usage patterns and adverse event rates for individual NPs belonging to each of three main psychedelic structural families. Targeting the most widely used representatives for each class, we expanded on their phenomenological distinctions. METHODS A two-part survey was employed. We investigated the prevalence of novel phenethylamines, tryptamine and lysergamides in NP users (N = 1180), contrasting the type and incidence of adverse events (AEs) using a set of logistic regressions. Honing in on 2-4-Bromo-2,5-dimethoxyphenyl)ethanamine (2C-B) (48.6%), 1-propionyl-lysergic acid diethylamide (1P-LSD) (34.2%) and 4-Acetoxy-N,N-dimethyltryptamine (4-AcO-DMT) (23.1%), we examined their phenomenological separability using a gradient boosting (XGBoost) supervised classifier. RESULTS Novel phenethylamines had the highest prevalence of use (61.5%) seconded by tryptamines (43.8%) and lysergamides (42.9%). Usage patterns were identified for 32 different compounds, demonstrating variable dosages, durations and a common oral route of administration. Compared to phenethylamines, the odds for tryptamines and lysergamides users were significantly less for overall physical AEs. No significant differences in overall psychological AEs were found. Overall model area under the curve (AUC) stood at 0.79 with sensitivity (50.0%) and specificity (60.0%) for 2C-B ranking lowest. CONCLUSION NP classes may hold distinct AE rates and phenomenology, the latter potentially clouded by the subjective nature of these experiences. Further targeted research is warranted.
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Affiliation(s)
- P Mallaroni
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
| | - N L Mason
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - F R J Vinckenbosch
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands
| | - J G Ramaekers
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200, MD, Maastricht, the Netherlands.
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Spatiotemporal Mapping of Online Interest in Cannabis and Popular Psychedelics before and during the COVID-19 Pandemic in Poland. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19116619. [PMID: 35682204 PMCID: PMC9180639 DOI: 10.3390/ijerph19116619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/26/2022] [Accepted: 05/26/2022] [Indexed: 02/04/2023]
Abstract
Background: Psychedelics represent a unique subset of psychoactive substances that can induce an aberrant state of consciousness principally via the neuronal 5-HT2A receptor. There is limited knowledge concerning the interest in these chemicals in Poland and how they changed during the pandemic. Nonetheless, these interests can be surveyed indirectly via the web. Objectives: We aim to conduct a spatial-temporal mapping of online information-seeking behavior concerning cannabis and the most popular psychedelics before and during the pandemic. Methods: We retrieved online information search data via Google Trends concerning twenty of the most popular psychedelics from 1 January 2017 to 1 January 2022 in Poland. We conducted Holt–Winters exponential smoothing for time series analysis to infer potential seasonality. We utilized hierarchical clustering analysis based on Ward’s method to find similarities of psychedelics’ interest within Poland’s voivodships before and during the pandemic. Results: Twelve (60%) psychedelics had significant seasonality; we proved that psilocybin and ayahuasca had annual seasonality (p-value = 0.0120 and p = 0.0003, respectively), and four substances—LSD, AL-LAD, DXM, and DOB—exhibited a half-yearly seasonality, while six psychedelics had a quarterly seasonal pattern, including cannabis, dronabinol, ergine, NBOMe, phencyclidine, and salvinorin A. Further, the pandemic influenced a significant positive change in the trends for three substances, including psilocybin, ergine, and DXM. Conclusions: Different seasonal patterns exist for psychedelics, and some might correlate with school breaks or holidays in Poland. The pandemic induced some changes in the temporal and spatial trends. The spatial-temporal trends could be valuable information to health authorities and policymakers responsible for monitoring and preventing addictions.
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Peel M. Acute behavioural disturbance: recognition, assessment and management. Emerg Nurse 2022; 30:e2126. [PMID: 35357781 DOI: 10.7748/en.2022.e2126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2022] [Indexed: 11/09/2022]
Abstract
Acute behavioural disturbance (ABD) is a clinical emergency which typically affects overweight men in their mid-thirties who chronically misuse illicit stimulants. People with ABD are most likely to be seen in police custody or emergency departments, therefore nurses working in these areas must be able to recognise the signs and symptoms and know how to respond appropriately. Presentation varies, but the signs and symptoms commonly include extreme agitation, hyperthermia, hostility and exceptional strength without fatigue. Further, it is important to recognise that people with ABD are at risk of developing metabolic acidosis, hyperkalaemia, rhabdomyolysis or disseminated intravascular coagulation. This article gives an overview of ABD and describes the main elements of management and treatment.
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Affiliation(s)
- Matthew Peel
- Leeds Community Healthcare NHS Trust, Leeds, England
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28
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Ivory ST, Rotella JA, Schumann J, Greene SL. A cluster of 25B-NBOH poisonings following exposure to powder sold as lysergic acid diethylamide (LSD). Clin Toxicol (Phila) 2022; 60:966-969. [PMID: 35343858 DOI: 10.1080/15563650.2022.2053150] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
INTRODUCTION 25B-NBOH is a synthetic hallucinogen closely related to the "NBOMe" family of N-substituted 2C phenethylamine derivatives. There have been no published reports documenting the clinical toxicity of NBOH derivatives. CASE SERIES Five patients presented to the Emergency Department (ED) with altered conscious state following exposure to powder sold as "powdered LSD" at a party. A 24-year-old male who ingested the powder developed mydriasis, tachycardia, hypertension, and severe agitation requiring parenteral sedation. A 22-year-old male who insufflated the powder developed status epilepticus requiring intubation. Both patients developed acute kidney injury and one had rhabdomyolysis. In both cases, blood analysis detected 25-NBOH and no other illicit/licit drugs. Three other patients developed mild hallucinations. Hyperthermia was not documented in any case. DISCUSSION Exposure to 25B-NBOH in a powdered form produced sympathomimetic toxicity, including hallucinations. Insufflation of 25B-NBOH led to rapid onset of status epilepticus in one case. Toxicity in all cases resolved within 12 h. Despite in vitro evidence of 5-HT2A receptor agonism, hyperthermia was not observed. Potent hallucinogens are often delivered via blotter paper to avoid excessive dosing. The severe clinical toxicity documented in these cases highlights the potential for development of adverse health effects with exposure to apparent small volumes of potent sympathomimetics.
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Affiliation(s)
- Sean T Ivory
- Department of Emergency Medicine, The Northern Hospital, Melbourne, Australia
| | - Joe-Anthony Rotella
- Department of Emergency Medicine, The Northern Hospital, Melbourne, Australia.,Victorian Poisons Information Centre, Austin Health, Melbourne, Australia
| | - Jennifer Schumann
- Victorian Institute of Forensic Medicine, Monash University, Melbourne, Australia
| | - Shaun L Greene
- Victorian Poisons Information Centre, Austin Health, Melbourne, Australia
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29
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Hearn BG, Brubaker MD, Richardson G. Counselors’ attitudes toward psychedelics and their use in therapy. JOURNAL OF COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1002/jcad.12429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Affiliation(s)
- Benjamin G. Hearn
- College of Education, Criminal Justice, and Human Services University of Cincinnati Cincinnati Ohio USA
| | - Michael D. Brubaker
- College of Education, Criminal Justice, and Human Services University of Cincinnati Cincinnati Ohio USA
| | - George Richardson
- College of Education, Criminal Justice, and Human Services University of Cincinnati Cincinnati Ohio USA
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30
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Herian M, Wojtas A, Maćkowiak M, Wawrzczak-Bargiela A, Solarz A, Bysiek A, Madej K, Gołembiowska K. Neurotoxicological profile of the hallucinogenic compound 25I-NBOMe. Sci Rep 2022; 12:2939. [PMID: 35190675 PMCID: PMC8861095 DOI: 10.1038/s41598-022-07069-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 02/04/2022] [Indexed: 12/20/2022] Open
Abstract
4-Iodo-2,5-dimethoxy-N-(2-methoxybenzyl)phenethylamine (25I-NBOMe) is a new psychoactive substance with strong hallucinogenic properties. Our previous data reported increased release of dopamine, serotonin, and glutamate after acute injections and a tolerance development in the neurotransmitters release and rats’ behavior after chronic treatment with 25I-NBOMe. The recreational use of 25I-NBOMe is associated with severe intoxication and deaths in humans. There is no data about 25I-NBOMe in vivo toxicity towards the brain tissue. In this article 25I-NBOMe-crossing through the blood–brain barrier (BBB), the impact on DNA damage, apoptosis induction, and changes in the number of cortical and hippocampal cells were studied. The presence of 25I-NBOMe in several brain regions shortly after the drug administration and its accumulation after multiple injections was found. The DNA damage was detected 72 h after the chronic treatment. On the contrary, at the same time point apoptotic signal was not identified. A decrease in the number of glial but not in neural cells in the frontal (FC) and medial prefrontal cortex (mPFC) was observed. The obtained data indicate that 25I-NBOMe passes easily across the BBB and accumulates in the brain tissue. Observed oxidative DNA damage may lead to the glial cells’ death.
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Affiliation(s)
- Monika Herian
- Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna, 31-343, Kraków, Poland
| | - Adam Wojtas
- Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna, 31-343, Kraków, Poland
| | - Marzena Maćkowiak
- Laboratory of Pharmacology and Brain Biostructure, Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna, 31-343, Kraków, Poland
| | - Agnieszka Wawrzczak-Bargiela
- Laboratory of Pharmacology and Brain Biostructure, Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna, 31-343, Kraków, Poland
| | - Anna Solarz
- Laboratory of Pharmacology and Brain Biostructure, Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna, 31-343, Kraków, Poland
| | - Agnieszka Bysiek
- Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna, 31-343, Kraków, Poland
| | - Katarzyna Madej
- Department of Analytical Chemistry, Faculty of Chemistry, Jagiellonian University, 2 Gronostajowa, 30-387, Kraków, Poland
| | - Krystyna Gołembiowska
- Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, 12 Smętna, 31-343, Kraków, Poland.
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31
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Schetz D, Schetz A, Kocić I. A retrospective analysis of the "Neverending Trip" after administration of a potent full agonist of 5-HT2A receptor - 25I-NBOMe. Biomed Pharmacother 2022; 146:112295. [PMID: 34980551 DOI: 10.1016/j.biopha.2021.112295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/30/2021] [Accepted: 10/05/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND 5-HT2A receptor (e.g. 25I-NBOMe) agonists not only pose risks of acute intoxication but also long-term effects and significant adverse reactions, e.g. hallucinogen persisting perception disorder (HPPD), derealization, and depersonalization. AIMS We evaluated the risk associated with single and repeated use of 25I-NBOMe. We aimed to identify factors that may increase the risk of HPPD, increase its severity and determine the time when the first symptoms appear. Herein, we report the first extensive evaluation of 25I-NBOMe-induced HPPD. METHOD We assessed all reports (58) collected by The Pomeranian Pharmacovigilance Centre (PPC) from 2013 to 2020. RESULTS The study included a total of 58 reports of adverse reactions caused by 25I-NBOMe. In the case of 15 reports (in patients aged 19-26 years), symptoms persisted many months after the discontinuation of 25I-NBOMe. The most common were: pseudohallucinations, bizarre delusions, derealizations and in some cases development or worsening of depression has been diagnosed. HPPD-like symptoms were most common in patients who took the drug regularly (i.e., several times a month). The risk of HPPD-like symptoms is higher in patients who have severe visual pseudohallucinations, severe bizarre delusions, derealization and/or depersonalization onset immediately after taking the drug. Recurrence of HPPD symptoms may be provoked by many factors, however, there is some cases there is no apparent reason. HPPD after 25I-NBOMe use can last from 2 months up to 2 years. In some patients, pharmacological treatment was necessary due to 25I-NBOMe-induced HPPD and depression. CONCLUSIONS The study showed long-lasting effects after 25I-NBOMe administration and allowed for the determination of HPPD risk factors.
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Affiliation(s)
- Daria Schetz
- Department of Pharmacology, Medical University of Gdańsk, Poland.
| | - Adriana Schetz
- Institute of Philosophy and Cognitive Science, University of Szczecin, Poland
| | - Ivan Kocić
- Department of Pharmacology, Medical University of Gdańsk, Poland
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32
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Tirri M, Bilel S, Arfè R, Corli G, Marchetti B, Bernardi T, Boccuto F, Serpelloni G, Botrè F, De-Giorgio F, Golembiowska K, Marti M. Effect of -NBOMe Compounds on Sensorimotor, Motor, and Prepulse Inhibition Responses in Mice in Comparison With the 2C Analogs and Lysergic Acid Diethylamide: From Preclinical Evidence to Forensic Implication in Driving Under the Influence of Drugs. Front Psychiatry 2022; 13:875722. [PMID: 35530025 PMCID: PMC9069068 DOI: 10.3389/fpsyt.2022.875722] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 03/09/2022] [Indexed: 11/25/2022] Open
Abstract
In the last decade, the market for new psychoactive substances has been enriched by numerous psychedelic phenethylamines, which mimic the psychoactive effect of lysergic acid diethylamide (LSD). In particular, the -NBOMe series, which are more potent than their 2C compounds analogs, are considered worthy substitutes for LSD by users. The purpose of this study was to assess the effects of 25H-NBOMe and its halogenated derivatives (25I-NBOMe and 25B-NBOMe) in comparison to their 2C compounds analogs and LSD on the sensorimotor (visual, acoustic, and overall tactile), reaction time, spontaneous (total distance traveled) and stimulated (drag, accelerod test) motor activity, grip strength test, and prepulse inhibition (PPI) responses in mice. Systemic administration of -NBOMe, 2C compounds analogs, and LSD (0.001-10 mg/kg) differently impaired the sensorimotor, reaction time, motor, and PPI responses in mice. In particular, halogenated (25I and 25B)-NBOMe derivatives appear to be more effective than the entire class of 2C compounds analogs in altering visual and acoustic responses, affecting reaction time, and motor and sensory gating in PPI test. In fact, the specific rank order of compounds potency for nearly all of the experiments showed that (25I and 25B)-NBOMe were more potent than 2C compounds analogs and LSD. -NBOMe and 2C compounds analogs impaired not only the reception of incoming sensory stimuli (visual and acoustic), but their correct brain processing (PPI) in an equal and sometimes stronger way than LSD. This sensory impairment directly affected the spontaneous motor response and reaction time of mice, with no change in performance in stimulated motor activity tests. These aspects should be carefully considered to better understand the potential danger that psychedelic phenethylamines, in particular -NBOMe, may pose to public health, with particular reference to decreased performance in driving and hazardous works that require special sensorimotor skills.
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Affiliation(s)
- Micaela Tirri
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Sabrine Bilel
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Raffaella Arfè
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Giorgia Corli
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Beatrice Marchetti
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Tatiana Bernardi
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Federica Boccuto
- Department of Chemistry and Pharmaceutical Sciences, University of Ferrara, Ferrara, Italy
| | - Giovanni Serpelloni
- Neuroscience Clinical Center and Transcranial Magnetic Stimulation (TMS) Unit, Verona, Italy
| | - Francesco Botrè
- Institute of Sport Science University of Lausanne (ISSUL), Lausanne, Switzerland
| | - Fabio De-Giorgio
- Section of Legal Medicine, Department of Health Care Surveillance and Bioethics, Università Cattolica del Sacro Cuore, Rome, Italy.,Fondazione Policlinico Universitario A. Gemelli Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Krystyna Golembiowska
- Department of Pharmacology, Maj Institute of Pharmacology, Polish Academy of Sciences, Krakòw, Poland
| | - Matteo Marti
- Section of Legal Medicine and Laboratory for Advanced Therapy Technologies (LTTA) Centre, Department of Translational Medicine, University of Ferrara, Ferrara, Italy.,Department of Anti-Drug Policies, Collaborative Center for the Italian National Early Warning System, Presidency of the Council of Ministers, Rome, Italy
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van den Berg M, Magaraggia I, Schreiber R, Hillhouse TM, Porter JH. How to account for hallucinations in the interpretation of the antidepressant effects of psychedelics: a translational framework. Psychopharmacology (Berl) 2022; 239:1853-1879. [PMID: 35348806 PMCID: PMC9166823 DOI: 10.1007/s00213-022-06106-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/24/2022] [Indexed: 01/02/2023]
Abstract
RATIONALE Recent trials with psychedelics in major depressive disorder and treatment-resistant depression showed remarkable improvements in depressive symptoms that can last for up to several months after even a single administration. The lack of an appropriate placebo control group-as patients are often able to discriminate the subjective effects of the drug-and an incomplete understanding of the role of the hallucinogenic and mystical experience, hampers the interpretation of these therapeutic effects. OBJECTIVES To control for these factors, we developed a translational framework based on establishing pharmacokinetic/pharmacodynamic (PK/PD) relationships in rodents and humans for hallucinogenic (i.e., discriminative stimulus effects in rodents and humans; head twitch responses in rodents; questionnaires in humans) and therapeutic effects. For the latter, we selected the pattern separation and attentional set-shifting tasks as measures for cognitive flexibility because of their high translational value. We predict that these PK/PD analyses will lead to a more objective evaluation of improvements in patients compared to relying only on the currently used self-reported questionnaires. We hypothesize that-if the role of the hallucinogenic experience is not central in the antidepressant effects of psychedelics-the ED50's for the therapeutic effects will be significantly lower than for the hallucinogenic and mystical effects. CONCLUSION Our framework will help to inform future studies that aim at the elucidation of the mechanism(s) of action of psychedelics in depression, and the role of the acute subjective and/or hallucinogenic experience in their effects.
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Affiliation(s)
- Manon van den Berg
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands ,Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Igor Magaraggia
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands ,Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands
| | - Rudy Schreiber
- Faculty of Psychology and Neuroscience, Section Neuropsychology & Psychopharmacology, Maastricht University, Maastricht, The Netherlands.
| | - Todd M. Hillhouse
- Department of Psychology, University of Wisconsin Green Bay, Green Bay, WI USA
| | - Joseph H. Porter
- Department of Psychology, Virginia Commonwealth University, Richmond, USA
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Nykodemová J, Šuláková A, Palivec P, Češková H, Rimpelová S, Šíchová K, Leonhardt T, Jurásek B, Hájková K, Páleníček T, Kuchař M. 2C-B-Fly-NBOMe Metabolites in Rat Urine, Human Liver Microsomes and C. elegans: Confirmation with Synthesized Analytical Standards. Metabolites 2021; 11:metabo11110775. [PMID: 34822433 PMCID: PMC8624686 DOI: 10.3390/metabo11110775] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
Compounds from the N-benzylphenethylamine (NBPEA) class of novel psychoactive substances are being increasingly utilized in neurobiological and clinical research, as diagnostic tools, or for recreational purposes. To understand the pharmacology, safety, or potential toxicity of these substances, elucidating their metabolic fate is therefore of the utmost interest. Several studies on NBPEA metabolism have emerged, but scarce information about substances with a tetrahydrobenzodifuran ("Fly") moiety is available. Here, we investigated the metabolism of 2-(8-bromo-2,3,6,7-tetrahydrobenzo[1,2-b:4,5-b']difuran-4-yl)-N-(2-methoxybenzyl)ethan-1-amine (2C-B-Fly-NBOMe) in three different systems: isolated human liver microsomes, Cunninghamella elegans mycelium, and in rats in vivo. Phase I and II metabolites of 2C-B-Fly-NBOMe were first detected in an untargeted screening and identified by liquid chromatography-tandem mass spectrometry (LC-MS/MS). Several hypothesized metabolites were then synthesized as reference standards; knowledge of their fragmentation patterns was utilized for confirmation or tentative identification of isomers. Altogether, thirty-five phase I and nine phase II 2C-B-Fly-NBOMe metabolites were detected. Major detected metabolic pathways were mono- and poly-hydroxylation, O-demethylation, oxidative debromination, and to a lesser extent also N-demethoxybenzylation, followed by glucuronidation and/or N-acetylation. Differences were observed for the three used media. The highest number of metabolites and at highest concentration were found in human liver microsomes. In vivo metabolites detected from rat urine included two poly-hydroxylated metabolites found only in this media. Mycelium matrix contained several dehydrogenated, N-oxygenated, and dibrominated metabolites.
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Affiliation(s)
- Jitka Nykodemová
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic; (J.N.); (P.P.); (H.Č.); (B.J.); (K.H.)
| | - Anna Šuláková
- Department of Experimental Neurobiology, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (A.Š.); (K.Š.); (T.P.)
| | - Petr Palivec
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic; (J.N.); (P.P.); (H.Č.); (B.J.); (K.H.)
| | - Hedvika Češková
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic; (J.N.); (P.P.); (H.Č.); (B.J.); (K.H.)
| | - Silvie Rimpelová
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Technická 3, 166 28 Prague, Czech Republic;
- Correspondence: (S.R.); (M.K.); Tel.: +420-220-444-431 (M.K.)
| | - Klára Šíchová
- Department of Experimental Neurobiology, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (A.Š.); (K.Š.); (T.P.)
| | - Tereza Leonhardt
- Department of Biochemistry and Microbiology, University of Chemistry and Technology Prague, Technická 3, 166 28 Prague, Czech Republic;
| | - Bronislav Jurásek
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic; (J.N.); (P.P.); (H.Č.); (B.J.); (K.H.)
| | - Kateřina Hájková
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic; (J.N.); (P.P.); (H.Č.); (B.J.); (K.H.)
| | - Tomáš Páleníček
- Department of Experimental Neurobiology, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (A.Š.); (K.Š.); (T.P.)
| | - Martin Kuchař
- Forensic Laboratory of Biologically Active Substances, Department of Chemistry of Natural Compounds, University of Chemistry and Technology Prague, Technická 5, 166 28 Prague, Czech Republic; (J.N.); (P.P.); (H.Č.); (B.J.); (K.H.)
- Department of Experimental Neurobiology, National Institute of Mental Health, Topolová 748, 250 67 Klecany, Czech Republic; (A.Š.); (K.Š.); (T.P.)
- Correspondence: (S.R.); (M.K.); Tel.: +420-220-444-431 (M.K.)
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Determination of new psychoactive substances and other drugs in postmortem blood and urine by UHPLC–MS/MS: method validation and analysis of forensic samples. Forensic Toxicol 2021; 40:88-101. [DOI: 10.1007/s11419-021-00600-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
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Hirschfeld T, Smit-Rigter L, van der Gouwe D, Reiche S, Stöver H, Majić T. Safer Tripping: Serotonergic Psychedelics and Drug Checking. Submission and Detection Rates, Potential Harms, and Challenges for Drug Analysis. CURRENT ADDICTION REPORTS 2021. [DOI: 10.1007/s40429-021-00385-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Purpose of Review
With the continuous emergence of new psychoactive substances, drug checking (DC) services are challenged by an increasingly complex drug market. Considering the resumed scientific and public interest in serotonergic psychedelics (SPs) like LSD, psilocybin, and 2C-B, we present the results of a literature search investigating the presence and proportion of SPs in DC samples.
Recent Findings
In 15 identified reports, submission and detection rates of SPs were comparably low, but increasing. Samples contained considerable amounts of adulterations or analogues, mostly novel SPs with unknown toxicological profiles and in some cases potentially life-threatening effects. The detection of SPs, however, requires advanced analysis techniques currently not available to most DC services.
Summary
Given the substantial proportion of novel SPs in DC samples and the associated risks, DC can be a valuable harm reduction and monitoring tool for SPs if analysis techniques with high sensitivity are employed.
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GC–MS and GC–IR analysis of substituted N-benzyl 4-bromo-2,5-dimethoxyphenylisopropylamines. Forensic Chem 2021. [DOI: 10.1016/j.forc.2021.100326] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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38
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Pope JD, Black MJ, Drummer OH, Schneider HG. Urine toxicology screening by liquid chromatography time-of-flight mass spectrometry in a quaternary hospital setting. Clin Biochem 2021; 95:66-72. [PMID: 33989561 DOI: 10.1016/j.clinbiochem.2021.05.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/04/2021] [Accepted: 05/09/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Validation of a non-targeted method for urine drug screening (UDS) by liquid chromatography quadrupole time-of-flight mass spectrometry (LC-QTOF), and comparison to an established GC-MS method in a hospital setting. METHODS 217 UDS specimens sent to a quaternary hospital pathology department, were analysed by a CEDIA® immunoassay screen (six drug panels; amphetamines, barbiturates, benzodiazepines, cocaine metabolites, cannabinoids and opiates) on an Abbott Architect instrument. Specimens were subsequently analysed by an established non-targeted qualitative GC-MS method and results compared with a general unknown screening method by LC-QTOF that was under evaluation as a replacement method. RESULTS 42 selected drugs were evaluated; limits of identification ranged from 2 to 100 µg/L and most drugs (n = 39) were stabile for 24 h after preparation. Matrix effects greater than 25% were observed in seven of the selected drugs. 87% of the specimens tested positive to 1 or more drug panels in a CEDIA® screen. A total of 537 positive drug findings were identified by GC-MS compared to 1,267 positive findings by LC-QTOF. On average, each GC-MS screen identified 2.5 ± 1.8 drugs and the LC-QTOF screen identified 5.8 ± 3.2 drugs. No drugs were identified in 11.3% of the GC-MS screens, whereas drugs were detected in 99% of these by the LC-QTOF. In almost all instances, the LC-QTOF screen could provide mass spectrometric confirmatory results of positive immunoassay screens and was able to identify a wider range of additional drugs and drug metabolites. CONCLUSIONS The described general unknown screening (non-targeted, qualitative) LC-QTOF method can detect a larger range of drugs encountered in a hospital setting. The method has been shown to be suitable for comprehensive toxicology screening in a clinical toxicology laboratory.
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Affiliation(s)
- Jeffrey D Pope
- Clinical Biochemistry, Alfred Health, 55 Commercial Rd, Melbourne 3004, Australia; School of Public Health and Preventative Medicine, Commercial Rd, Melbourne 3004, Monash University, Australia.
| | - Marion J Black
- Clinical Biochemistry, Alfred Health, 55 Commercial Rd, Melbourne 3004, Australia
| | - Olaf H Drummer
- School of Public Health and Preventative Medicine, Commercial Rd, Melbourne 3004, Monash University, Australia; Victorian Institute of Forensic Medicine, 65 Kavanagh St, Southbank 3006, Australia
| | - Hans G Schneider
- Clinical Biochemistry, Alfred Health, 55 Commercial Rd, Melbourne 3004, Australia; School of Public Health and Preventative Medicine, Commercial Rd, Melbourne 3004, Monash University, Australia
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Roberts DM, Premachandra KH, Chan BS, Auld R, Jiranantakan T, Ewers C, McDonald C, Shaw V, Brown JA. A cluster of lysergic acid diethylamide (LSD) poisonings following insufflation of a white powder sold as cocaine. Clin Toxicol (Phila) 2021; 59:969-974. [PMID: 33849370 DOI: 10.1080/15563650.2021.1904140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Adulteration, substitution or contamination of illicit substances can have clinically significant implications when other illicit substances are included. Such circumstances can present as clusters of poisonings, including severe toxicity and death following exposure to unexpected illicit substances. We report a cluster of laboratory-confirmed lysergic acid diethylamide (LSD) in a powder that was sold as cocaine and used recreationally. METHODS The Prescription, Recreational and Illicit Substance Evaluation (PRISE) program established by the New South Wales Ministry of Health includes State-based hospital toxicology services, Poisons Information Centre, Forensic & Analytical Science Service and emergency services to identify clusters of severe and unusual toxicity associated with substance use. PRISE criteria include a known cluster (geographically or situationally related) of people with acute severe toxicity, especially when accompanied by a toxidrome that is inconsistent with the history of exposure. A timely comprehensive drug screen and quantification is performed in eligible cases and the results are related to the clinical features. The need for a public health response is then considered. Four individuals inhaled a white powder that was sold as cocaine and developed severe toxicity that was not consistent with cocaine which prompted transfer to hospital for further management. RESULTS LSD was confirmed in four subjects, and the concentrations in 3 of the individuals were 0.04-0.06 mg/L which are among the highest reported in the literature. Common clinical features were hallucinations, agitation, vomiting, sedation, hypertension, and mydriasis. One subject required intubation and admission to the intensive care unit, two required overnight admission, and the fourth was discharged following oral diazepam after observation. No subject suffered persistent injury. CONCLUSIONS A close working relationship between pre-hospital emergency services, hospital-based clinical services, public health authorities, and analytical laboratories appears to be advantageous. Favourable clinical outcomes are observed from LSD poisoning despite high exposures with good supportive care.
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Affiliation(s)
- Darren M Roberts
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Darlinghurst, Australia.,St Vincent's Clinical School, University of New South Wales, Darlinghurst, Australia.,NSW Poisons Information Centre, Sydney Children's Hospitals Network, Westmead, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Kulanka H Premachandra
- Department of Clinical Pharmacology and Toxicology, St Vincent's Hospital, Darlinghurst, Australia.,St Vincent's Clinical School, University of New South Wales, Darlinghurst, Australia
| | - Betty S Chan
- NSW Poisons Information Centre, Sydney Children's Hospitals Network, Westmead, Australia.,Clinical Toxicology Unit and Emergency Department, Prince of Wales Hospital, Randwick, Australia
| | - Robin Auld
- Centre for Alcohol and Other Drugs, NSW Ministry of Health, St Leonards, Australia
| | - Thanjira Jiranantakan
- NSW Poisons Information Centre, Sydney Children's Hospitals Network, Westmead, Australia.,Drug Health Services, Royal Prince Alfred Hospital, Camperdown, Australia.,Centre for Alcohol and Other Drugs, NSW Ministry of Health, St Leonards, Australia.,Edith Collins Centre, Central Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Christopher Ewers
- Illicit Drugs Analysis Unit, NSW Health Pathology, Forensic & Analytical Science Service, Lidcombe, Australia
| | - Catherine McDonald
- Forensic Toxicology, NSW Health Pathology, Forensic & Analytical Science Service, Lidcombe, Australia
| | - Vanessa Shaw
- Forensic Toxicology, NSW Health Pathology, Forensic & Analytical Science Service, Lidcombe, Australia
| | - Jared A Brown
- NSW Poisons Information Centre, Sydney Children's Hospitals Network, Westmead, Australia.,Centre for Alcohol and Other Drugs, NSW Ministry of Health, St Leonards, Australia
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Caroff SN, Watson CB, Rosenberg H. Drug-induced Hyperthermic Syndromes in Psychiatry. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2021; 19:1-11. [PMID: 33508784 PMCID: PMC7851465 DOI: 10.9758/cpn.2021.19.1.1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 11/02/2020] [Accepted: 11/16/2020] [Indexed: 12/11/2022]
Abstract
Hyperthermia, or extreme elevations in body temperature, can be life-threatening and may be caused by prescription drugs or illegal substances acting at a number of different levels of the neuraxis. Several psychotropic drug classes and combinations have been associated with a classic clinical syndrome of hyperthermia, skeletal muscle hypermetabolism, rigidity or rhabdomyolysis, autonomic dysfunction and altered mental status ranging from catatonic stupor to coma. It is critical for clinicians to have a high index of suspicion for these relatively uncommon drug-induced adverse effects and to become familiar with their management to prevent serious morbidity and mortality. Although these syndromes look alike, they are triggered by quite different mechanisms, and apart from the need to withdraw or restore potential triggering drugs and provide intensive medical care, specific treatments may vary. Clinical similarities have led to theoretical speculations about common mechanisms and shared genetic predispositions underlying these syndromes, suggesting that there may be a common “thermic stress syndrome” triggered in humans and animal models by a variety of pharmacological or environmental challenges.
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Affiliation(s)
- Stanley N Caroff
- Corporal Michael J. Crescenz VA Medical Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Malignant Hyperthermia Association of the United States, Sherburne, NY, USA
| | - Charles B Watson
- Malignant Hyperthermia Association of the United States, Sherburne, NY, USA
| | - Henry Rosenberg
- Malignant Hyperthermia Association of the United States, Sherburne, NY, USA
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Barnett BS, Greer GR. Psychedelic Psychiatry and the Consult-Liaison Psychiatrist: A Primer. J Acad Consult Liaison Psychiatry 2021; 62:460-471. [PMID: 34210406 DOI: 10.1016/j.jaclp.2020.12.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 12/26/2020] [Accepted: 12/27/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Psychedelic compounds such as lysergic acid diethylamide (LSD), psilocybin, and 3,4-Methylenedioxymethamphetamine (MDMA) share a long and complex history with psychiatry. A half century ago, psychedelics were widely employed by psychiatrists in investigational and clinical settings, with studies demonstrating promising findings for their use in the treatment of mental illness and substance use disorders. However, concerns were also raised about their abuse potential and other adverse effects. Owing to these worries and psychedelics' association with the counterculture movement, psychedelics were largely outlawed in the United States in 1970, bringing research on their therapeutic potential to a halt. However, in recent years, a resurgence of psychedelic research has revealed compelling, though early, evidence for the use of psychedelic-assisted therapy in treating alcohol use disorder, nicotine use disorder, posttraumatic stress disorder, and depression. OBJECTIVE Here we provide an overview of psychiatry's complicated relationship with psychedelics, while reviewing contemporary findings on psychedelic-assisted therapy, safety of psychedelic-assisted therapy, and risks of nonmedical use. We also make the case that psychiatry should consider preparing now for the possibility of Food and Drug Administration approval of psychedelic-assisted therapies in the near future. We conclude by discussing how growing societal interest in psychedelics could impact the work of consult-liaison psychiatrists, while also exploring how consult-liaison psychiatrists might contribute to future delivery of psychedelic treatments. METHODS We reviewed literature on psychedelic-assisted therapies and adverse events resulting from nonmedical psychedelic use. RESULTS We found a small, but rapidly growing literature indicating that psychedelic-assisted therapies may have treatment potential for mental illness and addiction. Our search also revealed a variety of rare adverse events stemming from nonmedical psychedelic use. CONCLUSIONS Despite past concerns about psychedelics, current data indicate psychedelic-assisted therapy may potentially reduce suffering owing to mental illness and addiction if administered thoughtfully and cautiously by trained professionals in medical settings.
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Affiliation(s)
- Brian S Barnett
- Department of Psychiatry and Psychology, Center for Behavioral Health, Neurological Institute, Cleveland Clinic, Cleveland, OH.
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Ordak M, Zmysłowska A, Bielski M, Rybak D, Tomaszewska M, Wyszomierska K, Kmiec A, Garlicka N, Zalewska M, Zalewski M, Nasierowski T, Muszynska E, Bujalska-Zadrozny M. Pharmacotherapy of Patients Taking New Psychoactive Substances: A Systematic Review and Analysis of Case Reports. Front Psychiatry 2021; 12:669921. [PMID: 33967865 PMCID: PMC8102790 DOI: 10.3389/fpsyt.2021.669921] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 03/31/2021] [Indexed: 11/13/2022] Open
Abstract
Background: In recent years, an increase in the frequency of hospitalizations of patients taking newer and newer psychoactive substances has been observed around the world. Each year, authors publish case reports of patients who consumed previously unknown NPS. Most publications of this type concern the period between 2014 and 2016. However, no publication systematically reviews the pharmacotherapy used in these cases. This study aims to review the case reports of patients taking NPS published between 2010 and 2019, as well as analyzing the pharmacotherapy used. Methods: We searched the Thomson (Web of Knowledge), PubMed/Medline, Science Direct, Scopus and Google Scholar databases. The search was performed using all possible combinations of the term "case report" describing the use of NPS, also referred to as designer medications, internet medications, research chemicals and herbal highs. Results: We analyzed 51 case reports on the intake of various types of NPS. Most of them (p < 0.001) concerned the use of synthetic cannabinoids (41.2%) and cathinones (31.4%). The pharmacotherapy applied primarily (p < 0.001) consisted of administering benzodiazepines to patients (62.7%), most of whom took only this group of medications (25.5%), followed by groups receiving benzodiazepines combined with neuroleptics (15.7%) and muscle relaxants (11.8%). Opioids were administered primarily to patients taking synthetic opioids (p < 0.001). Of the 5 cases of deaths from NPS reported in the literature, three relate specifically to the synthetic opioid MT-45. The later the time period, the more medications patients were administered (p = 0.02). Conclusion: In the pharmacotherapy for NPS poisoning, one should focus primarily on combating psychomotor agitation.
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Affiliation(s)
- Michal Ordak
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Zmysłowska
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Miłosz Bielski
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Daniel Rybak
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Maja Tomaszewska
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Wyszomierska
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Kmiec
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Natalia Garlicka
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Maria Zalewska
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | - Michal Zalewski
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
| | | | - Elzbieta Muszynska
- Department of Medical Biology, Medical University of Bialystok, Bialystok, Poland
| | - Magdalena Bujalska-Zadrozny
- Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland
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Cocchi V, Gasperini S, Hrelia P, Tirri M, Marti M, Lenzi M. Novel Psychoactive Phenethylamines: Impact on Genetic Material. Int J Mol Sci 2020; 21:ijms21249616. [PMID: 33348640 PMCID: PMC7766159 DOI: 10.3390/ijms21249616] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/04/2020] [Accepted: 12/15/2020] [Indexed: 12/16/2022] Open
Abstract
Psychedelic and stimulating phenethylamines belong to the family of new psychoactive substances (NPS). The acute toxicity framework has begun to be investigated, while studies showing genotoxic potential are very limited or not available. Therefore, in order to fill this gap, the aim of the present work was to evaluate the genotoxicity by treating TK6 cells with 2C-H, 2C-I, 2C-B, 25B-NBOMe, and the popular 3,4-Methylenedioxymethylamphetamine (MDMA). On the basis of cytotoxicity and cytostasis results, we selected the concentrations (6.25–35 µM) to be used in genotoxicity analysis. We used the micronucleus (MN) as indicator of genetic damage and analyzed the MNi frequency fold increase by an automated flow cytometric protocol. All substances, except MDMA, resulted genotoxic; therefore, we evaluated reactive oxygen species (ROS) induction as a possible mechanism at the basis of the demonstrated genotoxicity. The obtained results showed a statistically significant increase in ROS levels for all genotoxic phenethylamines confirming this hypothesis. Our results highlight the importance of genotoxicity evaluation for a complete assessment of the risk associated also with NPS exposure. Indeed, the subjects who do not have hazardous behaviors or require hospitalization by using active but still “safe” doses could run into genotoxicity and in the well-known long-term effects associated.
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Affiliation(s)
- Veronica Cocchi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (V.C.); (S.G.); (M.L.)
| | - Sofia Gasperini
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (V.C.); (S.G.); (M.L.)
| | - Patrizia Hrelia
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (V.C.); (S.G.); (M.L.)
- Correspondence:
| | - Micaela Tirri
- Department of Translational Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, 44121 Ferrara, Italy; (M.T.); (M.M.)
| | - Matteo Marti
- Department of Translational Medicine, Section of Legal Medicine and LTTA Center, University of Ferrara, 44121 Ferrara, Italy; (M.T.); (M.M.)
- Collaborative Center for the Italian National Early Warning System, Department of Anti-Drug Policies, Presidency of the Council of Ministers, 44121 Ferrara, Italy
| | - Monia Lenzi
- Department of Pharmacy and Biotechnology, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy; (V.C.); (S.G.); (M.L.)
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Ferrari E, Arantes LC, Salum LB, Caldas ED. Analysis of non-derivatized 2-(4-R-2,5-dimethoxyphenyl)-N-[(2-hydroxyphenyl)methyl]ethanamine using short column gas chromatography - mass spectrometry. J Chromatogr A 2020; 1634:461657. [PMID: 33161196 DOI: 10.1016/j.chroma.2020.461657] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 10/22/2020] [Accepted: 10/26/2020] [Indexed: 01/31/2023]
Abstract
The 25R-NBOH family is a group of thermally labile compounds that are relevant for forensic sciences and traditionally analyzed by GC-MS after derivatization - a step that is time consuming in a routine work. In this paper, the use of short analytical columns (4 and 10 m) showed to decrease compound degradation in the GC oven during chromatographic separation and to allow the analysis of non-derivatized 25R-NBOH compounds by GC-MS. A shorter column demanded a higher gas flow rate, and both factors decreased residence time of the analytes in the column and their degradation. The inlet temperature (250° C or 280°C) did not impact the response of 25R-NBOH. A 25R-NBOH fragmentation pathway by electron ionization was also presented for the first time. The GC-MS method with a 4 m column was successfully applied to other compounds of forensic interest, and it can be tested in the analysis of biological samples in toxicological investigations.
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Affiliation(s)
- Ettore Ferrari
- Forensic Analysis Laboratory, Criminalistic Institute, Civil Police of the Federal District, 70610-907 Brasília, Federal District, Brazil
| | - Luciano Chaves Arantes
- Forensic Analysis Laboratory, Criminalistic Institute, Civil Police of the Federal District, 70610-907 Brasília, Federal District, Brazil
| | - Lívia Barros Salum
- Forensic Analysis Laboratory, Criminalistic Institute, Civil Police of the Federal District, 70610-907 Brasília, Federal District, Brazil
| | - Eloisa Dutra Caldas
- Laboratory of Toxicology, Department of Pharmacy, University of Brasília, Campus Darcy Ribeiro, 70910-900 Brasília, Federal District, Brazil.
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