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Xu C, Zhang Z, Hou D, Wang G, Li C, Ma X, Wang K, Luo H, Zhu M. Effects of exercise interventions on negative emotions, cognitive performance and drug craving in methamphetamine addiction. Front Psychiatry 2024; 15:1402533. [PMID: 38827441 PMCID: PMC11140390 DOI: 10.3389/fpsyt.2024.1402533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/30/2024] [Indexed: 06/04/2024] Open
Abstract
Introduction Methamphetamine is currently one of the most commonly used addictive substances with strong addiction and a high relapse rate. This systematic review aims to examine the effectiveness of physical activity in improving negative emotions, cognitive impairment, and drug craving in people with methamphetamine use disorder (MUD). Methods A total of 17 studies out of 133 found from Embase and PubMed were identified, reporting results from 1836 participants from MUD populations. Original research using clearly described physical activity as interventions and reporting quantifiable outcomes of negative mood, cognitive function and drug craving level in people with MUD were eligible for inclusion. We included prospective studies, randomized controlled trials, or intervention studies, focusing on the neurological effects of physical activity on MUD. Results Taken together, the available clinical evidence showed that physical activity-based interventions may be effective in managing MUD-related withdrawal symptoms. Discussion Physical exercise may improve drug rehabilitation efficiency by improving negative emotions, cognitive behaviors, and drug cravings. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/, identifier CRD42024530359.
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Affiliation(s)
- Conghui Xu
- School of Medicine, Yunnan University, Kunming, China
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
| | - Zunyue Zhang
- School of Medicine, Yunnan University, Kunming, China
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
| | - Dezhi Hou
- School of Medicine, Yunnan University, Kunming, China
- Department of General Surgery I, First People’s Hospital of Yunnan Province, Kunming, China
| | - Guangqing Wang
- Department of Rehabilitation Education and Corrections, Drug Rehabilitation Administration of Yunnan Province, Kunming, China
| | - Congbin Li
- Department of Rehabilitation Education and Corrections, Drug Rehabilitation Administration of Yunnan Province, Kunming, China
| | - Xingfeng Ma
- Department of Rehabilitation Education and Corrections, Drug Rehabilitation Administration of Yunnan Province, Kunming, China
| | - Kunhua Wang
- School of Medicine, Yunnan University, Kunming, China
- Yunnan Technological Innovation Centre of Drug Addiction Medicine, Yunnan University, Kunming, China
| | - Huayou Luo
- Department of Gastrointestinal Surgery, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Mei Zhu
- Department of Ultrasound, The First Affiliated Hospital of Kunming Medical University, Kunming, China
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Ricci V, Maina G, Martinotti G. The Loss of Spatiality and Temporality in Twilight Consciousness: The Emergence of Exogenous Psychosis Induced by Novel Psychoactive Substances. Psychopathology 2024; 57:248-258. [PMID: 38631303 DOI: 10.1159/000536076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/29/2023] [Indexed: 04/19/2024]
Abstract
BACKGROUND The state of twilight consciousness is marked by a focused narrowing of awareness, maintaining vigilance and attention while simultaneously experiencing perceptual shifts in the surrounding environment. It is crucial to recognize that this twilight state represents not just a contraction but also an expansion of conscious experience. SUMMARY Substances of abuse, particularly new psychoactive substances, play a significant role in inducing this twilight state. They achieve this by deconstructing essential components of consciousness, such as the perception of time and space. KEY MESSAGE This paper aimed to explore the phenomenon of the twilight state of consciousness and shed light on how new psychoactive substances can alter the perception of time and space during this twilight phase, potentially triggering exogenous psychosis. This comprehensive inquiry employs a phenomenological approach to the study of consciousness, recognizing it as the primary tool for ascribing significance to this intricate yet often overlooked aspect of psychopathology.
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Affiliation(s)
- Valerio Ricci
- San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
| | - Giuseppe Maina
- San Luigi Gonzaga Hospital, University of Turin, Turin, Italy
- Department of Neurosciences "Rita Levi Montalcini", University of Turin, Turin, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università Degli Studi G. D'Annunzio Chieti-Pescara, Chieti, Italy
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Cavallotto C, Chiappini S, Mosca A, d’Andrea G, Di Carlo F, Piro T, Susini O, Stefanelli G, Di Cesare A, Ricci V, Pepe M, Dattoli L, Di Nicola M, Pettorruso M, Martinotti G. Examining Lurasidone Efficacy in Patients with Schizophrenia Spectrum Illness and Concurrent Alcohol and Substance Use Disorder: A Prospective, Multicentric, Real-World Investigation. J Clin Med 2024; 13:2206. [PMID: 38673478 PMCID: PMC11051375 DOI: 10.3390/jcm13082206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/18/2024] [Accepted: 04/09/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Dual disorders (DD) entail the coexistence of a substance use disorder (SUD) and another mental health condition, often within psychotic and affective disorders. This study aims to evaluate lurasidone, an innovative atypical antipsychotic, in individuals diagnosed with schizophrenia spectrum disorder and concurrent comorbidities of alcohol use disorder/substance use disorder (AUD/SUD). Methods: A cohort of 23 subjects diagnosed with schizophrenia spectrum disorder and comorbid AUD/SUD underwent psychometric assessments at baseline (T0) and one-month (T1) post-lurasidone initiation. Results: Lurasidone exhibited significant reductions in psychopathological burden, evidenced by decreased total PANSS scores (Z = 2.574, p = 0.011). Positive symptoms, substance craving (VAS Craving; Z = 3.202, p = 0.001), and aggressivity (MOAS scale; Z = 2.000, p = 0.050) were notably reduced. Clinical Global Impression (CGI) scores significantly improved (Z = 2.934, p = 0.003). Quality of life enhancements were observed in SF-36 subscales (energy, emotional well-being, and social functioning) (p < 0.05) and Q-LES-Q-SF scale (Z = -2.341, p = 0.021). A safety analysis indicated lurasidone's good tolerability, with only 8.7% reporting discontinuation due to side effects. Conclusions: This study offers initial evidence supporting lurasidone's efficacy and safety in dual diagnoses, highlighting positive effects on psychopathology, substance craving, and quality of life. These findings emphasize the need for tailored, comprehensive treatment strategies in managing the complexities of this patient population.
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Affiliation(s)
- Clara Cavallotto
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Stefania Chiappini
- School of Medicine, UniCamillus International Medical School University, 00131 Rome, Italy;
| | - Alessio Mosca
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Giacomo d’Andrea
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Francesco Di Carlo
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Tommaso Piro
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Ottavia Susini
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Giulia Stefanelli
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Andrea Di Cesare
- Department of Mental Health, ASL 02 Lanciano-Vasto-Chieti, 66100 Chieti, Italy;
| | - Valerio Ricci
- Department of Psychiatry, “San Luigi Gonzaga” Hospital, University of Turin, 10124 Turin, Italy
| | - Maria Pepe
- University Policlinic Foundation “A. Gemelli” IRCSS-Catholic University of the Sacred Heart, Largo Agostino Gemelli, 8, 00136 Rome, Italy (M.D.N.)
| | - Luigi Dattoli
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Marco Di Nicola
- University Policlinic Foundation “A. Gemelli” IRCSS-Catholic University of the Sacred Heart, Largo Agostino Gemelli, 8, 00136 Rome, Italy (M.D.N.)
| | - Mauro Pettorruso
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, “G. D’Annunzio” University, 66100 Chieti, Italy; (C.C.); (G.d.); (F.D.C.); (T.P.); (G.S.); (L.D.); (M.P.)
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Ricci V, Di Muzio I, Ceci F, Di Carlo F, Mancusi G, Piro T, Paggi A, Pettorruso M, Vellante F, De Berardis D, Martinotti G, Maina G. Aberrant salience in cannabis-induced psychosis: a comparative study. Front Psychiatry 2024; 14:1343884. [PMID: 38260781 PMCID: PMC10801803 DOI: 10.3389/fpsyt.2023.1343884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 12/20/2023] [Indexed: 01/24/2024] Open
Abstract
Background Natural Cannabis (NC) and Synthetic Cannabinoids (SCs) use can increase the risk and exacerbate the course of psychotic disorders. These could be influenced by the Aberrant Salience (AS) construct. It refers to an excess of attribution of meaning to stimuli that are otherwise regarded as neutral, thereby transform them into adverse, dangerous, or mysterious entities. This leads the patient to engage in aberrant and consequently incorrect interpretative efforts concerning the normal perception of reality and its relationship with our analytical abilities. AS appears to play a significant role in the onset and perpetuation of psychotic disorders. The internal conflict arising from aberrant attributions of significance leads to delusional thoughts, ultimately culminating in the establishment of a self-sustaining psychosis. Aims To examine the differences between psychoses course not associated with cannabis use and those associated with NC-use and SCs-use, in terms of psychotic and dissociative symptoms, AS, global functioning and suicidal ideation. Methods A sample of 62 patients with First Episode Psychosis (FEP) was divided into 3 groups: non cannabis users (non-users, N = 20); NC-users or rather Delta-9-tetrahydrocannabinol (THC) users (THC-users, N = 21); SCs-users, commonly referred to as SPICE-users (SPICE-users, N = 20). Each group underwent assessments at the onset of psychotic symptoms, as well as at the 3 months and 6 months marks, utilizing a range of psychopathological scales. These included the Positive and Negative Syndrome Scale (PANSS) for investigating psychotic symptoms, the Global Assessment of Functioning (GAF) scale for assessing overall functioning, the Dissociative Experiences Scale (DES-II) for measuring dissociative symptoms, the Scale for Suicide Ideation (SSI) for evaluating suicidal ideation and the Aberrant Salience Inventory (ASI) scale for gauging AS. Results SPICE-users showed more severe and persistent positive symptoms, while negative symptoms were mostly represented among non-users. Non-users showed better recovery than SPICE-users in global functioning. All groups showed a decrease in both ASI scores and subscale scores. SPICE-users exhibited higher global AS scores and less improvement in this aspect compared to other groups. Conclusion This study may help understanding the role of AS in both non-substance-related and substance-induced psychosis. This knowledge may lead clinician to a better diagnosis and identify patient-tailored psychopharmacological treatment.
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Affiliation(s)
- Valerio Ricci
- Department of Neuroscience, San Luigi Gonzaga University Hospital, Orbassano, Italy
| | - Ilenia Di Muzio
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio Chieti-Pescara, Chieti, Italy
| | - Franca Ceci
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio Chieti-Pescara, Chieti, Italy
| | - Francesco Di Carlo
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio Chieti-Pescara, Chieti, Italy
| | - Gianluca Mancusi
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio Chieti-Pescara, Chieti, Italy
| | - Tommaso Piro
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio Chieti-Pescara, Chieti, Italy
| | - Andrea Paggi
- Department of Neuroscience, San Luigi Gonzaga University Hospital, Orbassano, Italy
| | - Mauro Pettorruso
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio Chieti-Pescara, Chieti, Italy
- Department of Mental Health, ASL Lanciano-Vasto-Chieti, Chieti, Italy
| | - Federica Vellante
- Department of Mental Health, ASL Lanciano-Vasto-Chieti, Chieti, Italy
| | - Domenico De Berardis
- NHS, Department of Mental Health, Psychiatric Service for Diagnosis and Treatment, Hospital “G. Mazzini”, Teramo, Italy
| | - Giovanni Martinotti
- Department of Neurosciences, Imaging and Clinical Sciences, Università degli Studi G. D’Annunzio Chieti-Pescara, Chieti, Italy
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Giuseppe Maina
- Department of Neuroscience, San Luigi Gonzaga University Hospital, Orbassano, Italy
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Schifano F, Vento A, Scherbaum N, Guirguis A. Stimulant and hallucinogenic novel psychoactive substances; an update. Expert Rev Clin Pharmacol 2023; 16:1109-1123. [PMID: 37968919 DOI: 10.1080/17512433.2023.2279192] [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: 09/06/2023] [Accepted: 10/31/2023] [Indexed: 11/17/2023]
Abstract
INTRODUCTION The renewed interest in considering a range of stimulants, psychedelics and dissociatives as therapeutics emphasizes the need to draft an updated overview of these drugs' clinical and pharmacological issues. AREAS COVERED The focus here was on: stimulants (e.g. amphetamines, methamphetamine, and pseudoephedrine; phenethylamines; synthetic cathinones; benzofurans; piperazines; aminoindanes; aminorex derivatives; phenmetrazine derivatives; phenidates); classical (e.g. ergolines; tryptamines; psychedelic phenethylamines), and atypical (e.g. PCP/ketamine-like dissociatives) psychedelics.Stimulant and psychedelics are associated with: a) increased central DA levels (psychedelic phenethylamines, synthetic cathinones and stimulants); b) 5-HT receptor subtypes' activation (psychedelic phenethylamines; recent tryptamine and lysergamide derivatives); and c) antagonist activity at NMDA receptors, (phencyclidine-like dissociatives). EXPERT OPINION Clinicians should be regularly informed about the range of NPS and their medical, psychobiological and psychopathological risks both in the acute and long term. Future research should focus on an integrative model in which pro-drug websites' analyses are combined with advanced research approaches, including computational chemistry studies so that in vitro and in vivo preclinical studies of index novel psychoactives can be organized. The future of psychedelic research should focus on identifying robust study designs to convincingly assess the potential therapeutic benefits of psychedelics, molecules likely to present with limited dependence liability levels.
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Affiliation(s)
- F Schifano
- Psychopharmacology Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts (UK)
| | - A Vento
- Mental Health Department, Addiction Observatory (Osservatorio sulle dipendenze)- NonProfit Association - Rome, Rome, Italy
| | - N Scherbaum
- LVR-University Hospital, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Duisburg-Essen, Essen, Germany
| | - A Guirguis
- Psychopharmacology Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Herts (UK)
- Pharmacy, Swansea University Medical School, Faculty of Medicine, Health and Life Science, Swansea University, Wales, UK
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Di Carlo F, Verrastro V, Alessi MC, Sociali A, Altomare AI, Di Natale C, Stigliano G, Miuli A, Lalli A, Di Petta G, Chiappini S, Pettorruso M, Bowden-Jones H, Griffiths MD, Martinotti G. High-Risk Gaming Is Associated with Frequent Substance Use: An Exploratory Survey among Young Adults. Eur Addict Res 2023; 29:241-252. [PMID: 37276845 DOI: 10.1159/000529544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 12/19/2022] [Indexed: 06/07/2023]
Abstract
INTRODUCTION Internet gaming disorder (IGD) is an emerging condition within the field of behavioural addictions. IGD has been demonstrated to be highly comorbid with many other mental health disorders. Among these, substance use has been associated with IGD, and there are underlying similarities between behavioural addictions and substance use disorders. The main aims of the present study were (i) to investigate the association between high-risk gaming and substance use among young adults drawn from the general Italian population; and (ii) to explore the psychopathological correlates of high-risk gaming. METHODS Lifetime substance use, type of substances consumed, and frequency of use were investigated through an online survey in a sample of 913 adults aged 18-40 years. High-risk gaming was assessed using the ten-item Internet Gaming Disorder Test (IGDT-10). Psychopathology was assessed using the Revised 90-item Symptom Checklist (SCL-90-R). RESULTS High-risk gaming prevalence rate was 4.4%. High-risk gamers scored higher on all dimensions of psychopathology, confirming the association between high-risk gaming and psychiatric distress. Regarding substance use, high-risk gamers were more commonly polysubstance users and more commonly made use of psychodysleptic substances. High-risk gamers were more commonly frequent substance users, and 32.5% of high-risk gamers used or had used psychoactive substances often or everyday throughout their lives. DISCUSSION AND CONCLUSION The findings are in line with the concept of a common neurobiological vulnerability for both gaming and substance use. There is the need for more research to examine the phenomenology of gaming and its interplay with substance use to help develop effective interventions and prevention strategies.
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Affiliation(s)
- Francesco Di Carlo
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Maria Chiara Alessi
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Antonella Sociali
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Arianna Ida Altomare
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Chiara Di Natale
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Andrea Miuli
- Department of Mental Health, ASL2 Abruzzo, Chieti, Italy
| | - Aliseo Lalli
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Stefania Chiappini
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK
| | - Mauro Pettorruso
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Henrietta Bowden-Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Faculty of Brain Sciences, University College London, London, UK
| | - Mark D Griffiths
- Psychology Department, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
| | - Giovanni Martinotti
- Department of Neuroscience, Imaging, Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
- Department of Clinical and Pharmaceutical Sciences, University of Hertfordshire, Hatfield, UK
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First episode psychosis with and without the use of cannabis and synthetic cannabinoids: Psychopathology, global functioning and suicidal ideation and antipsychotic effectiveness. Psychiatry Res 2023; 320:115053. [PMID: 36682093 DOI: 10.1016/j.psychres.2023.115053] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/24/2022] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
BACKGROUND Natural Cannabis (NC) and Synthetic Cannabinoids (SCs) use can increase the risk of developing psychotic disorders and exacerbate their course. AIMS To examine the differences between psychoses not associated with cannabis use and those associated with NC and SCs use, evaluating psychotic symptoms, global functioning, dissociative symptoms and suicidal ideation. METHODS The sample of 61 patients with First Episode Psychosis (FEP) was divided into 3 groups: non-Cannabis users (non-users, N = 20); NC users (THC-users, N = 21); SCs users (SPICE-users, N = 20). Each group was assessed at FEP and after 3 and 9 months through specific psychopathological scales. RESULTS THC-users, and even more SPICE-users, displayed much more severe positive symptoms than non-users. Negative symptoms were higher among non-users. After 9 months the non-users had recovered significantly better than SPICE-users in their global functioning. Dissociative symptoms were significantly greater in substance users. Finally, suicidal ideation was higher in SPICE-users than in both THC-users and non-users. DISCUSSION The psychoses induced by NC and SCs showed different symptomatic pictures and outcomes from each other and when compared to the psychoses not associated with the use of substances; such knowledge could be relevant in identifying a specific drug treatment.
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Schifano F, Catalani V, Sharif S, Napoletano F, Corkery JM, Arillotta D, Fergus S, Vento A, Guirguis A. Benefits and Harms of 'Smart Drugs' (Nootropics) in Healthy Individuals. Drugs 2022; 82:633-647. [PMID: 35366192 DOI: 10.1007/s40265-022-01701-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2022] [Indexed: 12/14/2022]
Abstract
'Smart drugs' (also known as 'nootropics' and 'cognitive enhancers' [CEs]) are being used by healthy subjects (i.e. students and workers) typically to improve memory, attention, learning, executive functions and vigilance, hence the reference to a 'pharmaceutical cognitive doping behaviour'. While the efficacy of known CEs in individuals with memory or learning deficits is well known, their effect on non-impaired brains is still to be fully assessed. This paper aims to provide an overview on the prevalence of use; putative neuroenhancement benefits and possible harms relating to the intake of the most popular CEs (e.g. amphetamine-type stimulants, methylphenidate, donepezil, selegiline, modafinil, piracetam, benzodiazepine inverse agonists, and unifiram analogues) in healthy individuals. CEs are generally perceived by the users as effective, with related enthusiastic anecdotal reports; however, their efficacy in healthy individuals is uncertain and any reported improvement temporary. Conversely, since most CEs are stimulants, the related modulation of central noradrenaline, glutamate, and dopamine levels may lead to cardiovascular, neurological and psychopathological complications. Furthermore, use of CEs can be associated with paradoxical short- and long-term cognitive decline; decreased potential for plastic learning; and addictive behaviour. Finally, the non-medical use of any potent psychotropic raises serious ethical and legal issues, with nootropics having the potential to become a major public health concern. Further studies investigating CE-associated social, psychological, and biological outcomes are urgently needed to allow firm conclusions to be drawn on the appropriateness of CE use in healthy individuals.
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Affiliation(s)
- Fabrizio Schifano
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK.
| | - Valeria Catalani
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Safia Sharif
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Flavia Napoletano
- East London Foundation Trust (ELFT), Newham Early Intervention Service, London, UK
| | - John Martin Corkery
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Davide Arillotta
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Suzanne Fergus
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
| | - Alessandro Vento
- Department of Mental Health, ASL Roma 2, Rome, Italy
- Addictions' Observatory (ODDPSS), Rome, Italy
- Department of Psychology, Guglielmo Marconi University, Rome, Italy
| | - Amira Guirguis
- Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, College Lane Campus, Hatfield, UK
- Swansea University Medical School, Institute of Life Sciences 2, Swansea University, Singleton Park, Swansea, UK
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Dal Farra D, Valdesalici A, Zecchinato G, De Sandre A, Saccon D, Simonato P, Corazza O, Martinotti G, Smith AL, Solmi M. Knowledge and Use of Novel Psychoactive Substances in an Italian Sample with Substance Use Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:915. [PMID: 35055743 PMCID: PMC8776073 DOI: 10.3390/ijerph19020915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 12/30/2021] [Accepted: 01/10/2022] [Indexed: 01/27/2023]
Abstract
This study aims to determine prevalence and frequency of use of novel psychoactive substances (NPS) and to identify the factors associated with NPS use in an Italian sample of patients diagnosed with substance use disorder (SUD). Prevalence and correlates of NPS knowledge and use were assessed in 185 patients with SUD in three addiction services (Padova, Belluno, Feltre) in the Veneto region with an ad-hoc designed survey. Two thirds of the samples reported knowing NPS and one third reported using them. NPS were considered by them less dangerous than "regular" substances of abuse (t = 6.06 mean 0.78, p < 0.001). Factors associated with NPS use were youth (OR = 4.81; p < 0.001), studentship (OR = 4.99; p = 0.004), subsequent mental disorders diagnosis (OR = 2.49; p = 0.027), suicide attempt history (OR = 11.67; p < 0.001), home detention (OR = 2.30; p = 0.040), residential care (OR = 5.66; p = 0.002), and polysubstance abuse (t = 8.99 mean 2.65 p < 0.001). NPS use in patients with SUD is highly prevalent, particularly in the youngest age group, and associated with psychiatric comorbidity and worse prognosis. It is crucial to systematically assess NPS use and inform addiction service users with SUD of the toxic and potentially lethal side effects. Mental healthcare professionals working in addiction services should receive education and training. Cohort and longitudinal studies are needed.
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Affiliation(s)
- Deborah Dal Farra
- Department of General Psychology, University of Padua, 35122 Padova, Italy; (D.D.F.); (A.V.)
| | - Alice Valdesalici
- Department of General Psychology, University of Padua, 35122 Padova, Italy; (D.D.F.); (A.V.)
| | | | - Alfio De Sandre
- Addiction Department, AULSS 1 Dolomiti, 32021 Agordo, Italy;
| | - Diego Saccon
- Addiction Department, AULSS 4 Veneto Orientale, 30027 San Donà di Piave, Italy;
| | | | - Ornella Corazza
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK; (O.C.); (G.M.)
| | - Giovanni Martinotti
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UK; (O.C.); (G.M.)
- Department of Neuroscience, Imaging, Clinical Sciences, University “G.d’Annunzio”, 66100 Chieti-Pescara, Italy
| | - Andrew L. Smith
- Department of Psychiatry, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, ON K1N 6N5, Canada;
- Department of Mental Health, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute (OHRI), University of Ottawa, Ottawa, ON K1N 6N5, Canada
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Deligianni ML, Studer J, Gmel G, Khazaal Y, Bertholet N. Consciousness alterations in a cohort of young Swiss men: Associations with substance use and personality traits. Front Psychiatry 2022; 13:1056159. [PMID: 36683973 PMCID: PMC9846235 DOI: 10.3389/fpsyt.2022.1056159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 12/02/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Substance-induced consciousness alterations (CA) have mainly been studied among users of psychedelics but not among people using street drugs. AIMS Explore occurrences of three different types of substance-induced CA [ego dissolution (ED), visual pseudo-hallucinations (VPH), anxiety/paranoia (A/P)] and their perceived influences on life, together with their associations with substance use and personality correlates in a general population sample of 25-year-old men. METHODS 2,796 young Swiss men lifetime substance users completed a self-report questionnaire including history of use (never, former, and current) of different substances categories (psychedelics, cocaine, psychostimulants, ecstasy, MDMA, and other drugs), substance-induced ego dissolution (ED), visual pseudo-hallucinations (VPH) and anxiety/paranoia (A/P), the influence of these CA experiences on life, and personality traits (sensation seeking, sociability, anxiety-neuroticism, and aggression-hostility). RESULTS 32.2% reported at least one CA (i.e., ED, VPH or A/P), with 20.5% reporting ED, 16.7% VPH, and 14.6% A/P. Former and current use of psychedelics and ketamine was significantly associated with occurrences of all three types of CAs and with a positive influence of CA on life. Associations between the former and current use of other substances and the different types of CA were less consistent, and perceived influences on life were not statistically significant. Sociability was negatively associated with occurrences of all three types of CA. Positive associations were found between anxiety-neuroticism and ED and A/P, between aggression-hostility and A/P, and between sensation seeking and ED and VPH. CONCLUSION This study supports the potential for psychedelics to induce CAs perceived as beneficial to life among people using street drugs, possibly reflecting the mechanism underlying the therapeutic potential of psychedelics.
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Affiliation(s)
- Marianthi Lousiana Deligianni
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
| | - Joseph Studer
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.,Service of Adult Psychiatry North-West, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Gerhard Gmel
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.,Research Department, Addiction Switzerland, Lausanne, Switzerland.,Centre for Addiction and Mental Health, Institute for Mental Health Policy Research, Toronto, ON, Canada.,Faculty of Health and Social Science, University of the West of England, Bristol, United Kingdom
| | - Yasser Khazaal
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland.,Research Centre, Montreal University Institute of Mental Health, Montreal, QC, Canada
| | - Nicolas Bertholet
- Addiction Medicine, Department of Psychiatry, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland
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