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This review focuses on the effects and mechanisms of action of amphetamine-type stimulants (ATS) and their adverse effects on the cardiovascular, nervous, and immune systems. ATS include amphetamine (AMPH), methamphetamine (METH, “crystalmeth,” or “ice”), methylenedioxymethamphetamine (MDMA, “ecstasy,” or “Molly”), MDMA derivatives (e.g., methylene...
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Context 1
... serotonin syndrome is a life-threatening condition that requires immediate medical attention. Medications that can produce a serotonin syndrome when combined with MDMA include commonly prescribed antidepressants, such as selective serotonin reuptake inhibitors, serotonin, and noradrenaline reuptake inhibitors, monoamine oxidase (MAO) inhibitors, antimigraine triptans, some opioid analgesics (fentanyl, tramadol, and dextromethorphan), and the antidepressant buspirone (Table 2) [29][30][31] . ...Context 2
... or unintended polydrug use can potentiate individual harmful effects and produce drug-drug interactions with misused substances and medications, making the stabilizing of agitated patients or counteracting life-threatening overdoses difficult (Table 2). Users who intentionally consume opioids and METH want to experience the desired subjective effects of both substances, avoid excessive sedation, and have milder withdrawal symptoms 72 . ...Context 3
... serotonin syndrome is a life-threatening condition that requires immediate medical attention. Medications that can produce a serotonin syndrome when combined with MDMA include commonly prescribed antidepressants, such as selective serotonin reuptake inhibitors, serotonin, and noradrenaline reuptake inhibitors, monoamine oxidase (MAO) inhibitors, antimigraine triptans, some opioid analgesics (fentanyl, tramadol, and dextromethorphan), and the antidepressant buspirone (Table 2) [29][30][31] . ...Context 4
... or unintended polydrug use can potentiate individual harmful effects and produce drug-drug interactions with misused substances and medications, making the stabilizing of agitated patients or counteracting life-threatening overdoses difficult (Table 2). Users who intentionally consume opioids and METH want to experience the desired subjective effects of both substances, avoid excessive sedation, and have milder withdrawal symptoms 72 . ...Citations
... Methamphetamine (MA), an amphetamine-type stimulant (ATS) colloquially termed "ice", is distinguished by its high addiction potential and is one of the illicit drugs most extensively misused globally (Paz-Ramos et al., 2023). The prevalent consumption of MA is tied to significant health and social ramifications, amplifying the strain on medical and healthcare systems (Jiang et al., 2021). ...
Sleep problems and impulsivity frequently occur in methamphetamine (MA) abstainers and are linked to aberrant brain function. However, the interplay between these factors remains poorly understood. This study aimed to investigate the relationship between sleep, impulsivity, and regional homogeneity (ReHo) through mediation analysis in MA abstainers. 46 MA abstainers and 44 healthy controls were included. Impulsivity and sleep problems were evaluated using the Barratt Impulsivity Scale and the Pittsburgh Sleep Quality Scale, respectively. ReHo, indicative of local brain spontaneous neural activity, was assessed using resting-state functional magnetic resonance imaging. Results unveiled correlations between different dimensions of impulsivity and ReHo values in specific brain regions. Motor impulsivity correlated with ReHo values in the left postcentral gyrus and left precentral gyrus, while non-planning impulsivity was only associated with ReHo values in the left precentral gyrus. Additionally, the need for sleep medications correlated with ReHo values in the left precentral gyrus and bilateral postcentral gyrus. Also, the need for sleep medications was positively correlated with cognitive impulsivity and motor impulsivity. Mediation analysis indicated that reduced ReHo values in the left precentral gyrus mediated the association between impulsivity and the need for sleep medications. These findings imply that addressing sleep problems, especially the need for sleep medications, might augment spontaneous neural activity in specific brain regions linked to impulsivity among MA abstainers. This underscores the importance of integrating sleep interventions into comprehensive treatment strategies for MA abstainers.
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.
