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Bath salts and polyconsumption: in search of drug-drug interactions

  • Ana Belen Lopez-RodriguezEmail author
  • Maria-Paz Viveros
Review

Abstract

Background and rationale

Polydrug use is a widespread phenomenon, especially among adolescents and young adults. Synthetic cathinones are frequently consumed in combination with other drugs of abuse. However, there is very little information regarding the consequences of this specific consumption pattern.

Objectives

The aim of this review is to introduce this topic and highlight the gaps in the existing literature. In three different sections, we focus on specific interactions of synthetic cathinones with alcohol, cannabinoids, and the stimulants nicotine and cocaine. We then dedicate a section to the existence of sex and gender differences in the effects of synthetic cathinones and the long-term psychophysiological consequences of adolescent and prenatal exposure to these drugs.

Major findings

Epidemiological studies, case reports, and results obtained in animal models point to the existence of pharmacological and pharmacokinetic interactions between synthetic cathinones and other drugs of abuse. This pattern of polyconsumption can cause the potentiation of negative effects, and the dissociation between objective and subjective effects can increase the combined use of the drugs and the risk of toxicity leading to serious health problems. Certain animal studies indicate a higher vulnerability and effect of cathinones in females. In humans, most of the users are men and case reports show long-term psychotic symptoms after repeated use.

Conclusions

The co-use of synthetic cathinones and the other drugs of abuse analyzed indicates potentiation of diverse effects including dependence and addiction, neurotoxicity, and impaired cognition and emotional responses. The motivations for and effects of synthetic cathinone use appear to be influenced by sex/gender. The long-term consequences of their use by adolescents and pregnant women deserve further investigation.

Keywords

Bath salts Polyconsumption Drug interactions Novel psychoactive substances 

Abbreviations

3-FMC

3-Fluoromethcathinone

4-CMC

4-Chloromethcathinone

5-HT

Serotonin

α-PHP

Alpha-pyrrolidinohexiophenone

α-PVP

α-Pyrrolidinovalerophenone

AB-CHMINACA

N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(cyclohexylmethyl)-1H-indazole-3-carboxamide

AB-FUBINACA

N-(1-amino-3-methyl-1-oxobutan-2-yl)-1-(4-fluorobenzyl)-1H-indazole-3-carboxamide)

BrdU

5-Bromo-2′-deoxyuridine

CNS

Central nervous system

CPP

Conditional place preference

CXCL12

C-X-C Motif Chemokine Ligand 12

DA

Dopamine

DAT

Dopamine transporter

EPC

Environmental place conditioning

EtOH

Ethanol

fMRI

Functional magnetic resonance imaging

L-SPD

Stepholidine

MDMA

3,4-Methylenedioxymethamphetaminen

MDPV

4-Methylenedioxypyrovalerone

MEPH

Mephedrone, 4-methylmethcathinone

METH

Methylone, 3,4-methylenedioxy-N-methylcathinone

mPFC

Medial prefrontal cortex

NA

Noradrenaline

NAc

Nucleus accumbens

nAChR

Nicotinic acetylcholine receptor

NPS

Novel psychoactive substances

PND

Post-natal day

SERT

Serotonin transporter

THC

Delta-9-tetrahydrocannabinol

WIN

WIN 55,212–2

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of Biochemistry and Immunology, Trinity College Institute of NeuroscienceTrinity College DublinDublin 2Ireland
  2. 2.School of Biological SciencesComplutense UniversityMadridSpain

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