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

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


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.


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.


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.


Bath salts Polyconsumption Drug interactions Novel psychoactive substances 



















Central nervous system


Conditional place preference


C-X-C Motif Chemokine Ligand 12




Dopamine transporter


Environmental place conditioning




Functional magnetic resonance imaging








Mephedrone, 4-methylmethcathinone


Methylone, 3,4-methylenedioxy-N-methylcathinone


Medial prefrontal cortex




Nucleus accumbens


Nicotinic acetylcholine receptor


Novel psychoactive substances


Post-natal day


Serotonin transporter




WIN 55,212–2


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


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© 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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