title: Novel psychoactive substances: the pharmacology of stimulants and hallucinogens.
abstract: There are increasing levels of concern relating to the rapidly evolving novel psychoactive substances/NPS and web markets' scenarios. The paper aims at providing an overview of the clinical pharmacological issues related to some of the most popular NPS categories, e.g. stimulants and hallucinogens. NPS intake is typically associated with the imbalance of a complex range of neurotransmitter pathways/receptors, namely: dopamine; cannabinoid/CB1; and 5-HT2A. The intake is almost invariably undetectable with standard screening tests. Hence, it may frequently occur that the acute management of NPS misusers will need to focus on decreasing levels of both self/outward-directed aggression and agitation. Benzodiazepines may be considered as first line treatment. Alternatively, propofol and/or antipsychotics can be administered. Focus will be as well on treatment of possible rhabdomyolysis and hyperthermia. Indeed, future studies should inform better tailored management/treatment strategies.
authors.affiliation: a 'Psychopharmacology; drug misuse; and novel psychoactive substances' Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , Herts , UK.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Schifano
authors.affiliation: a 'Psychopharmacology; drug misuse; and novel psychoactive substances' Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , Herts , UK.
authors.forename: G Duccio
authors.initials: GD
authors.lastname: Papanti
authors.affiliation: a 'Psychopharmacology; drug misuse; and novel psychoactive substances' Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , Herts , UK.
authors.forename: Laura
authors.initials: L
authors.lastname: Orsolini
authors.affiliation: a 'Psychopharmacology; drug misuse; and novel psychoactive substances' Research Unit, School of Life and Medical Sciences , University of Hertfordshire , Hatfield , Herts , UK.
authors.forename: John M
authors.initials: JM
authors.lastname: Corkery
mesh_terms: D000818:Animals; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000494:pharmacology*; D005334:Fever / Q000139:chemically induced / Q000628:therapy; D006213:Hallucinogens / Q000009:adverse effects / Q000494:pharmacology*; D006801:Humans; D015742:Propofol / Q000627:therapeutic use; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000494:pharmacology*; D012206:Rhabdomyolysis / Q000139:chemically induced / Q000628:therapy; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy
chemical_list: D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D006213:Hallucinogens; D011619:Psychotropic Drugs; D001569:Benzodiazepines; D015742:Propofol
keywords: Novel psychoactive substances; drug misuse; hallucinogenic drugs; phenethylamines; psychiatric disturbances; synthetic cannabimimetics; synthetic cathinones