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Xylazine as an emerging new psychoactive substance; focuses on both 5‐HT7 and κ‐opioid receptors' molecular interactions and isosteric replacement

Giuseppe Floresta, Alberto Granzotto, Vincenzo Patamia, Davide Arillotta, Gabriele Duccio Papanti, Amira Guirguis, John Corkery, Giovanni Martinotti, Stefano L. Sensi, Fabrizio Schifano

Archiv der Pharmazie March 1, 2025 DOI: 10.1002/ardp.202500041 via OpenAlex

Summary

Xylazine, a veterinary sedative now used recreationally with fentanyl, interacts with human serotonin 7 (5-HT7R) and kappa-opioid (KOR) receptors. Computational docking and molecular dynamics simulations identified binding motifs and showed that small structural changes can improve xylazine's affinity for these receptors. These findings may help explain xylazine's psychoactive effects and guide treatments for overdoses.

Study at a glance

Characteristics Computational study Peer reviewed
Topics Ketamine Serotonin
Keywords Xylazine Opioid Pharmacology Psychoactive substance 5-HT Receptor
Citations 12
Key finding Minimal structural modifications to xylazine can potentiate its interaction with 5-HT7R and KOR.

Abstract

Abstract Xylazine, traditionally used as a veterinary sedative, has recently emerged as a new psychoactive substance, being typically ingested in combination with fentanyl derivatives and hence raising significant public health concerns. Despite its increasing prevalence, little is known about its molecular interactions with human neuroreceptors, specifically the serotonin 7 (5‐HT 7 R) and kappa‐opioid (KOR) receptors, which play critical roles in mood regulation, consciousness and nociception. Hence, the binding affinity and molecular interactions of xylazine with both 5‐HT 7 R and KOR through docking simulations and molecular dynamics calculations were investigated. These computational approaches revealed critical insights into receptor binding motifs and highlighted structural modifications that could enhance receptor affinity. The isosteric replacements within the xylazine structure to improve its binding efficacy were assessed, demonstrating that minimal structural modifications can potentiate its interaction with 5‐HT 7 R and KOR. These findings may well advance our understanding of xylazine's mechanism of action, possibly contributing to identifying suitable treatment/management approaches in treating xylazine‐related overdoses.

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