The Benzydamine Experience: A Systematic Review of Benzydamine Abuse
Stefania Chiappini, Andrea Miuli, Alessio Mosca, Mauro Pettorruso, Amira Guirguis, Martin Corkery John, Giovanni Martinotti, Massimo Di Giannantonio, Fabrizio Schifano
Current Neuropharmacology January 14, 2021 DOI: 10.2174/1570159x19666210113151136 via OpenAlex
Summary
Benzydamine, an over-the-counter anti-inflammatory drug, is being diverted and used recreationally at high dosages (500–1500 mg) for its hallucinogenic properties. A systematic review of eleven articles from 1997–2019, including case reports, surveys, and case series, along with analysis of European adverse drug reaction reports from 2005–2020, found three reported abuse cases. The findings suggest healthcare professionals should be aware of potential misuse and that emergency physicians should consider benzydamine abuse when patients present with psychotic symptoms.
Study at a glance
| Characteristics | Systematic review Case report Peer reviewed |
|---|---|
| Dose | 500 to 1500 mg |
| Keywords | Medicine Recreational drug Medical prescription Adverse effect Psychiatry |
| Citations | 19 |
| Key finding | Benzydamine may be diverted for recreational use due to hallucinogenic effects at high dosages, and healthcare professionals should be vigilant about its misuse. |
Abstract
BACKGROUND: Both prescription and over-the-counter (OTC) drugs recently emerged among novel psychoactive substances (NPS) being reported as ingested for recreational purposes. Among them, benzydamine (BZY), normally prescribed as an OTC anti-inflammatory drug, is reportedly being diverted and recreationally used. OBJECTIVE: The aim of this study was to investigate how the misuse of BZY has been reported, illustrating its psychotropic molecular mechanism, and studying its psychopathological effects. METHODS: We firstly conducted a systematic review of the literature concerning the abuse of BZY and its effects. For data gathering purposes, both PRISMA and PROSPERO guidelines were followed. All research methods were approved by PROSPERO (identification code CRD42020187266). Second, we analysed BZY-related data from the European Monitoring Agency (EMA) Adverse Drug Reactions (ADRs) database recorded during 2005-2020 regarding its abuse. RESULTS: Eleven articles, published during 1997-2019, were included in our systematic review, including five case reports, four surveys, and two retrospective case series analyses. While nine articles dealt with the recreational use of BZY, two described an oral overdose of the drug. When specified, dosages of BZY consumed ranged from 500 to 1500mg. The EMA dataset contained three cases of BZY abuse. CONCLUSION: Results from the systematic review showed BZY might be diverted for typical hallucinogenic properties occurring at high dosages. Healthcare professionals should be warned about a possible misuse/abuse of a commonly prescribed anti-inflammatory drug and be vigilant when prescribing it. Physicians working in emergency units should know that psychotic symptoms may be related to BZY abuse.