Pharmacopsychiatry
April 25, 2017
Norbert Scherbaum, Fabrizio Schifano, Udo Bonnet
46 citations
Hundreds of new psychoactive substances (NPS) have been identified in Europe, mainly synthetic cannabinoids and new synthetic stimulants like cathinones. These are often developed by modifying basic chemical structures such as phenethylamine or tryptamine. Although their pharmacology and toxicology are hardly known, they are sold online as "bath salts" or "incense mixtures" and advertised as "legal highs." Little is known about the prevalence of NPS use, but some molecules may cause severe adverse reactions. Unlike cannabis, synthetic cannabinoid users may experience epileptic seizures, loss of consciousness, and persisting psychopathological disorders. Future studies should inform better-tailored management strategies.
Frontiers in Psychiatry
July 7, 2020
Michael Specka, Thomas Kuhlmann, Jürgen Sawazki et al.
42 citations
Among patients undergoing in-patient detoxification from illicit drugs in Germany, use of novel psychoactive substances (NPS) was rare. About 32% reported having tried synthetic cannabimimetics at least once in their lifetime, but usually only a few times, and nearly no one had used them in the 30 days before admission. Urine analysis confirmed the low recent use. In contrast, lifetime and current use of opiates, alcohol, cocaine, benzodiazepines, and cannabis was high. An important reason given for trying NPS was that they were not detected by drug testing in prisons or treatment facilities. A notable finding was that 18% reported regular unprescribed pregabalin use during their lifetime, and 20% had recently used it, indicating diversion of legal medications is a serious concern.
Frontiers in psychiatry
January 1, 2022
Udo Bonnet, Michael Specka, Ann-Kristin Kanti et al.
4 citations
Substance-dependent users and addiction medicine experts rank the harms of traditional illicit drugs (heroin, cocaine, amphetamines) highest, with alcohol and benzodiazepines also in a top-harm tier. Both groups place methadone, nicotine, and cannabis in the midrange, and buprenorphine and psychotropic mushrooms at the lowest harm level. Users rate the benefits of traditional illicit drugs, cannabis, and nicotine more positively than experts do, while experts judge methadone as significantly less harmful than users do. Users attribute the most benefits to buprenorphine, methadone, and cannabis, likely reflecting that over 50% of the user sample sought opiate detoxification treatment. The findings inform psychoeducation and policy debates.
Fortschr Neurol Psychiatr
June 8, 2026
Udo Bonnet, Norbert Scherbaum, Georg Juckel et al.
Ketamine, administered intravenously at subnarcotic doses, has emerged as a rapid-acting treatment for treatment-resistant depression. This historical overview traces its development, compares it with the newer esketamine nasal spray, and discusses future prospects. Intravenous ketamine infusions have shown efficacy in rapidly reducing depressive symptoms, while esketamine, a derivative, offers a more convenient nasal route but may have different efficacy and safety profiles. The article highlights the need for further research to optimize dosing, duration of effect, and long-term outcomes, as well as to understand the mechanisms underlying ketamine's antidepressant action.