Pharmaceuticals (Basel)
October 23, 2020
Andreia Machado Brito-Da-Costa, Diana Dias-Da-Silva, Nelson G. M. Gomes et al.
111 citations
Ayahuasca's psychoactive effects stem from the interplay of its alkaloids: N,N-dimethyltryptamine (DMT), harmine, harmaline, and tetrahydroharmine. DMT is rapidly absorbed and metabolized, but its oral activity requires monoamine oxidase inhibition by β-carbolines (harmine, harmaline) to prevent breakdown. Harmine and harmaline are quickly metabolized, while tetrahydroharmine has a longer half-life. The pharmacokinetics and pharmacodynamics of these compounds influence the duration and intensity of subjective effects, as well as potential toxicity. Understanding these processes is crucial for clinical management of adverse reactions and for forensic interpretation in cases of intoxication or death.
Pharmaceuticals
February 3, 2021
Andreia Machado Brito-Da-Costa, Áurea Madureira-Carvalho, Diana Dias Da Silva et al.
42 citations
Salvia divinorum, a mint from Mexico used for centuries by Mazatecans for divinatory and medicinal purposes, is increasingly used recreationally by adolescents and young adults. Its main psychoactive compound, salvinorin A, is a non-nitrogenous diterpenoid that acts selectively on the κ-opioid receptor. Absorption occurs through oral mucosa or respiratory tract; when swallowed, it is rapidly broken down in the gastrointestinal system to its inactive metabolite salvinorin B. The compound is quickly distributed, accumulates in the brain, and is rapidly eliminated, matching its short-lived effects. No reports of toxicity or serious adverse outcomes were found. Proposed therapeutic applications include treatment of chronic pain, gastrointestinal and mood disorders, neurological diseases, and drug dependence, but clinical acceptance is limited by psychotropic side effects and misuse.
Addiction
December 8, 2025
María Rita Concepción García, Nelson G. M. Gomes, Diana Dias Da Silva
MDMA (ecstasy), commonly used for its stimulant and empathogenic effects especially among young adults in recreational settings, can cause hyponatraemia—a low blood sodium concentration that alters mental state and is life-threatening if untreated. Although hyponatraemia is a common electrolyte disorder in clinical care, acute MDMA-induced hyponatraemia was first reported in 1993. Women face higher incidence rates and greater odds of severe effects. This review describes the clinical manifestations, prevalence, pathophysiological mechanisms, and therapeutic approaches for correcting this electrolyte imbalance.