Swiss Medical Weekly
January 11, 2015
Matthias Liechti
188 citations
Novel psychoactive substances, often sold as 'legal highs' or 'research chemicals', pose health risks similar to classic illicit drugs. They are chemically diverse, including phenethylamines, synthetic cathinones, and tryptamines, and act on monoamine neurotransmitter systems. Stimulants like pipradrols and pyrovalerone cathinones block dopamine and noradrenaline reuptake, while entactogens such as MDMA-like cathinones enhance serotonin release. Hallucinogens, including tryptamines, directly activate 5-HT2A serotonin receptors. Synthetic cannabinoids act on CB1 receptors like THC. The ratio of serotonergic to dopaminergic activity helps predict a substance's psychotropic effects, toxicity, and addiction potential. Most poisonings are mild to moderate, but serotonergic drugs can cause serotonin syndrome, hyperthermia, and seizures; dopaminergic drugs are highly addictive and linked to psychosis; synthetic cannabinoids may cause agitation, hypertension, and renal failure. Treatment is supportive.
Swiss Medical Weekly
April 21, 2007
75 citations
A single intravenous infusion of ketamine (0.5 mg/kg) produced a rapid and substantial improvement in depression symptoms in a 55-year-old man with treatment-resistant major depression and co-occurring alcohol and benzodiazepine dependence. Depression scores dropped by more than half within two days, with the Hamilton Depression Rating scale falling from 36 to 16 and the Beck Depression Inventory from 26 to 9. The patient reported feeling better within 25 minutes of the infusion, and the positive effects lasted for at least seven days. The presence of substance use disorders did not diminish ketamine's antidepressant action.
Swiss Medical Weekly
September 30, 2019
Felix Mller, Stefan Borgwardt
10 citations
LSD produces extensive alterations in functional brain connectivity, particularly increasing connectivity within the thalamocortical system. These changes align with models suggesting hallucinogenic drugs inhibit cerebral filtering of external and internal data. Recent neuroimaging studies in the UK and Switzerland using fMRI have revived research into LSD's neuronal effects, which were unclear despite decades of earlier psychiatric investigation into its potential for treating depression, anxiety, addiction, and personality disorders. However, these studies face limitations, including potential biases in neuroimaging measurements.
Swiss Medical Weekly
July 1, 2025
Samuel E Christen, Elias Bekka, Yasmin Schmid et al.
3 citations
Caffeine, nicotine, cannabis, and psilocybin are naturally occurring psychoactive substances that alter perception, consciousness, cognition, and emotions. Their natural origins have led to long histories of human use and cultural significance. Caffeine and nicotine are widely available as everyday stimulants, while psilocybin is strictly regulated and cannabis is legal in some regions. Their pharmacological and toxicological properties are well known, but ongoing research investigates therapeutic use for specific diseases and disorders. This narrative review provides an overview of these four substances, summarizing evidence on therapeutic potential, health benefits, and associated risks.