Novel psychoactive substances of interest for psychiatry

Novel psychoactive substances encompass a wide variety of drugs, including synthetic cannabinoids, cathinone derivatives, psychedelic phenethylamines, novel stimulants, synthetic opioids, tryptamine derivatives, dissociatives, piperazines, GABA receptor agonists, prescribed medications, psychoactive plants, and performance-enhancing drugs. Users are often drawn to them for intense psychoactive effects and their likely undetectability in routine drug tests. These substances act on neurotransmitter pathways such as dopamine, cannabinoid CB1, GABA-A/B, 5-HT2A, glutamate, and kappa opioid receptors—systems whose imbalance is linked to mental health conditions. The paper provides psychiatrists with updated knowledge on the clinical pharmacology and psychopathological consequences of these drugs, along with a brief overview of clinical management.

Study at a glance

Abstract

Novel psychoactive substances include synthetic cannabinoids, cathinone derivatives, psychedelic phenethylamines, novel stimulants, synthetic opioids, tryptamine derivatives, phencyclidine-like dissociatives, piperazines, GABA-A/B receptor agonists, a range of prescribedmedications, psychoactive plants/herbs, and a large series of performance and image enhancing drugs. Users are typically attracted by these substances due to their intense psychoactive effects and likely lack of detection in routine drug screenings. This paper aims at providing psychiatrists with updated knowledge of the clinical pharmacology and psychopathological consequences of the use of these substances. Indeed, these drugs act on a range of neurotransmitter pathways/receptors whose imbalance has been associated with psychopathological conditions, including dopamine, cannabinoid CB1, GABA-A/B, 5-HT2A, glutamate, and k opioid receptors. An overall approach in terms of clinical management is briefly discussed.Peer reviewe