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Stimulants: cocaine, amphetamines and party drugs
Published in Berry Beaumont, David Haslam, Care of Drug Users in General Practice, 2021
The leaves of the khat shrub have been chewed for centuries in the Horn of Africa and the Arabian peninsula. They contain cathinone, which has an effect very similar to that of amphetamine. Khat is legally sold in bunches by greengrocers in areas such as the East End of London and Cardiff, where there are large Somali communities. Methcathinone (‘Jeff’) is a product similar to methamphetamine derived from khat. It has been a drug of abuse in the former Soviet Union but not yet in the UK. Many consider that the UK may in the near future suffer an epidemic invasion of such amphetamine-type stimulants (ATS).
Synthetic Cathinones and Related Fatalities in the United Kingdom
Published in Ornella Corazza, Andres Roman-Urrestarazu, Handbook of Novel Psychoactive Substances, 2018
John M. Corkery, Christine Goodair, Hugh Claridge
Norpseudoephedrine (SD-(-)-cathinone is metabolized primarily to R/S-(-)-norephedrine, and R-(+)-cathinone is metabolized primarily to R/R-(-)-norpseudoephedrine (Brenneisen, Geisshüsler, & Schorno, 1986). These two molecules (ephedrine and pseudoephedrine) are key pre-cursor chemicals in the production of methcathinone, a synthetic cathinone.
Stimulants
Published in G. Hussein Rassool, Alcohol and Drug Misuse, 2017
In the 1950’s and 1960’s amphetamines were widely prescribed for symptoms of depression, and as appetite suppressants. Therapeutically, amphetamines have also been used for the treatment of obesity, asthma and other respiratory problems. Prescription medications for attention deficit hyperactivity disorder (ADHD) are also often stimulants as they relieve hyperactivity, interrupting and fidgeting. Stimulants like methylphenidate are prescribed to increase alertness and physical activity. Stimulants come in a variety of forms, including amphetamines, cocaine and methamphetamines. Many stimulants, such as nicotine and cocaine, are harmful and addictive. The most widely used illegal stimulants are amphetamines, cocaine and crack. Ritalin (Methylphenidate) and Diethylproprion (Tenuate, Apisate) have a similar effect to amphetamines, but are less potent. Illicit produced stimulants include methamphetamine (including crystal meth) and methcathinone. Amphetamine-type stimulants (ATS) are a group of substances comprised of synthetic stimulants, including amphetamine, methamphetamine, methcathinone and ecstasy-type substances (e.g., MDMA and its analogues) (UNODC 2014).
Manganese concentration in patients with encephalopathy following ephedrone use: a narrative review and analysis of case reports
Published in Clinical Toxicology, 2022
Michal Ordak, Natalia Sloniewicz, Tadeusz Nasierowski, Elzbieta Muszynska, Magdalena Bujalska-Zadrozny
de Bie et al. described the case of a 36-year-old man from Azerbaijan who noticed a decrease in his libido in 2005 [18]. In 2004, the patient began to self-inject a methcathinone solution prepared by combining pseudoephedrine hydrochloride with potassium permanganate. He used this solution one to two times a day. Soon after, the patient experienced excessive sleepiness and slowness of movement. These symptoms progressed rapidly for the first few months and then stabilized. The patient was difficult to understand due to palilalia. He did not drool but occasionally choked. He had difficulty walking but reported no problems with maintaining his balance. He had restless legs syndrome (RLS). The patient experienced difficulties in performing fine motor movements but had no gastrointestinal symptoms. The patient's manganese content was measured in whole blood (897 nmol/L) and urine (2804.3 nmol/24 h). Pramipexole dihydrochloride in doses up to 75 mg/day had no effect on Parkinsonism but relieved his RLS. He stopped taking this due to excessive daytime sleepiness and a craving for sweets. Selegiline hydrochloride and levodopa-carbidopa at doses of up to 600/150 mg/day were unsuccessful. Thereafter, a naturopathic physician treated him with a series of calcium disodium EDTA infusions without effect on his symptoms [18].
Manganese-induced neurodegenerative diseases and possible therapeutic approaches
Published in Expert Review of Neurotherapeutics, 2020
Airton C. Martins, Priscila Gubert, Gustavo R. Villas Boas, Marina Meirelles Paes, Abel Santamaría, Eunsook Lee, Alexey A. Tinkov, Aaron B. Bowman, Michael Aschner
Several epidemiological studies evaluated the correlation between Mn exposure and parkinsonism. In a cohort study with 886 American workers, exposed to Mn-containing welding fume was associated with progression of parkinsonism in a dose-dependent manner [32]. Likewise, it was reported that Mn mine workers in South Africa associated cumulative Mn exposure with parkinsonian signs and poorer quality of life [61]. Methcathinone abuse, a psychostimulant that uses potassium permanganate as an oxidant, has also been correlated with extrapyramidal syndrome [62]. However, other authors do not report cognitive deficits and there is a lack of neuropathological studies in methcathinone users to clarify the association between methcathinone users and the PD development [63,64].
Pharmacotherapeutic strategies for methamphetamine use disorder: mind the subgroups
Published in Expert Opinion on Pharmacotherapy, 2019
Edna Soares, Frederico C. Pereira
Methamphetamine (METH) is one of the most frequently abused and problematic psychostimulants across the world. METH, a potent and highly addictive synthetic amphetamine-type stimulant (ATS, a group of stimulants commonly including amphetamine, methamphetamine, ephedrine, methcathinone, methylphenidate and MDMA or ‘Ecstasy’) imposes an increasing public health burden (United Nations Office on Drugs and Crime) [1]. In 2016, an estimated 34.2 million adults worldwide [1] and 1.7 million within European Union [2] used METH in the last year. METH is the greatest challenge among synthetic drugs, mostly in Northern America and Oceania. METH accounts for the majority of global ATS seizures and represents 12% globally, especially in East and Southeast Asia. METH market is extending beyond their usual regions which will likely increase the number of METH users. Consistently, 450,000 people died as a result of drug use in 2015, representing a 60% increase since 2000 [1]. Almost one-third of those deaths were directly associated with drug use disorders and the rest indirectly attributed to unsafe drug use practices. These findings clearly demonstrate the harmfulness of drug use and the need for treatment, only currently provided to one in six people. Moreover, psychostimulant use disorder, including METH dependence, lacks approved pharmacotherapies as no significant clinical outcome regarding prolonged abstinence or METH use reduction was obtained to date. The most effective treatments so far are psychosocial interventions including cognitive behavioral therapy (CBT) and contingency management (CM) [3]. Still, they result in limited long-term recovery and subsequently relapse.