Drugs That Can Precipitate Seizures
Stanley R. Resor, Henn Kutt in The Medical Treatment of Epilepsy, 2020
The San Francisco General Hospital report confirms the well-documented risk of seizures associated with the recreational use of cocaine, amphetamine, and phencyclidine by other authors (228). The incidence of seizures among patients with medical complications of cocaine abuse has been estimated to be 4.3 to 7.9% (229,230) and may be dependent on the dose and route of administration (229,231). Self-limiting generalized seizures are most often described (228,229), however, partial seizures and status epilepticus also may occur (228,229,232,233). Amphetamine and its derivatives also have convulsant properties which are particularly apparent after intravenous use (228,234,235). Phencyclidine has been reported to cause seizures in 3.1% of intoxicated patients (236) and 18% of patients with PCP-induced coma (237).
Psychotic Disorders and Co-occurring Substance Use Disorders
Tricia L. Chandler, Fredrick Dombrowski, Tara G. Matthews in Co-occurring Mental Illness and Substance Use Disorders, 2022
There are various disorders that can be diagnosed based on the consumption of substances (Steeds et al., 2015). The qualifier ‘substance induced’ is placed on these diagnoses to indicate that the symptoms observed are a result of specific substance use, and when the individual is not using substances, these symptoms most likely will not be present (Brown et al., 2019). Substance-induced psychotic disorder can occur if an individual is using a variety of substances. An individual using phencyclidine (also known as PCP or angel dust) may experience symptoms of euphoria, hallucinations, and distortions of self and reality. Those using phencyclidine may be perceived as having delusions or paranoia as the substance can cause an impending feeling of doom (Steeds et al., 2015). More common substances such as THC can cause instances when individuals experience distortions in reality and some audio or visual hallucinations. Those who have used cocaine for several days may show symptoms of paranoia and altered reality, which is worsened by a lack of sleep associated with the use of the drug. It is also not uncommon for those experiencing withdrawal to report incidents of hallucinations or altered perception (Massoud et al., 2018). With substance-induced disorders, the time frame for symptoms is acute and related to substance use, with most symptoms dissipating within a few days of taking the substance, although they can last up to two weeks. Urinalysis and speaking with collateral contacts are recommended during assessments to help differentiate between psychotic disorders and mood-induced disorders.
A Strategy for the Biological Assessment of Addiction
Howard Shaffer, Barry Stimmel in The Addictive Behaviors, 2014
Phencyclidine, most commonly known as “PCP” or “Angel Dust,” has been used recreationally with increasing frequency since the late 1950s. Phencyclidine historically has been classified as a hallucinogen because in toxic doses it typically produces severe agitation, excitement, and psychotic-like reactions including paranoid delusions and auditory hallucinations. In low to moderate doses there may be little or no hallucinosis, and reactions may include drowsiness, ataxia, excitability, and nystagmus. Note that all of these latter signs and symptoms resemble those produced by low dose sedative-hypnotics. Because of the multiform reactions to this drug and the difficulty in correlating dose levels with effects, phencyclidine will be considered separately.
Overdoses and deaths related to the use of ketamine and its analogues: a systematic review
Published in The American Journal of Drug and Alcohol Abuse, 2023
Tharcila V. Chaves, Bob Wilffert, Zila M. Sanchez
The use of ketamine analogues, such as phencyclidine (aka PCP, angel dust), methoxetamine (MXE) and dizocilpine (MK-801) is also a point of concern. In Sweden, Bäckberg et al. (2015) described how the use of methoxylated PCP analogues (3-methoxy-phencyclidine or 3-MeO-PCP and 4-methoxy-phencyclidine or 4-MeO-PCP) was first noted in mid-2013. They have found that intoxications involving new psychoactive substances (NPS) and poly-substance use were common (17). Furthermore, Chong et al. (2017) described a ketamine analogue in the streets of Hong Kong: 2-Oxo-PCE (deschloro-N-ethyl-ketamine). In Hong Kong, ketamine was the second most commonly misused drug after heroin, in the period from 2007 to 2010 (18,19). There are suspicions around the substitution of ketamine for 2-Oxo-PCE in street supplies, possibly for evading detection (20).
Novel Sunifiram-carbamate hybrids as potential dual acetylcholinesterase inhibitor and NMDAR co-agonist: simulation-guided analogue design and pharmacological screening
Published in Journal of Enzyme Inhibition and Medicinal Chemistry, 2022
Khalid A. Agha, Nader E. Abo-Dya, Abdul Rashid Issahaku, Clement Agoni, Mahmoud E. S. Soliman, Eatedal H. Abdel-Aal, Zakaria K. Abdel-Samii, Tarek S. Ibrahim
N-methyl-D-aspartate receptor (NMDAR) is another approach in enhancing cognition,8 it is a glutamate receptor and ion channel protein found in nerve cells as tetrameric complex and is a promising target for cognitive enhancement since it is centrally involved in cognitive processes.9 It was shown that transient activation of NMDAR is the trigger for the induction of long-term potentiation (LTP) at synapses of neurons in the hippocampus which are likely to explain their importance for learning and memory.10 Also, it has the ability to increase acetylcholine release and its inhibition result in decrease in acetylcholine secretion.11,12 Biochemical and molecular studies of NMDA receptor showed that both mRNA and protein levels of NMDARs are reduced in AD brain and AD model, suggesting hypofunction of NMDAR with increasing AD pathologic severity.13 These observations supported by findings that blocking NMDAR by ketamine and phencyclidine can induce schizophrenic like symptoms including cognitive decline in healthy individuals and exacerbate cognitive deficit in schizophrenic individuals.14,15
Prevalence of Stimulant, Hallucinogen, and Dissociative Substances Detected in Biological Samples of NPS-Intoxicated Patients in Italy
Published in Journal of Psychoactive Drugs, 2021
Pietro Papa, Antonella Valli, Marcello Di Tuccio, Eleonora Buscaglia, Elena Brambilla, Giulia Scaravaggi, Mariapina Gallo, Carlo Alessandro Locatelli
Eleven different dissociative substances (Table 4) were identified in 115 patients (7.9% of total cases, 46.7% of positives). The 73% of users were male and the age of the patients ranged from 14 to 62 years (mean = 24.6). Intoxication by the illegal use of ketamine was diagnosed in 105 patients throughout the considered period. Forty-one times ketamine was the only detected NPS, while in 7 cases methoxetamine, an analogue of ketamine, was present. During the period 2012–2014 methoxetamine was identified in 13 other cases. Methoxyphencyclidine (MeO-PCP) and ethylketamine, analogues of ketamine, were detected in 2 cases, one positive for both substances, the other for MeO-PCP and methoxetamine. From 2013, diphenidine (2 cases) and methoxyphenidine (2 cases) appeared in our casuistry. Indeed, data literature (Wallach et al. 2016) report the presence of these substances as chemical research has been available on the internet since 2013 as a legal replacement for the ketamine analogues banned in some European countries. In 2019, 2 cases of phencyclidine and fluoroketamine, respectively, were observed. With regard to the association with different NPS, ketamine was associate with cathinones, atropine, PMMA, and DOC. The designer benzodiazepine flubromazepam was identified in an intoxication involving methoxphenidine (Valli et al. 2017). GHB was involved in an intoxication case with ketamine. Conventional drugs of abuse were detected in 53 of the ketamine-positive cases (50.1%), distributed as follow: 25.5% phytocannabinoids, 17.3% cocaine, 11.2% amphetamines, and 18.4% ecstasy.
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