Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-19T00:32:31.922Z Has data issue: false hasContentIssue false
  • English
  • Français

Substance-related exogenous psychosis: a postmodern syndrome

Published online by Cambridge University Press:  25 June 2020

Giovanni Martinotti Open the ORCID record for Giovanni Martinotti [Opens in a new window] ,
Luisa De Risio ,
Chiara Vannini ,
Fabrizio Schifano ,
Mauro Pettorruso  and
Massimo Di Giannantonio
Giovanni Martinotti
Affiliation:
Department of Neuroscience, Imaging, and Clinical Sciences, University “G.d’Annunzio”, Chieti-Pescara, Italy
Luisa De Risio
Affiliation:
Department of Psychiatry and Addiction, Rome, Italy
Chiara Vannini*
Affiliation:
Department of Neuroscience, Imaging, and Clinical Sciences, University “G.d’Annunzio”, Chieti-Pescara, Italy
Fabrizio Schifano
Affiliation:
Department of Pharmacy, Pharmacology, and Clinical Sciences, University of Hertfordshire, Hertfordshire, United Kingdom
Mauro Pettorruso
Affiliation:
Department of Neuroscience, Imaging, and Clinical Sciences, University “G.d’Annunzio”, Chieti-Pescara, Italy
Massimo Di Giannantonio
Affiliation:
Department of Neuroscience, Imaging, and Clinical Sciences, University “G.d’Annunzio”, Chieti-Pescara, Italy
*
Chiara Vannini, Email: chiaravannini08@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

There is growing recognition that substance use is associated with the emergence of psychosis.Elements of post-modernity dominate contemporary social contexts and operate as existential background factors that contribute to the emergence of substance-related psychotic phenomena, particularly use of potent and highly rewarding novel psychoactive substances (NPS). About 25% of first-episode psychoses are substance-induced (SIP). DSM-5 SIP diagnosis is based on the assumption that symptoms are transient and disappear after sustained abstinence. This narrowed definition does not consider the issue of persistent SIP. There is a clear need for a new diagnostic framework that provides reliable, unambiguous clinical criteria to differentiate between comorbid conditions (i.e., schizophrenia patients with a substance use disorder) and substance-related psychoses. In the present contribution, we aim to outline a novel and separate clinical entity: substancerelated exogenous psychosis (SREP). Within this diagnostic category, we refer to both transientand persistent psychoses associated with substance use. SREP is conceived as a distinct psychoticdisorder with psychopathological specificities that clearly differentiate it from schizophrenia. We address differences in terms of clinical presentation, epidemiology, etiological models and treatment response. SREP is characterized by altered states of consciousness, persecutory delusions, visual and cenesthetic hallucinations, impulsivity and psychomotor agitation, affectiveand negative symptoms, a pervasive feeling of unreality and intact insight. Delusions are typically secondary to abnormal perception resulting from a characteristic “sensorialization” of the world. Longitudinal studies are warranted to substantiate our hypothesis of a novel diagnostic categoryand support the clinical validity of SREP. This may have important implications in terms of early differential diagnosis and staging (i.e., between comorbid conditions, persistent and transientsubstance-related psychotic states) as well as choice of treatment interventions.

Keywords

Psychosisnovel psychoactive substancespsychopathologysubstance abusemental health
Type
Guidelines
Information
CNS Spectrums , Volume 26 , Issue 1 , February 2021 , pp. 84 - 91
Copyright
© The Author(s), 2020. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Whitley, R. Postmodernity and mental health. Harv Rev Psychiatry. 2008;16:352–364.CrossRefGoogle ScholarPubMed
Husserl, E. Ideas Pertaining to a Pure Phenomenology and to a Phenomenological Philosophy. Dordrecht, The Netherlands: Kluwer; 1982.CrossRefGoogle Scholar
Kimura, B. Scritti di Psicopatologia e Fenomenologia. Roma, Italy: Giovanni Fioriti; 2005.Google Scholar
Sullivan, O, Gershuny, J. Speed-up society? Evidence from the UK 2000 and 2015 time use diary surveys. Sociology. 2017;52:20–38.CrossRefGoogle Scholar
Rosa, H. Social Acceleration: A New Theory of Modernity. New York, NY: Columbia University Press; 2013.CrossRefGoogle Scholar
Colvile, R. The Great Acceleration: How the World Is Getting Faster, Faster. New York, NY: Bloomsbury; 2016.Google Scholar
Crary, J. 24/7: Late Capitalism and the Ends of Sleep. London, UK: Verso Books; 2013.Google Scholar
Schulte, B. Overwhelmed: Work, Love and Play When No-One Has the Time. New York, NY: Sarah Crichton Books; 2014.Google Scholar
Bauman, Z. Liquid Modernity. Cambridge, UK: Polity Press; 1999.Google Scholar
Meares, R. The sense of the spirit as a form of conversation. Asian J Psychiatr. 2012;5:190–192.CrossRefGoogle ScholarPubMed
Whiteford, HA, Ferrari, AJ, Degenhardt, L, Feigin, V, Vos, T. The global burden of mental, neurological and substance use disorders: an analysis from the Global Burden of Disease Study 2010. PLoS One. 2015;10:e0116820.CrossRefGoogle ScholarPubMed
Devereux, G. Normale e anormale. In: Devereux, G, ed. Saggi di etnopsichiatria generale. Roma, Italy: Armando Editore; 1956:23–93.Google Scholar
Cinosi, E, Martinotti, G, Simonato, P, et al. Following “the Roots” of Kratom (Mitragyna Speciosa): the evolution of an Enhancer from a traditional use to increase work and productivity in Southeast Asia to a recreational psychoactive drug in Western countries. Biomed Res Int. 2015;2015. doi:10.1155/2015/968786.CrossRefGoogle ScholarPubMed
Schifano, F, Leoni, M, Martinotti, G, Rawaf, S, Rovetto, F. Importance of cyberspace for the assessment of the drug abuse market: preliminary results from the Psychonaut 2002 project. Cyberpsychol Behav. 2003;6(4):405–410.CrossRefGoogle ScholarPubMed
Schifano, F, Deluca, P, Agosti, L, et al. New trends in the cyber and street market of recreational drugs? The case of 2C-T-7 (“Blue Mystic”). J Psychopharmacol. 2005;19(6):675–679.CrossRefGoogle Scholar
Santacroce, R, Corazza, O, Martinotti, G, Bersani, FS, Valeriani, G, Di Giannantonio, M. Psyclones: a roller coaster of life? Hidden synthetic cannabinoids and stimulants in apparently harmless products. Hum Psychopharmacol. 2015;30(4):265–271. doi:10.1002/hup.2410.CrossRefGoogle ScholarPubMed
Martinotti, G, Di Nicola, M, Quattrone, D, et al. Novel psychoactive substances and induced phenomena in psychopathology: the lysergic psychoma. J Psychopathology. 2015;21:400–405.Google Scholar
Corazza, O, Valeriani, G, Bersani, FS, Corkery, J, Martinotti, G, Bersani, G, et al. “Spice,” “Kryptonite,” “Black Mamba”: an overview of brand names and marketing strategies of novel psychoactive substances on the Web. J Psychoactive Drugs. 2014;46(4):287–294. doi:10.1080/02791072.2014.944291.CrossRefGoogle ScholarPubMed
Council of the European Union decision 2005/387/JHA United Nations Office on Drugs and Crime (UNODC), World Drug Report, United Nations Publication, Sales.Google Scholar
Corazza, O, Assi, S, Simonato, P, et al. Promoting innovation and excellence to face the rapid diffusion of novel psychoactive substances in the EU: the outcomes of the ReDNet project. Hum Psychopharmacol. 2013;28:317–323.CrossRefGoogle ScholarPubMed
Eurobarometer. Young people and drugs: analytical report. http://ec.europa.eu/public%20opinion/flash/fl%20233%20en.pdf. 2009.Google Scholar
Salomone, A, Palamar, JJ, Gerace, E, Di Corcia, D, Vincenti, M. Hair testing for drugs of abuse and new psychoactive substances in a high-risk population. Anal Toxicol. 2017;41(5):376–381. doi:10.1093/jat/bkx020.CrossRefGoogle ScholarPubMed
Simonato, P, Corazza, O, Santonastaso, P, et al. Novel psychoactive substances as a novel challenge for health professionals: results from an Italian survey. Hum Psychopharmacol. 2013;28(4):324–331. doi: 10.1002/hup.2300.CrossRefGoogle ScholarPubMed
European Monitoring Centre for Drugs and Drug Addiction-EMCDDA, Annual Report 2015.Google Scholar
Corkery, JM, Elliott, S, Schifano, F, Corazza, O, Ghodse, AH. 2-DPMP (desoxypipradrol, 2-benzhydrylpiperidine, 2-phenylmethylpiperidine) and D2PM (diphenyl-2-pyrrolidin-2-yl-methanol, diphenylprolinol): a preliminary review. Prog Neuropsychopharmacol Biol Psychiatry. 2012;39(2):253–258.CrossRefGoogle ScholarPubMed
Corkery, JM, Loi, B, Claridge, H, et al. Gamma hydroxybutyrate (GHB), gamma butyrolactone (GBL) and 1,4-butanediol (1,4-BD; BDO): a literature review with a focus on UK fatalities related to non-medical use. Neurosci Biobehav Rev. 2015;53:52–78.CrossRefGoogle ScholarPubMed
Soyka, M. Substance misuse, psychiatric disorder and violent and disturbed behaviour. Br J Psychiatry. 2000;176:345–350.CrossRefGoogle ScholarPubMed
Fazel, S, Smith, EN, Chang, Z, Geddes, JR. Risk factors for interpersonal violence: an umbrella review of meta-analyses. Br J Psychiatry. 2018;213(4):609–614.CrossRefGoogle ScholarPubMed
Shafi, A, Gallagher, P, Stewart, N, Martinotti, G, Corazza, O. The risk of violence associated with novel psychoactive substance misuse in patients presenting to acute mental health services. Hum Psychopharmacol. 2017;32:CrossRefGoogle ScholarPubMed
Martinotti, G, Cinosi, E, Santacroce, R, et al. Substance-related psychopathology and aggressiveness in a nightlife holiday resort: results from a pilot study in a psychiatric inpatient unit in Ibiza. Hum Psychopharmacol. 2017;32:e2586. https://doi.org/10.1002/hup.25866 CrossRefGoogle Scholar
Jablensky, A, McGrath, J, Herrman, H, et al. Psychotic disorders in urban areas: an overview of the Study on Low Prevalence Disorders. Aust N Z J Psychiatry. 2000;34(2):221–236.CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 5th edition. Arlington, VA: American Psychiatric Publishing; 2013.Google Scholar
Beckmann, D, Lowman, KL, Nargiso, J, McKowen, J, Watt, L, Yule, AM. Substance-induced psychosis in youth. Child Adolesc Psychiatr Clin N Am. 2020;29(1):131–143. doi:10.1016/j.chc.2019.08.006.CrossRefGoogle ScholarPubMed
Weibell, MA, Hegelstad, V, Johannessen, JO. Substance-induced psychosis: conceptual and diagnostic challenges in clinical practice. In: Preedy, VR, ed. Neuropathology of Drug Addictions and Substance Misuse. Cambridge, MA: Academic Press; 2016.Google Scholar
Mathias, S, Lubman, DI, Hides, L. Substance-induced psychosis: a diagnostic conundrum. J Clin Psychiatry. 2008;69(3):358–367.CrossRefGoogle ScholarPubMed
Rounsaville, BJ. DSM-V research agenda: substance abuse/psychosis comorbidity. Schizophr Bull. 2007;33(4):947–952.CrossRefGoogle ScholarPubMed
Angrist, BM, Gershon, S. The phenomenology of experimentally induced amphetamine psychosis—preliminary observations. Biol Psychiatry. 1970;2(2):95–107.Google ScholarPubMed
World Health Organization (WHO). The ICD-10 Classification of Mental and Behavioural Disorders. 1992.Google Scholar
Schanzer, BM, First, MB, Dominguez, B, Hasin, DS, Caton, CL. Diagnosing psychotic disorders in the emergency department in the context of substance use. Psychiatr Serv. 2006;57(10):1468–1473.CrossRefGoogle ScholarPubMed
Caton, CL, Hasin, DS, Shrout, PE, et al. Stability of early-phase primary psychotic disorders with concurrent substance use and substance-induced psychosis. Br J Psychiatry. 2007;190:105–111.CrossRefGoogle ScholarPubMed
Crebbin, K, Mitford, E, Paxton, R, Turkington, D. First-episode drug-induced psychosis: a medium term follow up study reveals a high-risk group. Soc Psychiatry Psychiatr Epidemiol. 2009;44(9):710–715.CrossRefGoogle ScholarPubMed
Murrie, B, Lappin, J, Large, M, Sara, G. Transition of substance-induced, brief, and atypical psychoses to schizophrenia: a systematic review and meta-analysis. Schizophr Bull. 2020;46:505–516.CrossRefGoogle ScholarPubMed
Weibell, MA, Hegelstad, WTV, Auestad, B, et al. The effect of substance use on 10-year outcome in first-episode psychosis. Schizophr Bull. 2017;43:843–851.CrossRefGoogle ScholarPubMed
Weibell, MA, Johannessen, JO, Auestad, B, et al. Early substance use cessation improves cognition-10 years outcome in first-episode psychosis patients. Front Psychiatry. 2019;10:–495.CrossRefGoogle ScholarPubMed
Wilson, L, Szigeti, A, Kearney, A, Clarke, M. Clinical characteristics of primary psychotic disorders with concurrent substance abuse and substance-induced psychotic disorders: a systematic review. Schizophr Res. 2018;197:78–86.CrossRefGoogle ScholarPubMed
Hannah, E, Jongsma, MPH, Gayer-Anderson, C, et al. Treated incidence of psychotic disorders in the multinational EU-GEI study. JAMA Psychiatry. 2018;75:36–46.Google Scholar
Di Forti, M, Quattrone, D, Freeman, TP, et al. The contribution of cannabis use to variation in the incidence of psychotic disorder across Europe (EU-GEI): a multicentre case-control study. Lancet Psychiatry. 2019;6:427–436.CrossRefGoogle ScholarPubMed
Kienast, T, Stoffers, J, Bermpohl, F, Lieb, K. Borderline personality disorder and comorbid addiction: epidemiology and treatment. Dtsch Arztebl Int. 2014;111:280–286.Google ScholarPubMed
Sass, LA, Parnas, J. Schizophrenia, consciousness, and the self. Schizophrenia Bulletin. 2003;29(3):427–444.CrossRefGoogle ScholarPubMed
Bonhoeffer, K. Die exogenen Reaktionstypen. Archiv f. Psychiatrie. 1917;58:58–70.CrossRefGoogle Scholar
Wearne, TA, Cornish, JL. A comparison of methamphetamine-induced psychosis and schizophrenia: a review of positive, negative, and cognitive symptomatology. Front Psychiatry. 2018;9:491.CrossRefGoogle ScholarPubMed
Caton, CL, Drake, RE, Hasin, DS, et al. Differences between early-phase primary psychotic disorders with concurrent substance use and substance-induced psychoses. Arch Gen Psychiatry. 2005;62:137–145.CrossRefGoogle ScholarPubMed
Vik, PW, Cellucci, T, Jarchow, A, Hedt, J. Cognitive impairment in substance abuse. Psychiatr Clin North Am. 2004;27(1):97–109.CrossRefGoogle ScholarPubMed
Messas, G, Tamelini, M, Mancini, M, Stanghellini, G. New perspectives in phenomenological psychopathology: its use in psychiatric treatment. Front Psychiatry. 2018;9:466.CrossRefGoogle ScholarPubMed
Di Petta, G. Le Psicosi Sintetiche. Giovanni Fioriti Editore; 2016.Google Scholar
Akiyama, K, Saito, A, Shimoda, K. Chronic methamphetamine psychosis after long-term abstinence in Japanese incarcerated patients. Am J Addict. 2011;20(3):240–249.CrossRefGoogle ScholarPubMed
Fraser, S, Hides, L, Philips, L, Proctor, D, Lubman, DI. Differentiating first episode substance induced and primary psychotic disorders with concurrent substance use in young people. Schizophr Res. 2012;136(1–3):110–115.CrossRefGoogle ScholarPubMed
Hides, L, Dawe, S, McKetin, R, et al. Primary and substance-induced psychotic disorders in methamphetamine users. Psychiatry Res. 2015;226(1):91–96.CrossRefGoogle ScholarPubMed
Voce, A, Burns, R, Castle, D, Calabria, B, McKetin, R. Is there a discrete negative symptom syndrome in people who use methamphetamine? Compr Psychiatry. 2019;93:27–32.CrossRefGoogle Scholar
Messas, G. The association between substance use/abuse and psychosis: a phenomenological viewpoint. 2015–2016. Messas, Guilherme. Comprendre 25-26.Google Scholar
Matsumoto, T, Kamijo, A, Miyakawa, T, et al. Methamphetamine in Japan: the consequences of methamphetamine abuse as a function of route of administration. Addiction. 2002;97(7):809–817.CrossRefGoogle ScholarPubMed
Martinotti, G, Lupi, M, Carlucci, L, et al. Novel psychoactive substances: use and knowledge among adolescents and young adults in urban and rural areas. Hum Psychopharmacol. 2015;30(4):295–301.CrossRefGoogle Scholar
Goldstick, JE, Stoddard, SA, Carter, PM, Zimmerman, MA, Walton, MA, Cunningham, RM. Characteristic substance misuse profiles among youth entering an urban emergency department: neighborhood correlates and behavioral comorbidities. Am J Drug Alcohol Abuse. 2016;42(6):671–681.CrossRefGoogle ScholarPubMed
Johnson, , Wu, CY, Winder, GS, Casher, MI, Marshall, VD, Bostwick, JR. The effects of cannabis on inpatient agitation, aggression, and length of stay. J Dual Diagn. 2016;12(3–4):244–251.CrossRefGoogle ScholarPubMed
Homman, L, Seglert, J, Morgan, MJ. An observational study on the sub-acute effects of mephedrone on mood, cognition, sleep and physical problems in regular mephedrone users. Psychopharmacology. 2018;235(9):2609–2618. doi:10.1007/s00213-018-4953-1.CrossRefGoogle ScholarPubMed
Sullivan, S, Herzig, D, Mohr, C, et al. Theory of mind and social functioning in first episode psychosis. Cogn NeuroPsychiatry. 2013;18(3):219–242.CrossRefGoogle ScholarPubMed
Kehr, J, Ichinose, F, Yoshitake, S, et al. Mephedrone, compared with MDMA (ecstasy) and amphetamine, rapidly increases both dopamine and 5-HT levels in nucleus accumbens of awake rats. Br J Pharmacol. 2011;164(8):1949–1958.CrossRefGoogle ScholarPubMed
Capriola, M. Synthetic cathinone abuse. Clin Pharmacol. 2013;5:109–115. doi:10.2147/CPAA.S42832.Google ScholarPubMed
Lovrecic, B, Lovrecic, M, Gabrovec, B, et al. Non-medical use of novel synthetic opioids: a new challenge to public health. Int J Environ Res Public Health. 2019;16(2):177. doi:10.3390/ijerph16020177.CrossRefGoogle ScholarPubMed
Deruiter, WK, Cheng, C, Gehrs, M, Langley, J, Dewa, CS. Substance abuse and smoking among a Canadian cohort of first episode psychosis patients. Community Ment Health J. 2013;49(6):815–821.CrossRefGoogle ScholarPubMed
Dargan, PI, Albert, S, Wood, DM. Mephedrone use and associated adverse effects in school and college/university students before the UK legislation change. QJM. 2010;103(11):875–879. doi:10.1093/qjmed/hcq134.CrossRefGoogle ScholarPubMed
Mdege, ND, Meader, N, Lloyd, C, Parrott, S, McCambridge, J. In: NIHR Journals Library, ed. The Novel Psychoactive Substances in the UK Project: Empirical And Conceptual Review Work To Produce Research Recommendations. Southampton, UK; 2017.Google ScholarPubMed
Warrick, BJ, Hill, M, Hekman, K, et al. A 9-state analysis of designer stimulant, “bath salt,” hospital visits reported to poison control centers. Ann Emerg Med. 2013;62(3):244–251. doi:10.1016/j.annemergmed.2012.12.017.CrossRefGoogle Scholar
Mugele, J, Nañagas, KA, Tormoehlen, LM. Serotonin syndrome associated with MDPV use: a case report. Ann Emerg Med. 2012;60(1):100–102.CrossRefGoogle ScholarPubMed
Hohmann, N, Mikus, G, Czock, D. Effects and risks associated with novel psychoactive substances: mislabeling and sale as bath salts, spice, and research chemicals. Dtsch Arztebl Int. 2014;111(9):139–147.Google ScholarPubMed
Turner, J, Mitchell, JL, Carroll, BT, Denysenko, L. Dextromethorphan/quinidine withdrawal-emergent catatonia. Ann Clin Psychiatry. 2016;28(2):138–139.Google ScholarPubMed
Otahbachi, M, Cevik, C, Bagdure, S, Nugent, K. Excited delirium, restraints, and unexpected death: a review of pathogenesis. Am J Forensic Med Pathol. 2010;31:107–112.CrossRefGoogle ScholarPubMed
Penders, TM, Gestring, R. Hallucinatory delirium following use of MDPV: “Bath Salts”. Gen Hosp Psychiatry. 2011;33(5):525–526.CrossRefGoogle ScholarPubMed
Weaver, MF. Prescription sedative misuse and abuse. Yale J Biol Med. 2015;88(3):247–256.Google ScholarPubMed
Penders, TM, Gestring, RE, Vilensky, DA. Intoxication delirium following use of synthetic cathinone derivatives. Am J Drug Alcohol Abuse. 2012;38:616–617.CrossRefGoogle ScholarPubMed
Kalayasiri, R, Kraijak, K, Maes, M, Mutirangura, A. Methamphetamine (MA) use induces specific changes in LINE-1 partial methylation patterns, which are associated with MA-induced paranoia: a multivariate and neuronal network study. Mol Neurobiol. 2019;56:4258–4272.CrossRefGoogle ScholarPubMed
Baumeister, D, Tojo, LM, Tracy, DK. Legal highs: staying on top of the flood of novel psychoactive substances. Ther Adv Psychopharmacol. 2015;5(2):97–132.CrossRefGoogle Scholar
Schifano, F, Papanti, GD, Orsolini, L, Corkery, JM. Novel psychoactive substances: the pharmacology of stimulants and hallucinogens. Expert Rev Clin Pharmacol. 2016;9(7):943–954.CrossRefGoogle ScholarPubMed
Orsolini, L, Chiappini, S, Papanti, D, De Berardis, D, Corkery, JM, Schifano, F. The bridge between classical and “synthetic”/chemical psychoses: towards a clinical, psychopathological, and therapeutic perspective. Front Psychiatry. 2019;10:851.CrossRefGoogle Scholar
Bonaccorso, S, Metastasio, A, Ricciardi, A, et al. Synthetic cannabinoid use in a case series of patients with psychosis presenting to acute psychiatric settings: clinical presentation and management issues. Brain Sci. 2018;8(7):133 CrossRefGoogle Scholar
Winstock, AR, Barratt, MJ. The 12-month prevalence and nature of adverse experiences resulting in emergency medical presentations associated with the use of synthetic cannabinoid products. Hum Psychopharmacol. 2013;28:390–393.CrossRefGoogle ScholarPubMed
Brakoulias, V. Products containing synthetic cannabinoids and psychosis. Aust N Z J Psychiatry. 2012;46(3):281–282. doi:10.1177/0004867411433974.CrossRefGoogle ScholarPubMed
Celofiga, A, Koprivsek, J, Klavz, J. Use of synthetic cannabinoids in patients with psychotic disorders: case series. J Dual Diagn. 2014;10(3):168–173.CrossRefGoogle ScholarPubMed
Schifano, F, Orsolini, L, Papanti, D, Corkery, J. NPS: medical consequences associated with their intake. Curr Top Behav Neurosci. 2017;32:351–380.CrossRefGoogle ScholarPubMed
Oluwabusi, OO, Lobach, L, Akhtar, U, Youngman, B, Ambrosini, PJ. Synthetic cannabinoid-induced psychosis: two adolescent cases. J Child Adolesc Psychopharmacol. 2012;22(5):393–395.CrossRefGoogle ScholarPubMed
Ustundag, MF, Ozhan Ibis, E, Yucel, A, Ozcan, H. Synthetic cannabis-induced mania. Case Rep Psychiatry. 2015;2015:Google ScholarPubMed
Papanti D, , Schifano, F, Botteon, G, et al. “Spiceophrenia”: a systematic overview of “spice”-related psychopathological issues and a case report. Hum Psychopharmacol. 2013;28(4):379–389.CrossRefGoogle ScholarPubMed
Wood, DM, Dargan, PI. Novel psychoactive substances: how to understand the acute toxicity associated with the use of these substances. Ther Drug Monit. 2012;34(4):363–367.CrossRefGoogle ScholarPubMed
Naviglio, S, Papanti, D, Moressa, V, Ventura, A. An adolescent with an altered state of mind. BMJ. 2015;350:h299.CrossRefGoogle ScholarPubMed
Skryabin, VY, Vinnikova, M, Nenastieva, A, Alekseyuk, V. Hallucinogen persisting perception disorder: a literature review and three case reports. J Addict Dis. 2019;37:268–278.CrossRefGoogle Scholar
Suzuki, J, El-Haddad, S. A review: fentanyl and non-pharmaceutical fentanyls. Drug Alcohol Depend. 2017;171:107–116. doi:10.1016/j.drugalcdep.2016.11.033.CrossRefGoogle ScholarPubMed
Solimini, R, Pichini, S, Pacifici, R, Busardò, FP, Giorgetti, R. Pharmacotoxicology of non-fentanyl derived new synthetic opioids. Front Pharmacol. 2018;9:654. doi:10.3389/fphar.2018.00654.CrossRefGoogle ScholarPubMed
Rech, MA, Donahey, E, Cappiello Dziedzic, JM, Oh, L, Greenhalgh, E. New drugs of abuse. Pharmacotherapy. 2014;35(2):189–197.CrossRefGoogle ScholarPubMed
Schifano, F, Napolitano, F, Chiappini, S, et al. New/emerging psychoactive substances and associated psychopathological consequences. Psychol Med. 2019. doi: 10.1017/S0033291719001727 CrossRefGoogle Scholar