Department of Clinical Pharmacy, Onze Lieve Vrouwe Gasthuis (OLVG) Hospital, Amsterdam.
Amsterdam Medical Center, Amsterdam Institute for Addiction Research, Amsterdam.
Ther Drug Monit. 2020 Apr;42(2):271-281. doi: 10.1097/FTD.0000000000000725.
The novel phenethylamines 4-fluoroamphetamine (4-FA) and 2,5-dimethoxy-4-bromophenethylamine (2C-B) fall in the top 10 most used new psychoactive substances (NPSs) among high-risk substance users. Various phenethylamines and NPS are also highly used in populations with mental disorders, depression, or attention deficit hyperactivity disorder (ADHD). Moreover, NPS use is highly prevalent among men and women with risky sexual behavior. Considering these specific populations and their frequent concurrent use of drugs, such as antidepressants, ADHD medication, and antiretrovirals, reports on potential interactions between these drugs, and phenethylamines 4-FA and 2C-B, were reviewed.
The authors performed a systematic literature review on 4-FA and 2C-B interactions with antidepressants (citalopram, fluoxetine, fluvoxamine, paroxetine, sertraline, duloxetine, bupropion, venlafaxine, phenelzine, moclobemide, and tranylcypromine), ADHD medications (atomoxetine, dexamphetamine, methylphenidate, and modafinil), and antiretrovirals.
Limited literature exists on the pharmacokinetics and drug-drug interactions of 2C-B and 4-FA. Only one case report indicated a possible interaction between 4-FA and ADHD medication. Although pharmacokinetic interactions between 4-FA and prescription drugs remain speculative, their pharmacodynamic points toward interactions between 4-FA and ADHD medication and antidepressants. The pharmacokinetic and pharmacodynamic profile of 2C-B also points toward such interactions, between 2C-B and prescription drugs such as antidepressants and ADHD medication.
A drug-drug (phenethylamine-prescription drug) interaction potential is anticipated, mainly involving monoamine oxidases for 2C-B and 4-FA, with monoamine transporters being more specific to 4-FA.
新型苯乙胺类毒品 4-氟苯丙胺（4-FA）和 2,5-二甲氧基-4-溴苯丙胺（2C-B）在高危药物使用者中使用最多的新精神活性物质（NPS）中排名前十。各种苯乙胺类和 NPS 也在患有精神障碍、抑郁症或注意力缺陷多动障碍（ADHD）的人群中大量使用。此外，NPS 的使用在具有风险性行为的男性和女性中也非常普遍。考虑到这些特定人群及其经常同时使用的药物，如抗抑郁药、ADHD 药物和抗逆转录病毒药物，我们对这些药物与 4-FA 和 2C-B 之间潜在相互作用的报告进行了综述。
作者对 4-FA 和 2C-B 与抗抑郁药（西酞普兰、氟西汀、氟伏沙明、帕罗西汀、舍曲林、度洛西汀、安非他酮、文拉法辛、苯乙肼、吗氯贝胺和曲拉唑酮）、ADHD 药物（阿托莫西汀、右旋苯丙胺、哌甲酯和莫达非尼）和抗逆转录病毒药物的相互作用进行了系统的文献回顾。
关于 2C-B 和 4-FA 的药代动力学和药物相互作用的文献有限。仅有一份病例报告表明 4-FA 与 ADHD 药物之间可能存在相互作用。尽管 4-FA 与处方药之间的药代动力学相互作用仍具有推测性，但它们的药效学表明 4-FA 与 ADHD 药物和抗抑郁药之间存在相互作用。2C-B 的药代动力学和药效学特征也表明 2C-B 与抗抑郁药和 ADHD 药物等处方药之间存在相互作用。
预计会出现药物-药物（苯乙胺类药物-处方药）相互作用的可能性，主要涉及 2C-B 和 4-FA 的单胺氧化酶，而单胺转运体对 4-FA 更为特异。
