Ordak Michal, Zmysłowska Aleksandra, Bielski Miłosz, Rybak Daniel, Tomaszewska Maja, Wyszomierska Katarzyna, Kmiec Aleksandra, Garlicka Natalia, Zalewska Maria, Zalewski Michal, Nasierowski Tadeusz, Muszynska Elzbieta, Bujalska-Zadrozny Magdalena
Department of Pharmacodynamics, Centre for Preclinical, Research and Technology (CePT), Medical University of Warsaw, Warsaw, Poland.
Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland.
Front Psychiatry. 2021 Apr 23;12:669921. doi: 10.3389/fpsyt.2021.669921. eCollection 2021.
In recent years, an increase in the frequency of hospitalizations of patients taking newer and newer psychoactive substances has been observed around the world. Each year, authors publish case reports of patients who consumed previously unknown NPS. Most publications of this type concern the period between 2014 and 2016. However, no publication systematically reviews the pharmacotherapy used in these cases. This study aims to review the case reports of patients taking NPS published between 2010 and 2019, as well as analyzing the pharmacotherapy used. We searched the Thomson (Web of Knowledge), PubMed/Medline, Science Direct, Scopus and Google Scholar databases. The search was performed using all possible combinations of the term "case report" describing the use of NPS, also referred to as designer medications, internet medications, research chemicals and herbal highs. We analyzed 51 case reports on the intake of various types of NPS. Most of them ( < 0.001) concerned the use of synthetic cannabinoids (41.2%) and cathinones (31.4%). The pharmacotherapy applied primarily ( < 0.001) consisted of administering benzodiazepines to patients (62.7%), most of whom took only this group of medications (25.5%), followed by groups receiving benzodiazepines combined with neuroleptics (15.7%) and muscle relaxants (11.8%). Opioids were administered primarily to patients taking synthetic opioids ( < 0.001). Of the 5 cases of deaths from NPS reported in the literature, three relate specifically to the synthetic opioid MT-45. The later the time period, the more medications patients were administered ( = 0.02). In the pharmacotherapy for NPS poisoning, one should focus primarily on combating psychomotor agitation.
近年来，世界各地都观察到服用新型精神活性物质的患者住院频率有所增加。每年，作者都会发表关于服用此前未知新型精神活性物质患者的病例报告。这类报告大多涉及2014年至2016年期间。然而，没有出版物系统地综述这些病例中使用的药物治疗方法。本研究旨在综述2010年至2019年期间发表的服用新型精神活性物质患者的病例报告，并分析所使用的药物治疗方法。我们检索了汤森路透（科学网）、PubMed/Medline、Science Direct、Scopus和谷歌学术数据库。检索使用了描述新型精神活性物质使用情况的“病例报告”一词的所有可能组合，新型精神活性物质也被称为设计药物、网络药物、研究化学品和草药兴奋剂。我们分析了51例关于摄入各类新型精神活性物质的病例报告。其中大多数（<0.001）涉及合成大麻素（41.2%）和卡西酮（31.4%）的使用。主要应用的药物治疗方法（<0.001）包括给患者使用苯二氮䓬类药物（62.7%），其中大多数患者仅服用这一类药物（25.5%），其次是接受苯二氮䓬类药物与抗精神病药物联合使用的患者组（15.7%）和肌肉松弛剂（11.8%）。阿片类药物主要用于服用合成阿片类物质的患者（<0.001）。文献中报道的5例新型精神活性物质致死病例中，有3例具体涉及合成阿片类物质MT - 45。时间段越靠后，给患者使用的药物越多（P = 0.02）。在新型精神活性物质中毒的药物治疗中，应主要关注对抗精神运动性激越。
