Pepe Maria, Di Nicola Marco, Cocciolillo Fabrizio, Chiappini Stefania, Martinotti Giovanni, Calcagni Maria Lucia, Sani Gabriele
Department of Neuroscience, Section of Psychiatry, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy.
Department of Psychiatry, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy.
Pharmaceuticals (Basel). 2024 Mar 31;17(4):452. doi: 10.3390/ph17040452.
New Psychoactive Substances (NPS) are modifying the drug scenario worldwide and have become a public health concern because of their toxicological profiles and their harmful physical/psychological effects. 3-Methoxy-Phencyclidine (3-MeO-PCP), a non-competitive antagonist of glutamate N-methyl-D-aspartate (NMDA) receptors, belongs to the phencyclidine-like subfamily of arylcyclohexylamines and has gained attention for its toxic, sometimes fatal, effects. Despite several cases of intoxication and death reported in the literature, little is known about substance-induced psychotic disorders (SIP) and potential cognitive impairment following 3-MeO-PCP intake. This literature review aimed to summarize available evidence about 3-MeO-PCP mechanisms of action and physical and psychotropic effects and to spread preliminary findings about persistent psychotic symptoms and impaired cognitive functioning. Additionally, the case of an SIP is reported in a 29-year-old man with small oral intakes of 3-MeO-PCP over two weeks until a high dose ingestion. Psychometric and neuropsychological assessment and brain [F]-fluorodeoxyglucose positron emission tomography integrated with computed tomography were used to support clinical description. Identifying and addressing the characteristic clinical features and neural substrates of NPS-induced psychoses might help clinicians with a more precise differentiation from other psychotic disorders. Although further studies are required, phenotyping the cognitive profile of NPS users might provide targets for tailored therapeutic approaches.
新型精神活性物质(NPS)正在改变全球毒品形势,由于其毒理学特征以及有害的生理/心理影响,已成为公共卫生问题。3-甲氧基苯环己哌啶(3-MeO-PCP)是谷氨酸N-甲基-D-天冬氨酸(NMDA)受体的非竞争性拮抗剂,属于芳基环己胺类苯环己哌啶样亚家族,因其毒性作用(有时是致命的)而受到关注。尽管文献中报道了几例中毒和死亡病例,但关于摄入3-MeO-PCP后物质所致精神障碍(SIP)及潜在认知损害的情况却知之甚少。这篇文献综述旨在总结关于3-MeO-PCP作用机制、生理和精神作用的现有证据,并传播关于持续性精神病性症状和认知功能受损的初步研究结果。此外,报告了一例SIP病例,患者为一名29岁男性,在两周内少量口服3-MeO-PCP,直至一次高剂量摄入。使用心理测量和神经心理学评估以及与计算机断层扫描相结合的脑[F]氟脱氧葡萄糖正电子发射断层扫描来辅助临床描述。识别和解决NPS所致精神病的特征性临床特征和神经基质可能有助于临床医生更精确地将其与其他精神病性障碍区分开来。尽管还需要进一步研究,但对NPS使用者的认知特征进行表型分析可能为量身定制的治疗方法提供靶点。