"The most used PS are synthetic cathinones, the leader of which being mephedrone or 4 MMC (4-methylmetcathinone). Their development was inspired by the Khat plant (Catha edulis) that is considered as a natural amphetamine and is used in certain countries of East Africa and the Arabian Peninsula (Kalix, 1990). These new designer substances are sold as bath salts 'not for human consumption' to circumvent the legislation (Coppola and Mondola, 2012). They belong to the phenylethylamine family (Petit et al., 2013) and are psychostimulants with an amphetamine- or cocaine-like effect. They generate agitation, euphoria, and empathy in users and increase libido and sexual performance.
"These PS have a strong addictogenic effect with dependence levels of 30% according to DSM-IV criteria (Dargan et al., 2011; Winstock et al., 2011). The main acute complications are cardiac, psychiatric, and neurological, and they can be fatal (Busardo et al., 2015; Ezaki et al., 2016; Sande, 2016; Kronstrand et al., 2018; Riley et al., 2019; Table 3).
"Blood levels in case of lethal intoxication are higher than in cases of non-lethal poisoning, and lethal situations arise from the combining of several drugs (Papaseit et al., 2017). These substances have been classified as narcotics in Europe since 2010 (Forsyth, 2012) and it is currently illegal to purchase or possess them, but they are usually obtained on the Internet or directly during party and play. Cathinones take the form of a white powder or small crystals. They are taken orally, by snorting, intrarectally (booty bump), or by injection (slamming).
"In the study of Spiller et al. (2011) the main clinical effects (>10%) related to cathinones consumption were agitation (82%), combative violent behavior (57%), tachycardia (56%), hallucinations (40%), paranoia (36%), confusion (34%), myoclonus (19%), hypertension (17%), chest pain (17%), and mydriasis (13%).
"In another serie, main complications of cathinones related to chemsex were psychotic symptoms, agitation, anxiety, suicidal ideation, or suicide attempt (Batisse et al., 2014). More recently, severe psychiatric symptoms have been observed with ephylone, a recent available synthetic cathinones, in a context of chemsex (Serre et al., 2019)."
Donnadieu-Rigole H, Peyrière H, Benyamina A, Karila L. Complications Related to Sexualized Drug Use: What Can We Learn From Literature? Front Neurosci. 2020;14:548704. Published 2020 Nov 27. doi:10.3389/fnins.2020.548704
