Synthetic Cathinones and Neurotoxicity Risks: A Systematic Review

Area of Science:

• Neuroscience
• Toxicology
• Pharmacology

Background:

• Synthetic cathinones (SCs) are a rapidly growing class of new psychoactive substances (NPS) posing challenges to public health and forensic toxicology.
• While cardiac effects are studied, the neurotoxicity of SCs remains less understood.
• SCs share structural similarities with cathinone and exhibit amphetamine-like stimulant properties.

Approach:

• A systematic literature search was conducted using PubMed and Scopus databases, adhering to PRISMA guidelines.
• 76 relevant studies published between 2005 and 2022 were included after screening 515 initial articles.
• The review synthesizes findings on neurotoxic mechanisms, human intoxication cases, fatalities, and animal model toxicity.

Key Points:

• SCs are associated with a range of neurological adverse effects, including encephalopathy, coma, convulsions, psychosis, and hyperthermia.
• Sympathomimetic and hallucinogenic toxidromes are common, alongside the risk of agitated delirium and serotonin syndrome.
• Animal studies (rats, mice, zebrafish larvae) corroborate the neurotoxic potential observed in humans.

Conclusions:

• Synthetic cathinones present significant neurotoxic risks, contributing to severe neurological events and fatalities.
• Further research is crucial to understand and mitigate the neurological impact of these substances.
• Public health strategies must address the growing threat of SC neurotoxicity.