Organophosphorus compounds and neurological conditions: Dr. Jekyll and Mr. Hyde

This article reviews the use, toxicology, and neurological effects of organophosphates (OPs) used as pharmacological agents. OPs, a versatile chemical family, have been applied in many sectors but pose significant risks, particularly to the nervous system. In the first part of this review, we discuss the toxicological effects of OPs, particularly their inhibition of the acetylcholinesterase (AChE) enzyme, leading to severe neurological impairments. Indeed, prolonged exposure to these chemicals can trigger neuroinflammation, oxidative stress, and changes in neurotransmitter systems, resulting in cognitive deficits, neuropsychiatric disorders, and, potentially, neurodegeneration. In the second part, we address the therapeutic potential of these chemicals, focusing mainly on their effects on the central nervous system (CNS). Some naturally occurring compounds, like citicoline, have shown neuroprotective properties, while synthetic OPs such as bisphosphonates and their derivatives are being explored to treat some mental conditions. However, the high toxicity and side effects of some of them, whether in the short or long term, may limit their use in clinical settings. Overall, there is a call for better animal models and continued research to develop safer therapeutic options.