Therapeutic strategies in “club drugs”
DOI:
https://doi.org/10.20882/adicciones.469Keywords:
Pharmacologic treatment, MDMA, GHB, KetamineAbstract
Objective: to describe and analyze the state of the art of the treatment of use-abuse of “club drugs” and their psychiatric adverse effects. Method: data from literature were organized according to the type of drug –MDMA, GHB (Gammahidroxibutirate) and Ketamine- and to the type of adverse effects. Results: does exist certain agreements in how to approach problems related with the use of MDMA and GHB; for acute, subacute and residual psychiatric disorders induced by Ecstasy, the use of benzodiazepines, antidepressants and/or atypical antipsychotics has been suggested; for intoxication and withdrawal syndromes induced by GHB and similar drugs, the use of benzodiazepines, and the use of mood stabilizers and atypical antipsychotics has been suggested. With respect to withdrawal and positive, negative and cognitive simtomatology induced by Ketamine, and due to the fact that there is no treatment currently in use, the results reported by recent studies are discussed. Conclusion: due to the insuficient clinical and therapeutical experience and to the lack of controlled clinical trials, there is no therapeutic consensus for “club drugs”.References
Bernard C. Introduction a l’etude de la medicine experimentale. Paris: Delagrange, 1934; pp:115
Torrens Melich M, Ariño Viar J, Marina Gonzalez PA, Solé Puig J, Villa Canal A. Alucinógenos, cánnabis, benzodiazepinas, juego patológico. En: Fernández Miranda JJ, Gutierrez Cienfuegos
E, Marina Gonzalez PA (eds). Actuaciones clínicas en trastornos adictivos. Madrid: Aula Médica, 2002.
Teter C, Guthrie SK. A comprehensive review of MDMA and GHB: two common club drugs. Pharmacotherapy 2001; 21: 1486-1513.
Malberg JE, Seiden LS. The role of ambient temperature and core temperature in amphetamine- induced neurotoxicity. En: Palomo T,
Beninger R, Archer T (eds). Interactive monoaminergic disorders. Madrid: Ed Síntesis, 1999.
Miotto K, Darakjian J, Basch J, Murria S, Zogg MA, Rawson R.Gamma-hydroxybutyric acid: Patterns of use, effects and withdrawal. Am J Addict 2001; 10: 232-241.
Carpenter WT jr. The schizophrenia Ketamine challenge study debate. Biol Psychiatry 1999; 46: 1081-1091.
Los Alegres Divorciados, Chirigota de Cádiz Carnaval (CD). Voy de alegre divorciado. Motilla – Córdoba: Ed. Fonoruz, 2002.
Bobes García J, González García-Portilla MP, Sáiz Martínez PA, González Seijo JC. Psicopatología y trastornos psiquiátricos relacionados con el uso de MDMA. En: Bobes García J, Lorenzo Fernández P, Sáiz Martínez PA (eds). Extasis (MDMA): Un abordaje comprehensivo. Tomo II. Barcelona: Masson, 1998.
Hekmatpanah CR, Peroutka SL. 5-hydroxytryptamine uptake blockers atenuate the 5-hydroxytryptamine-releasing effect of 3,4-
methylenedioxymethamphetamine and related agents. Eur J Pharmacol 1990; 177: 95-98.
Liechti ME, Baumann C, Gamma A, Vollenweider FX. Acute psychological effects of 3,4-methylenedioximethamphetamine (MDMA, ”Ectasy”) are attenuated by the serotonin uptake inhibitor citalopram. Neuropsychopharmacology 2000; 22: 513-521.
Landabaso MA, Iraurgi I, Jiménez-Lerma JM, Calle R, Sanz J, Gutiérrez-Fraile M. Ecstasyinduced psychotic disorder: Six-month followup study. Eur Addict Res 2002; 8 : 133-140.
Nimmerrichter AA, Walter H, Gutiérrez-Lobos KE, Lesch OM. Double-blind controlled trial of_-hydroxybutyrate and clomethiazole in the treatment of alcohol withdrawal. Alcohol Alcohol
; 1: 67-73.
Maremmani I, Lamanna F, Tagliamonte A. Longterm therapy using GHB (sodium gamma hydroxybutyrate) for treatment-resistant chronic alcoholics. J Psychoactive Drugs 2001; 33:135-142.
McDaniel CH, Miotto KA. Gamma-hydroxybutirate (GHB) and gamma -butyrolactone (GBL) withdrawal: Five case studies. J Psychoactive Drugs 2001; 32: 143-149.
Vollenweider FX, Vontobel P, Oye I, Hell D, Leenders KL. Effects of (S)-ketamine on striatal dopamine: A (11 C)raclopride PET study of a model psychosis in humans. J Psychiatr Res 2000; 34: 35-43.
Jansen KLR, Darracot-Cankovic R. The nonmedical use of ketamine, part two: A review of problem use and dependence. J Psychoactive Drugs 2001; 33: 151-158.
Landabaso Vázquez MA, Casete Fernández L, Díaz González T, Sanz Etxeberría J, Terán Prieto A. Cocaína y otrospsicoestimulantes. En: Fernández Miranda JJ, Gutiérrez Cienfuegos E, Marina Gonzalez PA (eds). Actuaciones clínicas en trastornos adictivos. Madrid: Aula Médica, 2002.
Callado LF, Meana J. Neurolépticos atípicos y consumo de sustancias. Bases farmacológicas. Trastornos Adictivos 2001; 3 (monográfico 2): 7-18.
Tollefson GD, Andersen SW. Should we consider mood disturbance in schizophrenia as an important determinant of quality of life?. J Clin Psychiatry 1999; 60: 23-28.
Krupitsky EM, Burakov AM, Romanova TN, Grinenko NI, Grinenko AY, Fletcher J, Petrakis IL, Krystal JH. Attenuation of ketamine effects by nimodipine pretreatment in recovering ethanol dependent men: Psychopharmacologic implications of the interaction of NMDA and L-type calcium channel antagonists. Neuropsychopharmacology 2001; 25: 936-947.
Bousoño García M, García-Prieto A, González García-Portilla P, Sáiz Martínez PA, Bascarán Fernández MT, Bobes García J. De la psiquiatría basada en pruebas a la humilde clínica cotidiana.
Una reflexión. En: Pichot P, Ezcurra J, González-Pinto A, Gutiérrez Fraile M (eds). Ciclo vital y trastornos psiquiátricos graves. Madrid:
Aula Médica, 2002.
Popper KP. La sociedad abierta y sus enemigos II. Barcelona: Planeta-Agostini, 1992.


