The Effects and Risks Associated with Synthetic Cathinones Use in Humans

  • Laurent Karila
  • Amine Benyamina
Part of the Current Topics in Neurotoxicity book series (Current Topics Neurotoxicity, volume 12)


New psychoactive substances (NPS) have drastically modified the world drug scene. Synthetic or substituted cathinones (SCs), a popular class of NPS, are β-keto amphetamine analogues. These drugs are also known as legal highs, research chemicals, bath salts, plant food, or glass cleaner, and labeled «not for human use» or «not tested for hazards or toxicity» . However, there is a lack of epidemiological data concerning the SCs. Several factors have contributed to their increasing popularity, including their falsely legal image, their more reasonable costs, and their distribution based on the new technologies. SCs are mainly used for their stimulant properties, often serving as a replacement for others illicit stimulant drugs. The psychoactive and sympathomimetic effects of these drugs resemble those of amphetamine, methamphetamine, ecstasy, and cocaine, albeit to varying degrees. Clinical effects of SCs are individual-, dose- and route of administration-dependent. The primary effects sought by the users include euphoria, empathy, increased sexual performance, and increased sociability. Recent reports on abuse of novel synthetic cathinone derivatives call attention to the serious physical and psychological risks resulting from their consumption, thereby emphasizing the growing use of these drugs might constitute an important public health issue. Acute toxicity is the leading cause of SCs-induced fatalities. Users report a number of negative physical and psychiatric effects associated with SCs use. Cardiac, psychiatric, and neurological adverse effects are the most common reported ones requiring medical care. SCs use may also lead to violence, homicidal combative behavior, self-mutilation, coma, and death.


New psychoactive substances Synthetic cathinones Substituted cathinones Substance abuse Substance use disorder Mephedrone Methylone MDPV α-PVP 4-MEC Adverse effects Fatalities 


  1. Aarde SM, Creehan KM, Vandewater SA et al (2015) In vivo potency and efficacy of the novel cathinone alpha-pyrrolidinopentiophenone and 3,4-methylenedioxypyrovalerone: self-administration and locomotor stimulation in male rats. Psychopharmacology 232(16):3045–3055. Scholar
  2. Adamowicz P, Gil D, Skulska A, Tokarczyk B (2013) Analysis of MDPV in blood—determination and interpretation. J Anal Toxicol 37(5):308–312. Scholar
  3. AIDES/Sidaction/AMG/Inserm (2013) SLAM, première enquête qualitative en France. Février 2013.
  4. Andrabi S, Greene S, Moukaddam N, Li B (2015) New drugs of abuse and withdrawal syndromes. Emerg Med Clin North Am 33(4):779–795. Scholar
  5. Baumann MH, Bukhari MO, Lehner KR et al (2017) Neuropharmacology of 3,4-methylenedioxypyrovalerone (MDPV), its metabolites, and related analogs. Curr Top Behav Neurosci 32:93–117. Scholar
  6. Boehringer Ingelheim G (1967) Pyrrolidino ketones. Unit 3314970 AGoogle Scholar
  7. Cheong JH, Choi MJ, Jang CG et al (2017) Behavioral evidence for the abuse potential of the novel synthetic cathinone alpha-pyrrolidinopentiothiophenone (PVT) in rodents. Psychopharmacology 234(5):857–867. Scholar
  8. Cottencin O, Rolland B, Karila L (2014) New designer drugs (synthetic cannabinoids and synthetic cathinones): review of literature. Curr Pharm Des 20(25):4106–4111CrossRefGoogle Scholar
  9. DEA (2017) Schedules of controlled substances: placement of 10 synthetic cathinones into schedule I. Accessed May 2017
  10. EMCDDA (2014a) European monitoring centre for drugs and drug addiction. European drug report 2014: trends and developments. Publications Office of the European Union 2014, Luxembourg, 80 ppGoogle Scholar
  11. EMCDDA (2014b) EMCDDA–Europol joint report on a new psychoactive substance: MDPV (3,4-methylenedioxypyrovalerone). Publications Office of the European Union, LuxembourgGoogle Scholar
  12. EMCDDA (2014c) Perspectives on drugs. Injection of synthetic cathinones. Accessed 5 May 2014
  13. EMCDDA (2017) European drug report 2017: trends and developments. Publications Office of the European Union, LuxembourgGoogle Scholar
  14. Emerson T, Cisek J (1993) Methcathinone: a Russian designer amphetamine infiltrates the rural midwest. Ann Emerg Med 22:1897–1903CrossRefGoogle Scholar
  15. Erowid (b) Methylone addictive potential.
  16. European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) (2010) Risk assessment report of a new psychoactive substance: 4-methylmethcathinone (mephedrone).
  17. Gannon BM, Rice KC, Collins GT (2017) Reinforcing effects of abused ‘bath salts’ constituents 3,4-methylenedioxypyrovalerone and alpha-pyrrolidinopentiophenone and their enantiomers. Behav Pharmacol 28(7):578–581. Scholar
  18. Glennon RA, Young R (2016) Neurobiology of 3,4-methylenedioxypyrovalerone (MDPV) and α-pyrrolidinovalerophenone (α-PVP). Brain Res Bull 126(Pt 1):111–126. Scholar
  19. Griffiths P, Lopez D, Sedefov R et al (2010) Khat use and monitoring drug use in Europe: the current situation and issues for the future. J Ethnopharmacol 132(3):578–583. Scholar
  20. Info.sheet: Naphyrone. Accessed 8 Nov 2012
  21. Jacob P, Shulgin A (1996) Inventors, Neurobiological Technologies, Inc., assignee. Preparation of novel N-substituted-2-amino-3′,4′-methylenedioxypropiophenones as anti-depressant and anti-parkinsonism agents. US Patent WO9639133, 6 June 1996Google Scholar
  22. Journal Officiel (2012) Arrêté du 27 juillet 2012 modifiant les arrêtés du 22 février 1990 fixant la liste des substances classées comme stupéfiants et la liste des substances psychotropes. Accessed 8 March 2016
  23. Karila L, Reynaud M (2010) Mephedrone: a designer drug legally available on the Web. Presse Med 39(7–8):834–835CrossRefGoogle Scholar
  24. Karila L, Reynaud M (2011) GHB and synthetic cathinones: clinical effects and potential consequences. Drug Test Anal 3(9):552–559. Scholar
  25. Karila L, Megarbane B, Cottencin O, Lejoyeux M (2015) Synthetic cathinones: a new public health problem. Curr Neuropharmacol 13(1):12–20. Scholar
  26. Karila L, Lafaye G, Scocard A et al (2017) MDPV and alpha-PVP use in humans: the twisted sisters. Neuropharmacology. Scholar
  27. Krikorian AD (1984) Kat and its use: an historical perspective. J Ethnopharmacol 12(2):115–178CrossRefGoogle Scholar
  28. Marusich JA, Antonazzo KR, Wiley JL et al (2014) Pharmacology of novel synthetic stimulants structurally related to the “bath salts” constituent 3,4-methylenedioxypyrovalerone (MDPV). Neuropharmacology 87:206–213. Scholar
  29. Marusich JA, Lefever TW, Blough BE et al (2016) Pharmacological effects of methamphetamine and alpha-PVP vapor and injection. Neurotoxicology 55:83–91. Scholar
  30. Meltzer P, Butler D, Deschamps J, Madras B (2006) 1-(4-Methylphenyl)-2-pyrrolidin-1-yl-pentan-1-one (Pyrovalerone) analogues: a promising class of monoamine uptake inhibitors. J Med Chem 49(4):1420–1432. Scholar
  31. Meyer MR, Wilhelm J, Peters FT, Maurer HH (2010) Beta-keto amphetamines: studies on the metabolism of the designer drug mephedrone and toxicological detection of mephedrone, butylone, and methylone in urine using gas chromatography-mass spectrometry. Anal Bioanal Chem 397(3):1225–1233. Scholar
  32. Morris H (2010) Mephedrone: the phantom menace. Vice:98–100Google Scholar
  33. Prosser JM, Nelson LS (2012) The toxicology of bath salts: a review of synthetic cathinones. J Med Toxicol 8(1):33–42. Scholar
  34. Psychoactive Substances Act (2016). Accessed 29 May 2016
  35. Randolph SA (2014) Synthetic drugs: bath salts and spice. Workplace Health Saf 62(2):88CrossRefGoogle Scholar
  36. Rosenbaum CD, Carreiro SP, Babu KM (2012) Here today, gone tomorrow…and back again? A review of herbal marijuana alternatives (K2, Spice), synthetic cathinones (bath salts), kratom, Salvia divinorum, methoxetamine, and piperazines. J Med Toxicol 8(1):15–32. Scholar
  37. Sanchez S (1929) Sur un homologue de l’ephedrine. Bull Soc Chim Fr 45:284–286Google Scholar
  38. Schifano F, Albanese A, Fergus S et al (2011) Mephedrone (4-methylmethcathinone; ‘meow meow’): chemical, pharmacological and clinical issues. Psychopharmacology 214(3):593–602. Scholar
  39. Schifano F, Corkery J, Ghodse A (2012) Suspected and confirmed fatalities associated with mephedrone (4-methylmethcathinone, “meow meow”) in the United Kingdom. J Clin Psychopharmacol 32:710–714. Scholar
  40. Shimizu E, Watanabe H, Kojima T et al (2007) Combined intoxication with methylone and 5-MeO-MIPT. Prog Neuropsychopharmacol Biol Psychiatry 31(1):288–291CrossRefGoogle Scholar
  41. Stanciu CN, Penders TM, Gnanasegaram SA et al (2017) The behavioral profile of methylenedioxypyrovalerone (MDPV) and α-pyrrolidinopentiophenone (PVP)—A systematic review. Curr Drug Abuse Rev. Scholar
  42. Thomae K (1963) α-Pyrrolidinoketones, patent specification 933507Google Scholar
  43. United Nations Office on Drugs and Crime (UNODC) (2015) Decision 58/12—Inclusion of 3,4-methylenedioxypyrovalerone (MDPV) in Schedule II of the Convention on Psychotropic Substances of 1971.74.
  44. UNODC (2016) World drug report 2016. United Nations Publication, Sales No. E.16.XI.7Google Scholar
  45. Wander A (1963) α-Pyrrolidinovalerophenones, patent specification 927475Google Scholar
  46. Weaver MF, Hopper JA, Gunderson EW (2015) Designer drugs 2015: assessment and management. Addict Sci Clin Pract 10:8. Scholar
  47. Weinstein AM, Rosca P, Fattore L, London ED (2017) Synthetic cathinone and cannabinoid designer drugs pose a major risk for public health. Front Psychiatry 8:156. Scholar
  48. WHO (2014) Methylone (bk‐MDMA)—critical review report—expert committee on drug dependence thirty‐sixth meeting—Geneva, 16–20 June 2014Google Scholar
  49. Winder GS, Stern N, Hosanagar A (2013) Are “bath salts” the next generation of stimulant abuse? J Subst Abuse Treat 44(1):42–45. Scholar
  50. Wood D, Hunter L, Measham F, Dargan P (2012) Limited use of novel psychoactive substances in South London nightclubs. QJM 105:959–964CrossRefGoogle Scholar
  51. Zawilska JB, Wojcieszak J (2013) Designer cathinones—an emerging class of novel recreational drugs. Forensic Sci Int 231(1–3):425–453. Scholar
  52. Zawilska J, Wojcieszak J (2017) α-Pyrrolidinophenones: a new wave of designer cathinones. Forensic Toxicol 35(2):201–216. Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Addiction Research and Treatment CenterPaul Brousse Hospital, Paris-Sud University, INSERM U1000VillejuifFrance
  2. 2.Addiction Research and Treatment CenterPaul Brousse Hospital (AP-HP), Paris-Sud UniversityVillejuifFrance
  3. 3.CESPParisFrance

Personalised recommendations