Acute cathinone poisoning: epidemiology, pathogenesis, clinical picture, diagnosis and treatment principles (literature review)

Introduction. Acute poisoning with modern psychoactive substances and narcotic drugs is today among the main reasons for emergency hospitalization of people with acute poisoning.

Material and methods. The work summarizes information about epidemiology, pathogenesis, clinical picture, as well as diagnosis and principles of treatment of patients with acute cathinone poisoning.

Results. Cathinones are synthetic drugs that are similar in a number of ways, including their structure and mechanism of action to amphetamines and are used as psychoactive substances. The circulation of synthetic cathinones is under the control of the international community. Synthetic cathinones continue to hold the lead both in the number of new modifications created and in the volume of illegal trafficking, which drug control authorities are trying to suppress both in Russia and in neighboring countries. The class of synthetic cathinones today is quite numerous, although among users of surfactants their popularity varies, with the presence of clearly defined “market leaders”. These compounds may be substrates for presynaptic monoamine transporters (dopamine transporter, norepinephrine transporter, and serotonin transporter). Transporters responsible for reuptake of released monoamines from the synaptic cleft into the presynaptic neuron may be able to terminate the action of that monoamine at the postsynaptic receptor and facilitate recycling of the monoamine for re-release. In acute poisoning with cathinones, the clinical picture is nonspecific. It may manifest itself in the form of psychomotor agitation and/or hallucinations. In more severe cases, there are violations of life support systems. To determine α-PVP in biological objects (blood, urine, hair, nail sections), gas and liquid chromatography-mass spectrometry is usually used. Treatment of cathinone poisoning includes maintaining vital body functions: restoring hemodynamics, correcting electrolyte balance and relieving mental symptoms.

Limitations. The study was conducted by studying the databases Scopus, Web of Science, PubMed, Russian Science Citation Index, eLIBRARY, Cyberleninka.

Conclusion. A literature review of acute cathinone poisoning allows us to become familiar with the current problem of abuse of synthetic stimulants of the central nervous system. Studying the mechanisms of action, clinical manifestations, treatment and prevention allows us to form more informed approaches to this problem and develop effective measures to prevent and solve it.

Authors contribution:
Makarovskaya N.P. – the concept and design of research, writing the text;
Batotsyrenov B.V., Balabanova O.L., Evdokimova E.A. – collection and processing of materials;
Lodyagin A.N. – responsibility for the integrity of all parts of the article, writing the text.
All co-authors – approval of the final version of the article.

Conflict of interests. The authors declare no conflict of interest.

Funding. The study had no sponsorship.

Received: August 08, 2024 / Revised: August 28, 2024 / Accepted: December 18, 2024 / Published: February 25, 2025