Neurocognitive performance following acute mephedrone administration, with and without alcohol

Abstract

Recreational use of mephedrone, alone and in combination with alcohol, has increased over the past years. Pharmacological properties of mephedrone share similarities with methylenedioxymethamphetamine (MDMA), but its effect on neurocognitive function has not been well established in humans. The present study assessed the effect of mephedrone alone and after co-administration with alcohol on neurocognitive function. It was hypothesised that mephedrone would improve psychomotor performance but impair memory performance, when administered alone. Neurocognitive performance was expected to be impaired following mephedrone when combined with alcohol. Eleven participants received single doses of 200 mg mephedrone or placebo combined with 0.8 g/kg alcohol or placebo. Neurocognitive performance was assessed at baseline (T), at one hour (T) and four hours after (T) mephedrone administration, by means of the Divided Attention Task (DAT), Critical Tracking Task (CTT), and the Spatial Memory Test (SMT). Mephedrone intoxication impaired short-term spatial memory at T and improved critical tracking performance at T Mephedrone alone did not affect divided attention, but did show an interaction with alcohol on reaction time at T Reaction time decreased when mephedrone was combined with alcohol as compared to alcohol alone. Alcohol intoxication impaired both short- and long-term spatial memory at T and divided attention at T and T Critical tracking performance was not affected by alcohol intoxication. The current findings support the hypothesis that mephedrone improves psychomotor performance, impairs spatial memory and does not affect divided attention performance. Stimulatory effects of mephedrone were not sufficient to compensate for the impairing effects of alcohol on most performance parameters.

The clinical challenges of synthetic cathinones

“…All of them presented with agitation and 6 patients required sedation and/or physical restraint. Conversely, Karila et al emphasized that the potential chronic health effects (e.g. reproduction toxicity, genotoxicity and carcinogenic potential) of mephedrone/methylone prolonged use remain to date unknown.…”

“…In general, the use of atypical antipsychotics including the psychonauts’ ideal trip terminator olanzapine, has shown good efficacy in containing episodes of aggression in different cohort and different phases of illness . Finally, treatment for patients with prolonged exposure to synthetic cathinones should ideally include a drug management plan coupled with psychotherapy …”

“…Considering the cocaine/MDMA-mixed effect molecules such as mephedrone and related compounds, mephedrone has been the most investigated. 67,68 Furthermore, Roberts et al 45 found that mexedrone, a mephedrone derivative, was found in 11 of 305 patients who presented to an emergency department (ED). All of them presented with agitation and 6 patients required sedation and/or physical restraint.…”

“…Conversely, Karila et al 68 Finally, increasing levels of clinical concerns have been associated with the use of pyrovalerone-like molecules, including α-PVP and MDPV, whose clinical effects are individual, dose-and route of administration-dependent. 71 Palamar et al 72 Umebachi et al 74 and blood lactate levels (5/7) were observed.…”

“…87 Finally, treatment for patients with prolonged exposure to synthetic cathinones should ideally include a drug management plan coupled with psychotherapy. 68…”