Recurrent Psychotic Episodes Induced by Synthetic Cathinones in a Monozygotic Twin with Drug Addiction: A Case Report

Abstract

We have described a clinical case of psychotic disorder induced by synthetic cathinones in one drug-addicted monozygotic twin. This clinical case is unique, because it offers the opportunity to observe many features of the singularity of the dependence syndrome in twin brothers: drug choice; motivation to use drugs; and the development of multiple, long-lasting psychoses in one of the brothers. We pursued a twelve-month follow-up of this case. The case substantiates the paucity of a fundamental understanding of mental disorders and highlights the importance of further research into the clinical features of drug-induced psychoses, especially those induced by novel psychoactive substances such as synthetic cathinones.

Keywords

synthetic cathinones / “bath salts” / psychotic disorders / twins / case report

References

[1] Simmons SJ, Leyrer-Jackson JM, Oliver CF, et al. DARK classics in chemical neuroscience: cathinone-derived psychostimulants. ACS Chem Neurosci. 2018;9(10):2379–2394. doi: 10.1021/acschemneuro.8b00147.

[2] Schifano F, Napoletano F, Arillotta D, et al. The clinical challenges of synthetic cathinones. Br J Clin Pharmacol. 2020;86(3):410–419. doi: 10.1111/bcp.14132.

[3] Liechti M. Novel psychoactive substances (designer drugs): overview and pharmacology of modulators of monoamine signaling. Swiss Med Wkly. 2015;145:w14043. doi: 10.4414/smw.2015.14043.

[4] Asadullin AR, Ahmetova EA, Nenast’eva AYu. Katinony. Novaja real’nost’ [Cathinones. New reality]. Narkology. 2017;16(1):87–92. Russian.

[5] Pozdnjakova ME, Brjuno VV The study of the drug situation in Russia and abroad: comparative analysis. Rossija reformirujushhajasja. 2016:17:202–249. doi:10.19181/ezheg.2019.9. Russian.

[6] Dubatova IV, Stoyakin IV, Karnaukh KA, Safronenko AV. Structural-dynamic analysis of clinical manifestations and features of psychotic disorders therapy in users of “designer” drugs. Siberian Herald of Psychiatry and Addiction Psychiatry. 2018;1(98): 36–41. doi: 10.26617/1810-3111-2018-1(98)-36-41.

[7] Sivolap YP, Yanushkevich MV, Savchenkov VA. The dual diagnosis: schizophrenia and substance abuse. Neurology Bulletin. 2017;XLIX(2):57–60. doi: 10.17816/nb14070. Russian.

[8] Mendelevich VD. Psychiatry in addiction medicine’s era: new diagnostic and therapeutic realities. Neurology Bulletin. 2015;XLVII(2):5–15. doi: 10.17816/nb13902. Russian.

[9] Fedotov IА, Quattrone D, Shustov DI. Substance-induced psychosis and schizophrenia: the interaction point. I.P. Pavlov Russian Medical Biological Herald. 2020;28(4):593–604. doi: 10.23888/PAVLOVJ2020284593-604. Russian.

[10] Imamura A, Morimoto Y, Ono S, et al. Genetic and environmental factors of schizophrenia and autism spectrum disorder: insights from twin studies. J Neural Transm (Vienna). 2020;127(11):1501–1515. doi: 10.1007/s00702-020-02188-w.

[11] Murrie B, Lappin J, Large M, Sara G. Transition of substance-induced, brief, and atypical psychoses to schizophrenia: a systematic review and meta-analysis. Schizophr Bull. 2020;46(3):505–516. doi: 10.1093/schbul/sbz102.

[12] Marty MA, Segal DL. DSM-5: Diagnostic and Statistical Manual of Mental Disorders. The Encyclopedia of Clinical Psychology. 1st ed. Cautin RL, Lilienfeld SO, editors. New York: John Wiley & Sons; 2015. 965–970 p. doi: 10.1002/9781118625392.wbecp0308.

[13] Kendler KS, Ohlsson H, Sundquist J, Sundquist K. Prediction of onset of substance-induced psychotic disorder and its progression to schizophrenia in a swedish national sample. Am J Psychiatry. 2019;176(9):711–719. doi: 10.1176/appi.ajp.2019.18101217.

[14] Yang M, Yang C, Liu T, London ED. Methamphetamine-associated psychosis: links to drug use characteristics and similarity to primary psychosis. Int J Psychiatry Clin Pract. 2020;24(1):31–37. doi: 10.1080/13651501.2019.1676451.

[15] McKetin R, Dawe S, Burns RA, et al. The profile of psychiatric symptoms exacerbated by methamphetamine use. Drug Alcohol Depend. 2016;161:104–109. doi: 10.1016/j.drugalcdep.2016.01.018.

[16] Gicas KM, Parmar PK, Fabiano GF, Mashhadi F. Substance-induced psychosis and cognitive functioning: A systematic review. Psychiatry Res. 2022;308:114361. doi: 10.1016/j.psychres.2021.114361.

RIGHTS & PERMISSIONS

Severtsev V.V., Budanova A.A.