A retrospective analysis of the “Neverending Trip” after administration of a potent full agonist of 5-HT2A receptor - 25I-NBOMe
This retrospective analysis (2022) analysed 58 reports of adverse reactions caused by 25I-NBOMe (an uncommonly used psychedelic) to identify factors that may increase the risk of hallucinogen persisting perception disorder (HPPD) following its use. In 15 reports, symptoms persisted months after HPPD use the most common of which were: pseudohallucinations, bizarre delusions and derealization. Additionally, 25I-NBOMe induced HPPD can last from 2 months up to 2 years in some cases.
Authors
- Schetz, D.
- Schetz, A.
- Kocić, I.
Published
Abstract
Background
5-HT2A receptor (e.g. 25I-NBOMe) agonists not only pose risks of acute intoxication but also long-term effects and significant adverse reactions, e.g. hallucinogen persisting perception disorder (HPPD), derealization, and depersonalization.
Aims
We evaluated the risk associated with single and repeated use of 25I-NBOMe. We aimed to identify factors that may increase the risk of HPPD, increase its severity and determine the time when the first symptoms appear. Herein, we report the first extensive evaluation of 25I-NBOMe-induced HPPD.
Method
We assessed all reports (58) collected by The Pomeranian Pharmacovigilance Centre (PPC) from 2013 to 2020.
Results
The study included a total of 58 reports of adverse reactions caused by 25I-NBOMe. In the case of 15 reports (in patients aged 19-26 years), symptoms persisted many months after the discontinuation of 25I-NBOMe. The most common were: pseudohallucinations, bizarre delusions, derealizations and in some cases development or worsening of depression has been diagnosed. HPPD-like symptoms were most common in patients who took the drug regularly (i.e., several times a month). The risk of HPPD-like symptoms is higher in patients who have severe visual pseudohallucinations, severe bizarre delusions, derealization and/or depersonalization onset immediately after taking the drug. Recurrence of HPPD symptoms may be provoked by many factors, however, there is some cases there is no apparent reason. HPPD after 25I-NBOMe use can last from 2 months up to 2 years. In some patients, pharmacological treatment was necessary due to 25I-NBOMe-induced HPPD and depression.
Conclusions
The study showed long-lasting effects after 25I-NBOMe administration and allowed for the determination of HPPD risk factors.
Research Summary of 'A retrospective analysis of the “Neverending Trip” after administration of a potent full agonist of 5-HT2A receptor - 25I-NBOMe'
Introduction
25I-NBOMe is a highly potent phenethylamine acting as a full agonist at the serotonin 5-HT2A receptor that emerged as a designer drug in the 2010s and has been misused as a substitute for LSD. Earlier literature has concentrated on acute toxicity of NBOMe compounds and on classic hallucinogens such as LSD, but chronic or long-term adverse effects of potent 5-HT2A agonists are poorly characterised. In particular, hallucinogen persisting perception disorder (HPPD) and related phenomena (derealization, depersonalization, persistent pseudohallucinations) have been described after classic psychedelics but less is known about their incidence and risk factors following NBOMe exposures. Schetz and colleagues set out to evaluate the risk of persistent, HPPD-like symptoms after single or repeated 25I-NBOMe use by analysing all medically confirmed adverse-reaction reports submitted to the Pomeranian Pharmacovigilance Centre (PPC) between 2013 and 2020. The investigators aimed to identify which exposures and acute symptom patterns predict later HPPD-like outcomes, to establish the typical timing of symptom onset, and to describe clinical course, triggers and responses to treatments in affected patients. This study represents a retrospective, case-series comparison between patients with only acute effects and those with prolonged HPPD-like symptoms drawn from the PPC database.
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Study Details
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- APA Citation
Schetz, D., Schetz, A., & Kocić, I. (2022). A retrospective analysis of the “Neverending Trip” after administration of a potent full agonist of 5-HT2A receptor - 25I-NBOMe. Biomedicine & Pharmacotherapy, 146, 112295. https://doi.org/10.1016/j.biopha.2021.112295
References (5)
Papers cited by this study that are also in Blossom
Martinotti, G., Santacroce, R., Pettorruso, M. et al. · Brain Sciences (2018)
Lerner, A. G. · The Israel Journal of Psychiatry and Related Sciences; Jerusalem (2015)
Nichols, D. E. · Pharmacological Reviews (2016)
Halpern, J. H., Pope Jr, H. G. · Drug and Alcohol Dependence (2003)
Bonson, K. R. · Neuropsychopharmacology (1996)
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