A systematic review of the effects of novel psychoactive substances ‘legal highs’ on people with severe mental illness
Bressington, D., Gray, R., Hughes, E., Ivanecka, A.
This systematic review (2016) examined the available literature on novel psychoactive substances with regard to their effects on people with severe mental illness. Analyses yielded mixed results, given that the people used various different types of substances, or even manifested different types of reactions in response to the same substance in one case with four patients who all had schizophrenia. The review highlights a lack of sufficient empiric evidence on the interaction between psychosis, brain dysfunction, prescribed medication, and novel psychoactive substances to establish adverse effects that are specific to mental illnesses.
Abstract
Introduction: Novel psychoactive substances (NPS) are synthetic substances that have been developed to produce altered states of consciousness and perceptions. People with severe mental illness (SMI) are more likely to use NPS than people without mental illness, but the short- and long-term effects of NPS are largely unknown.Method: We systematically reviewed the literature about the effects of NPS on people with SMI.Results: We included 12 case reports, 1 cross-sectional survey and 1 qualitative study. Participants included mostly males aged between 20 and 35 years. A variety of NPS were used, including synthetic cathinones and herbs such as Salvia. The most commonly reported effects of NPS were psychotic symptoms (in some cases novel in form and content to the patients' usual symptoms) and significant changes in behaviour, including agitation, aggression and violence. Patients' vital signs, such as blood pressure, pulse rate and temperature, were also commonly affected.Conclusion: NPS potentially have serious effects on people with SMI, but our findings have limited generalizability due to a reliance on case studies. There is a paucity of evidence about the long-term effects of these substances. Further research is required to provide a better understanding about how different NPS affect patients' mental and physical health.