Novel psychoactive substances the pharmacology of stimulants and hallucinogens.
There are increasing levels of concern relating to the rapidly evolving novel psychoactive substancesNPS and web markets scenarios. The paper aims at providing an overview of the clinical pharmacological issues related to some of the most popular NPS categories, e.g. stimulants and hallucinogens. NPS intake is typically associated with the imbalance of a complex range of neurotransmitter pathwaysreceptors, namely dopamine cannabinoidCB1 and 5-HT2A. The intake is almost invariably undetectable with standard screening tests. Hence, it may frequently occur that the acute management of NPS misusers will need to focus on decreasing levels of both selfoutward-directed aggression and agitation. Benzodiazepines may be considered as first line treatment. Alternatively, propofol andor antipsychotics can be administered. Focus will be as well on treatment of possible rhabdomyolysis and hyperthermia. Indeed, future studies should inform better tailored managementtreatment strategies.