Treatment of Acute Drug-Induced Psychoses, Associated with Modern Synthetic Psychoactive Substances

Abstract

Use of new synthetic drugs (synthetic cannabinoids — “spices”, synthetic psychostimulants — “salts”, synthetic GABA-agonists — “butyrates”) is associated with a high risk of psychoses. Nowadays there are no evidence-based guidelines for treatment of these psychotic disorders. Objective: to develop effective therapeutic strategies for the treatment of acute substance-induced psychoses associated with modern synthetic drugs. Material and methods: 96 patients with substance-induced psychoses associated with synthetic cannabinoids (n = 32), synthetic psychostimulants (n = 33), and synthetic GABA-agonists (n = 31) were examined. In these groups we estimated effectiveness of different combination therapy: desintoxication and benzodiazepine, desintoxication and benzodiazepine and haloperidol, desintoxication, benzodiazepine and phenibut. The following methods were used: clinical-psychopathological, laboratory, statistics. Results: сomparative efficacy of therapeutic strategies differed in three investigated groups. In psychoses associated with synthetic cannabinoids the most effective strategy was haloperidol add-on. Differences between treatment approaches in group of psychostimulants-induced psychoses were not found. In psychoses associated with synthetic GABA-agonists the most effective strategy was phenibut add-on. Conclusion: the choice of effective therapeutic intervention in drug-induced psychosis should be based on type of synthetic drug.