Bath Salts–Induced Delirium and Brief Psychotic Episode in an Otherwise Healthy Young Man

Sharma, Taral R.; Iskandar, Joseph W.; Ali, Rizwan; Shah, Urvi R.

doi:10.4088/pcc.11l01224

Cited by 4 publications

(3 citation statements)

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“…In published case series (35,37,51,52), and in most of case reports, the most common presenting clinical sign of patients taking bath salts is psychosis. In many of these cases, patients suffer from paranoia, visual and auditory hallucinations, and can be self-injurious or homicidal (37,53). Many of these patients also report amnesia surrounding their psychotic breaks (54,55).…”

Section: Discussionmentioning

confidence: 99%

“…Another contributing factor may be insomnia; in many of the cases, patients report being awake for days (54,55). It is important for the clinician to note that the psychosis induced by bath salts can present without the presence of acute sympathomimetic effects (53,56,57). Bath salts, therefore, should be considered in any young adult presenting with new onset psychosis.…”

Section: Discussionmentioning

confidence: 99%

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Synthetic Cathinones (“Bath Salts”)

Banks

Worst

Rusyniak

et al. 2014

The Journal of Emergency Medicine

139

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Background Synthetic cathinones are popularly referred to in the media as “bath salts.” Through the direct and indirect activation of the sympathetic nervous system, smoking, snorting, or injecting synthetic cathinones can result in tachycardia, hypertension, hyperthermia, myocardial infarction and death. Objectives The chemical structures and names of bath salts identified by the State of Ohio Bureau of Criminal Identification and Investigation Laboratory are presented. Based on their common pharmacophores the authors review the history, pharmacology, toxicology, detection methods and clinical implications of synthetic cathinones. Through the integration of this information, the pharmacological basis for the management of patients using synthetic cathinones is presented. Discussion Synthetic cathinones activate central serotonergic and dopaminergic systems contributing to acute psychosis and the peripheral activation of the sympathetic nervous system. The over stimulation of the sympathetic nervous system contributes to the many toxicities reported with bath salt use. The pharmacological basis for managing these patients is targeted at attenuating the activation of these systems. Conclusions Treatment of patients presenting after using bath salts should be focused on reducing agitation and psychosis, and supporting renal perfusion. The majority of successfully treated synthetic cathinones cases have used benzodiazepines and antipsychotics along with general supportive care.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Synthetic Cathinones (“Bath Salts”)

Banks

Worst

Rusyniak

et al. 2014

The Journal of Emergency Medicine

139

View full text Add to dashboard Cite

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“…98 One report presented information about delirium associated with bath salts. 99 In terms of psychotropics, delirium has been reported with discontinuation of sertraline, 100 use of olanzapine, 101 valproate associated hyperammonemia, [102][103][104] restarting of clozapine, 105 mirtazapine associated hyponatremia, 106 use of a combination of clozapine and electroconvulsive therapy (ECT), 107,108 use of a combination of lithium and ECT, 109,110 and postinjection delirium/sedation syndrome associated with olanzapine depot injection. [111][112][113][114][115] Some of the case reports/case series focus on substance-related delirium, [116][117][118][119][120][121][122][123][124][125][126][127][128] either during the withdrawal phase or intoxication phase.…”

Section: Case Reports Focusing On Deliriummentioning

confidence: 99%

Delirium Research in India: A Systematic Review

Grover

Kathiravan

Dua

2021

JNRP

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Delirium is the most common psychiatric diagnoses encountered in patients with various medical-surgical illnesses, in all the treatment set-ups, with relatively higher incidence and prevalence in the intensive care units. As delirium is encountered in multiple specialties, it is important to understand the research on this diagnosis. This study aims to assess the research output involving patients of delirium from India. A comprehensive search was undertaken using Medline (PubMed) and other databases. Search words included were “delirium,” “delirious,” “delirium tremens” AND “India.” No filters were used. Internet and hand searches yielded 305 articles. Out of these articles, 151 had the terms “delirium,” “delirious,” “delirium tremens” in the title and these were included for the review. Additionally, 14 articles were included for the review, although these did not have these terms in the title, but delirium was one of the major outcome parameters in these studies. Majority of the papers were original articles (n = 81), and these were followed by, case reports (n = 58), review articles (n = 10), letter to the editor (not as case reports but as a communication; n = 13), editorials (n = 2) and one clinical practice guideline. Most of the original papers have either focused on epidemiology (incidence, prevalence, outcome, etc.), symptom profile, with occasional studies focusing on effectiveness of various pharmacological interventions. There is a dearth of research in the field of delirium from India. There is a lack of studies on biomarkers, evaluation of nonpharmacological interventions, and evaluation of prevention strategies. It is the need of the hour to carry out more studies to further our understanding of delirium in the Indian context.

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Khat and synthetic cathinones: a review

et al. 2013

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For centuries, 'khat sessions' have played a key role in the social and cultural traditions among several communities around Saudi Arabia and most East African countries. The identification of cathinone as the main psychoactive compound of khat leaves, exhibiting amphetamine-like pharmacological properties, resulted in the synthesis of several derivatives structurally similar to this so-called natural amphetamine. Synthetic cathinones were primarily developed for therapeutic purposes, but promptly started being misused and extensively abused for their euphoric effects. In the mid-2000's, synthetic cathinones emerged in the recreational drug markets as legal alternatives ('legal highs') to amphetamine, 'ecstasy', or cocaine. Currently, they are sold as 'bath salts' or 'plant food', under ambiguous labels lacking information about their true contents. Cathinone derivatives are conveniently available online or at 'smartshops' and are much more affordable than the traditional illicit drugs. Despite the scarcity of scientific data on these 'legal highs', synthetic cathinones use became an increasingly popular practice worldwide. Additionally, criminalization of these derivatives is often useless since for each specific substance that gets legally controlled, one or more structurally modified analogs are introduced into the legal market. Chemically, these substances are structurally related to amphetamine. For this reason, cathinone derivatives share with this drug both central nervous system stimulating and sympathomimetic features. Reports of intoxication and deaths related to the use of 'bath salts' have been frequently described over the last years, and several attempts to apply a legislative control on synthetic cathinones have been made. However, further research on their pharmacological and toxicological properties is fully required in order to access the actual potential harm of synthetic cathinones to general public health. The present work provides a review on khat and synthetic cathinones, concerning their historical background, prevalence, patterns of use, legal status, chemistry, pharmacokinetics, pharmacodynamics, and their physiological and toxicological effects on animals and humans.

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Bath Salts–Induced Delirium and Brief Psychotic Episode in an Otherwise Healthy Young Man

Cited by 4 publications

References 0 publications

Synthetic Cathinones (“Bath Salts”)

Synthetic Cathinones (“Bath Salts”)

Delirium Research in India: A Systematic Review

Khat and synthetic cathinones: a review

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