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Fallbericht

„Badesalz“-Psychosen – Klinische Aspekte

Published Online:February 25, 2013https://doi.org/10.1024/0939-5911.a000230

Abstract

Einführung: Seit Ende 2011 ist die Zahl der Aufnahmen von Patienten mit psychotischer Symptomatik nach Konsum von synthetischen Cathinonen in unserer Suchtabteilung auf 2 – 3 Fälle pro Woche angestiegen (ca. 3 % aller Aufnahmen). Fallberichte: Wir berichten über sieben dieser Fälle, die in den letzten acht Monaten behandelt wurden. Die Patienten zeigten psychotische Symptomatik mit Wahn, Denkstörungen und optischen, sowie akustischen Halluzinationen. Einige waren agitiert, desorientiert, hilflos oder litten an oralen Dyskinesien. Die Therapien waren supportiv und beinhalteten typische und atypische Neuroleptika, Benzodiazepine und Clonidin. Die psychotische Symptomatik remittierte in fünf der sieben Fälle, zwei Patienten wurden nach einigen Behandlungstagen mit noch anklingender psychotischer Symptomatik entlassen. Diskussion: Das Psychosepotential der Cathinone sollte als hoch betrachtet werden. Die Droge wirkt entaktogen und hat ein hohes Suchtpotential. Aufgrund der weiten Verbreitung im Internet und der steigenden Popularität auch für Patienten ohne Erfahrungen mit illegalen Drogen, ebenso wie die unzureichende Labordiagnostik stellen synthetische Cathinone ein erhebliches diagnostisches und therapeutisches Problem für spezialisierte Suchtstationen, ebenso wie ambulante Einrichtungen dar. Schlussfolgerungen: Die wachsende Fallzahl und die alarmierenden Auswirkungen, verursacht durch den Konsum dieser Substanzen, zeigen, dass weitere Forschungsarbeit notwendig ist, um diese neue Droge und ihre Wirkungen auf den menschlichen Körper besser zu verstehen und um synthetische Cathinone in Routine-Drogentests untersuchen und neue Behandlungsleitlinien entwickeln zu können.


“Bath Salts” Induced Psychosis – Clinical Aspects

Introduction: Since late 2011 the number of patients with psychotic symptoms after consumption of synthetic cathinones admitted to our inpatient withdrawal increased to about 2 – 3 per week (about 3 % of all admissions). Case reports: We report seven of these cases treated in the last 8 months. The patients presented psychotic symptoms including paranoia, thought disorders and optical as well as acoustical hallucinations. Some were agitated, disoriented, helpless or suffered from oral dyskinesia. Therapies were supportive, including typical and atypical antipsychotics, benzodiazepines and clonidine. The psychotic syndrome remitted in five of the seven cases, two patients were discharged from the hospital still showing minor psychotic symptoms after several days of treatment. Discussion: The psychotic potential of cathinones should be considered as high. The drug acts entactogen and is highly addictive. Due to the widespread availability on the Internet and the increasing popularity even for patients without illegal drug experience before, as well as the insufficient laboratory tests synthetic cathinones are becoming a remarkable problem in diagnostic and treatment for specialized inpatient withdrawal as well as outpatient departments. Conclusion: The growing number of cases along with the alarming severity of the effects caused by the abuse of these substances shows that more research work is necessary to better understand this new drug and its effects in the human body in order to develop methods to detect synthetic cathinones via standard drug tests and to create new guidelines for treatment.

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