Drops of madness? Recreational misuse of tropicamide collyrium; early warning alerts from Russia and Italy

Department of Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy. Electronic address: .
General hospital psychiatry (Impact Factor: 2.67). 05/2013; 35(5). DOI: 10.1016/j.genhosppsych.2013.04.013
Source: PubMed

ABSTRACT BACKGROUND: Tropicamide is an antimuscarinic drug usually prescribed as an ophthalmic solution to induce short-term mydriasis and cycloplegia. Over the last 2 years, tropicamide has been reported in both Russia and Italy to be self-administered intravenously (IV) for recreational purposes. METHODS: The literature on tropicamide was searched in PsycInfo and Pubmed databases. Considering the absence of peer-reviewed data, results were integrated with a multilingual qualitative assessment of a range of Web sites, drug fora and other online resources (i.e., e-newsgroups, chat rooms, mailing lists, e-newsletters and bulletin boards): between January 2012 and January 2013, exploratory qualitative searches of more than 100 Web sites have been carried out in English and Italian using generic and specific keywords such as "legal highs," "research chemicals," "online pharmacy," "tropicamide," "mydriacil," "tropicacyl," "visumidriatic," "online pharmacies" and "tropicamide recreational abuse" in the Google search engine. RESULTS: Misuse of tropicamide typically occurs through IV injection; its effects last from 30 min to 6 h, and it is often taken in combination with other psychoactive compounds, most typically alcohol, marijuana and opiates. Medical effects of tropicamide misuse include slurred speech, persistent mydriasis, unconsciousness/unresponsiveness, hallucinations, kidney pain, dysphoria, "open eye dreams," hyperthermia, tremors, suicidal feelings, convulsions, psychomotor agitation, tachycardia and headache. DISCUSSION/CONCLUSIONS: More large-scale studies need to be carried out to confirm and better describe the extent of tropicamide misuse in the European Union and elsewhere. Health and other professionals should be rapidly informed about this new and alerting trend of misuse.

  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction. The number of new psychoactive substances (NPS) advertised for sale online is constantly increasing and it has become a phenomenon of global concern. Among NPS, Camfetamine has been rediscovered as recreational drug in 2011. Very little information is still available in the scientific literature on its nature and potential health risks. Methods. Data in scientific literature were integrated with a multilingual qualitative assessment of a range of online resources over the period of 32 months (May 2011–January 2014). Results. N-Methyl-3-phenyl-norbornan-2-amine (Camfetamine) may act as an indirect dopaminergic agonist in the central nervous system and may have mild-moderate opioid activity too. There are no current epidemiological data about recreational use of Camfetamine; our research shows that it is indeed used especially by individuals with a history of recreational polydrug misuse. It facilitates mental alertness, induces relaxation, and, unlike many other stimulants, seems not to be associated with severe physical effects. Valid causes for concern issued in our research may be Camfetamine intravenous or intramuscular administration as well as its use in conjunction with other psychoactive substances. Conclusions. It is here highlighted that more large-scale studies need to be carried out to confirm and better describe both the extent of Camfetamine misuse and possible psychotropic/adverse effects.
    BioMed Research International 07/2014; 2014:419026. DOI:10.1155/2014/419026 · 2.71 Impact Factor
    This article is viewable in ResearchGate's enriched format
  • [Show abstract] [Hide abstract]
    ABSTRACT: Introduction. The use of novel psychoactive substances (NPSs) has rapidly increased as well as their online availability. The aim of this paper is to provide a comprehensive review of the nature and the risks associated with 25C-NBOMe, which has recently appeared in the drug market. Methods. A systematic analysis of the scientific literature and a qualitative assessment of online and media resources (e.g., e-newsgroups, chat-rooms, and e-newsletters) in 10 languages were carried out. Results. 25C-NBOMe is sold online as legal LSD or as research chemical with different designations such as "Boom," "Pandora," "Holland film," or "N-bomb." It is a partial agonist of 5-HT2A receptors. It is usually ingested orally/sublingually and, less commonly, nasally, through injection, vaginally, rectally, and smoked. Its effects include sublingual numbing, stimulation, "body high," hallucinations, dissociation, and anxiety. 25C-NBOMe presents high risk of overdoses; acute toxicity and fatalities have been reported. Conclusions. 25C-NBOMe consumption represents an emerging phenomenon with potential harmful effects. Its use is increased by its online availability at low costs. Health and other professionals should be informed about this new trend of substance use.
    BioMed Research International 07/2014; 2014:734749. DOI:10.1155/2014/734749 · 2.71 Impact Factor
    This article is viewable in ResearchGate's enriched format
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Introduction: Novel Psychoactive Substances (NPSs) are often sold online as "legal" and "safer" alternatives to International Controlled Drugs (ICDs) with captivating marketing strategies. Our aim was to review and summarize such strategies in terms of the appearance of the products, the brand names, and the latest trends in the illicit online marketplaces. Methods: Scientific data were searched in PsychInfo and Pubmed databases; results were integrated with an extensive monitoring of Internet (websites, online shops, chat rooms, fora, social networks) and media sources in nine languages (English, French, Farsi, Portuguese, Arabic, Russian, Spanish, and Chinese simplified/traditional) available from secure databases of the Global Public Health Intelligence Network. Results: Evolving strategies for the online diffusion and the retail of NPSs have been identified, including discounts and periodic offers on chosen products. Advertisements and new brand names have been designed to attract customers, especially young people. An increased number of retailers have been recorded as well as new Web platforms and privacy systems. Discussion: NPSs represent an unprecedented challenge in the field of public health with social, cultural, legal, and political implications. Web monitoring activities are essential for mapping the diffusion of NPSs and for supporting innovative Web-based prevention programmes.
    Journal of psychoactive drugs 09/2014; 46(4):287-294. DOI:10.1080/02791072.2014.944291 · 1.10 Impact Factor


Available from
May 29, 2014