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Background: Phenibut (β-phenyl-γ-aminobutyric acid) is an analog of the neurotransmitter gamma-aminobutyric acid (GABA). Like abapentin and pregabalin, it inhibits α2-δsubunits of voltage-dependent presynaptic calcium channels. The potential harm resulting from the use of these gabapentinoids is currently a matter of debate. Methods: This review is based on pertinent publications retrieved by a selective literature search and on cases reported to the Giftinformationszentrum-Nord (GIZ-Nord), a poison information center at the University of Gttingen, Germany. Results: Phenibut is a prescription drug in Russia but its production, possession, use, trafficking, or administration is illegal in Germany. The phenibut toxicity syndrome resembles that of gabapentinoids and GABA mimetics: benzodiazepine-like withdrawal symptoms including epileptic seizures, delirium and paradoxical activation have been described, as have cases of abuse and dependence. A few cases of use in the setting of multidrug abuse, and of phenibut-related death, have been described to date in the USA. The GIZ-Nord received 17 inquiries about phenibut, 55 about gabapentin, and 126 about pregabalin over the period 20082022. Over the same period, the GIZ-Nord was informed of 1207 cases involving Z substances and 4324 involving benzodiazepines. In the majority of the registered intoxications, including those with phenibut, the symptoms were mild. Overdoses of phenibut (2100 g) were reported in 15 of the 17 cases; 8 of the persons who had taken an overdose were somnolent. In such cases, observation in intensive care was recommended. Respiratory depression or coma was not encountered in any case, not even in the patient who had taken 100 g of phenibut. Conclusion: Phenibut causes symptoms resembling those of gabapentinoid and benzodiazepine use. There have been reports of phenibut use in combination with other psychotropic drugs; in particular, its use together with opiates could increase the risk of coma and respiratory depression. No deaths due to phenibut intoxication have been published in Germany or elsewhere in Western Europe, although such cases may have been overlooked, as this drug is still largely unknown to Western medicine. [ABSTRACT FROM AUTHOR]

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Copyright of Synlett is the property of Georg Thieme Verlag Stuttgart and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Nervenarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Der Nervenarzt is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective: To shed more light on the role of heart rate and blood pressure during cannabis withdrawal. Methods: Post-hoc analysis of data collected during a prospective inpatient monitoring of withdrawal symptoms of 39 (8 female) adult (median 27 year old) treatment-seeking, predominantly white cannabis-dependents (Bonnet et al., Drug Alcohol Depend 2014; 143: 189-97). Beyond tobacco smoking, the body mass index, electrocardiogram and routine laboratory results were considered to estimate the cohort's risk for cardiovascular disease (CVD). Results: Abrupt cessation of recreational long-term daily cannabis use was not followed by significant changes in heart rate, blood and pulse pressure. Also, these measures were not significantly correlated with the severity of the cannabis withdrawal syndrome. The cohort's risk for CVD was moderate (all tobacco using, overweight in 9 of 35 patients and elevation of serum C-reactive protein in many patients). Its metabolic risk for CVD was minor considering the mostly normal blood pressure, normal serum lipids and glucose. Discussion: This merely minor metabolic risk might have contributed to the missing effects of cannabis cessation on the basic cardiovascular functions. [ABSTRACT FROM AUTHOR]

Hypercapnia as well as lowered intracellular pH (pHi) increase the bioelectric activity of CO2/H+-sensitive neurones (VLNcs) of the ventrolateral medulla oblongata. Here we describe that immunoreactive Na+/H+ exchanger (NHE3) is present in ventrolateral neurones from medullary organotypic cultures (obex level). To test whether VLNcs can be acidified and thereby activated by inhibition of NHE3, we used the novel high-affinity NHE3-inhibitors S1611 and S3226. Both drugs raised the firing rates of VLNcs to at least 150% of the control values, and depolarized membrane potential by up to 15 mV at concentrations (0.5–1 µmol/l) suitable for selective inhibition of NHE3. The changes in bioelectric activity strongly resembled the responses to hypercapnia ( PCO2: 60–100 mmHg). In BCECF-AM-loaded cultures a subfraction of ventrolateral VLNcs was found to be intracellularly acidified by 0.05–0.1 pH units following treatment with S1611; the time course of this acidification was similar to that evoked by hypercapnia. All drug effects were sustained and readily reversible upon washing. Non-CO2/H+-responsive medullary neurones as well as hippocampal CA3 neurones were unaffected by up to 20 µmol/l S1611. It is concluded that the selective inhibition of NHE3 acidifies and activates CO2/H+-sensitive neurones within the ventrolateral medulla oblongata. [ABSTRACT FROM AUTHOR]

There are high interindividual differences regarding the intensity of withdrawal symptoms in opiate addicts. This study was carried out in order to test whether the intensity of withdrawal is influenced by the 393T>C polymorphism of the GNAS1 gene. Only patients addicted exclusively to opiates were included. Thirty-three out of 39 patients undergoing inpatient detoxification treatment achieved a drug-free state. During the most intense period of withdrawal (stop of methadone and following days) TT homozygotes (n=4) had a significantly higher pulse rate (primary outcome criterion) than C-allele carriers (n=29). This study and a previous study about GNB3 825C>T underline the possible role of G-protein polymorphisms in the interindividual variability of opiate withdrawal. [ABSTRACT FROM AUTHOR]

Parotitis is a fairly uncommon adverse drug reaction of psychopharmacological treatment. Here, we report on an acute bilateral parotitis, which was associated with titration of venlafaxine in a 20-year-old female suffering from a severe depressive episode. The parotitis recovered quickly with oral penicillin and was most likely caused by bacteria assumed to spread from oral flora into Stensen's duct as a complication of pronounced venlafaxine-induced xerostomia. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to obtain rather rare information about the influence of chronic cannabis abuse on thyroid function. Methods: Thyroid function tests (TSH, total T3 , free T4 ) of 39 chronic cannabis-dependent subjects (ICD-10) were determined at admission (for in-patient detoxification). In a subgroup, serum levels of thyroid hormones were correlated with the serum levels of delta-9-tetrahydrocannabinol (THC, N = 24) and its major metabolites, THC-OH (N = 16) and THC-COOH (N = 24). Results: All of the tested patients were found to have TSH, total T3 and free T4 levels within the population reference range. The levels of thyroid hormones did not correlate significantly with levels of THC, THC-OH or THC-COOH in serum. Conclusion: These results argue against a relevant influence of chronic cannabis intake on thyroid function in humans. [ABSTRACT FROM AUTHOR]

The article presents an abstract of medical research. The research titled "Na+/H+ Exchanger Subtype 3: Detection and Selective Inhibition Within the Ventrolateral Medulla Oblongata of the New Born Rat" investigates the effect of selective activation of CO2/H+sensitive neurons within organotypic cultures of the ventrolateral medulla oblongata.