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CHEMICAL DEPENDENCE DUE TO ABUSE OF THE HOMEMADE SUBSTANCE, OBTAINED FROM MEDICINES “EFFECT” AND “COLDACT” (CLINICAL PECULIARITIES IN PRACTICE OF FORENSIC PSYCHIATRY)

P. T. Petryuk, A. V. Kanishchev, V. V. Kovalenko, V. M. Shevelyov

* Originally in Ukrainian:
Petryuk, P. T., Kanishchev, A. V., Kovalenko, V. V., Shevelyov, V. M. (2001). Chemical dependence due to abuse of the homemade substance, obtained from medicines “Effect” and “Coldact” (clinical peculiarities in practice of forensic psychiatry) The Journal of Psychiatry and Medical Psychology (Donetzk), 1, 65–69.

The study was conducted to investigate 15 patients with chemical dependence due to intravenous use of cathinone (made from phenylpropanolamine-containing over-the-counter medicine “Effect” or “Coldact”). These patients underwent forensic psychiatric examination because of their criminal accusation. The investigation estimated specific features of homemade cathinone abuse, such as extremely massive character of injections, considerable day dose increase, fast development of dependence, virtually continuous pattern of abuse (in contrast to all other stimulant drugs). Early onset of severe extrapyramidal disorders was found to be the distinctive feature of observed patients. Specific psychopathological symptoms of these patients are documented. In one patient cathinone abuse caused marked toxic brain injury and, as a consequence, mild cognitive disorder. All 15 patients were declared to be responsible. In authors’ opinion, the main cause of early neurological and mental (emotional and cognitive) disorders is the toxic action of manganese compound (potassium permanganate) that is used in large amounts in the process of homemade preparation of cathinone. Authors suggest that in the near future psychiatrists and forensic experts can meet more prominent cognitive impairments (up to dementia) in users of cathinone, made from phenylpropanolamine-containing medicines.

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