Analysis of Symptoms, Approaches to Therapy and Outcomes of Synthetic Cathinone-Induced Delirium: Systematic Review

INTRODUCTION: One of the important disorders that can be induced by using synthetic cathinones (SC) is delirium, differentiated from other psychotic complications in ICD-11. The article presents a systematic review of the literature with the aim to describe the symptoms, the effectiveness of empirical approaches to therapy and probable outcomes of delirium induced by SC. The analysis of scientific publications in eLibrary, CNKI, PubMed, Scopus databases was performed using search by keywords. In accordance with the recommendations of PRISMA, 23 articles were selected. CONCLUSION: Most of the articles found were about MDPV-induced delirium. No exact dose range of SC that can cause delirium is specified. Delirium is more often described after prolonged use of SC (for 1 month), in more rare cases after a single use. In most cases delirium develops within a few hours after intake of SC and is associated with intoxication, rather than with withdrawal syndrome. The clinical picture of the studied conditions, besides the triad of the main symptoms of delirium, includes psychomotor excitement with pronounced sympathicotonia, in the vast majority of cases psychotic symptoms (acute sensory delirium with paranoid syndrome, true visual hallucinations, insomnia, aggressiveness expressed in the form of hetero- or autoaggression) are also present. Of highest effectiveness is therapy with benzodiazepines and antipsychotics with the use of detoxification and general resuscitation measures. Most of the described cases of delirium resulted in complete recovery, deaths were associated with serotonin syndrome, suicides, accidents against the background excitement and acute somatic diseases with the underlying sympathicotonia.