3-Methoxy-Phencyclidine Induced Psychotic Disorder: A Literature Review and an 18F-FDG PET/CT Case Report

Abstract: New Psychoactive Substances (NPS) are modifying the drug scenario worldwide and\r\nhave become a public health concern because of their toxicological profiles and their harmful physical/psychological effects. 3-Methoxy-Phencyclidine (3-MeO-PCP), a non-competitive antagonist of\r\nglutamate N-methyl-D-aspartate (NMDA) receptors, belongs to the phencyclidine-like subfamily of\r\narylcyclohexylamines and has gained attention for its toxic, sometimes fatal, effects. Despite several\r\ncases of intoxication and death reported in the literature, little is known about substance-induced\r\npsychotic disorders (SIP) and potential cognitive impairment following 3-MeO-PCP intake. This\r\nliterature review aimed to summarize available evidence about 3-MeO-PCP mechanisms of action\r\nand physical and psychotropic effects and to spread preliminary findings about persistent psychotic\r\nsymptoms and impaired cognitive functioning. Additionally, the case of an SIP is reported in a\r\n29-year-old man with small oral intakes of 3-MeO-PCP over two weeks until a high dose ingestion.\r\nPsychometric and neuropsychological assessment and brain [18F]-fluorodeoxyglucose positron emission tomography integrated with computed tomography were used to support clinical description.\r\nIdentifying and addressing the characteristic clinical features and neural substrates of NPS-induced\r\npsychoses might help clinicians with a more precise differentiation from other psychotic disorders.\r\nAlthough further studies are required, phenotyping the cognitive profile of NPS users might provide\r\ntargets for tailored therapeutic approaches.