Acute and long-term psychiatric consequences of synthetic cannabinoids and related novel psychoactive substances: A systematic review.
Ricci et al.·Psychiatry researchImpact 4.1
Keine RichtungsangabeGRADEModerat0 Zitate
Stichprobek = 58 Studien n = 12 Pat.
DesignSystematic Review
”Kernaussage
Synthetische Cannabinoide gingen mit längeren psychosebedingten Klinikaufenthalten als herkömmliches Cannabis einher sowie in etwa 30 Prozent der Fälle mit über fünf Monate anhaltenden psychotischen Episoden.
Zusammenfassung
Systematische Review (PRISMA 2020) zu psychiatrischen Konsequenzen synthetischer Cannabinoide und Novel Psychoactive Substances über k=58 Studien; 28 Studien (48.3%) mit ≥6-Monats-Follow-up, 22 Studien (37.9%) High-Quality-Rating. Hospitalisierungen für synthetische Cannabinoid-assoziierte Psychose signifikant länger als für Cannabis-Psychose (43.45 vs. 22.91 Tage). In einer Fallserie prolongierte psychotische Episoden >5 Monate bei ~30% der Patienten. Synthetische Cathinone mit Rhabdomyolyse-Rate 63% assoziiert; NBOMe-Substanzen mit Fatalitätsrate ~15% und ICU-Admission-Rate ~40%.
ZusammenfassungSystematische Übersicht von 58 Studien zu psychiatrischen und neurologischen Folgen neuer psychoaktiver Substanzen, mit Schwerpunkt auf synthetischen Cannabinoiden (28 Studien).
Vertrauen in die Evidenz
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Moderat
Dritte von vier GRADE-Stufen, die Effektschätzung ist wahrscheinlich verlässlich.
Background: Novel psychoactive substances (NPS) represent an evolving public health threat, yet evidence on their acute and long-term psychiatric consequences remains limited.
Objective: To systematically review psychiatric and neurological consequences of NPS use across the full clinical spectrum, with primary focus on synthetic cannabinoids and related compounds, and to characterize differential risk patterns.
Methods: Following PRISMA 2020 guidelines, we searched six databases (January 2005-August 2025). Primary inclusion required longitudinal studies with >/=6-month psychiatric follow-up; supplementary inclusion encompassed severe acute complications or fatalities to characterize the full toxicity spectrum and avoid survivor bias. We employed narrative synthesis with thematic analysis by substance class, focusing primarily on synthetic cannabinoids (n = 28 studies), synthetic cathinones (n = 12), and hallucinogens (n = 8, primarily NBOMe compounds).
Results: Among 58 included studies, 28 (48.3 %) provided >/=6-month longitudinal follow-up, 22 (37.9 %) documented acute toxicity or fatalities, and 8 (13.8 %) mixed timeframes; 22 studies (37.9 %) were rated high quality. In one comparative cohort, hospitalizations for synthetic cannabinoid-related psychosis were markedly longer than for cannabis-related psychosis (43.45 vs. 22.91 days). In a case series, prolonged psychotic episodes beyond five months occurred in approximately 30 % of patients. Synthetic cathinone-related rhabdomyolysis rates reached 63 % in an outbreak series. NBOMe exposures were associated with fatality rates of approximately 15 % and Intensive Care admission rates of approximately 40 %.
Conclusions: Synthetic cannabinoids and related NPS may represent distinct toxicological class with enhanced psychiatric risks, potentially characterized by prolonged sequelae and severe neurological complications. Evidence suggests the need for clinical protocols, enhanced surveillance, and targeted prevention strategies.