Abstract
Piperazines, synthetic compounds known for their stimulant and hallucinogenic
effects, have gained prominence among novel psychoactive substances (NPS) and are frequently
associated with adverse psychiatric outcomes, including psychosis. Methods: A systematic review of
the literature available up to 23 May 2024 was conducted, using the PubMed, Scopus, and Web of
Science databases, in addition to the related gray literature, utilizing the following search strategy:
“piperazines” AND (“psychosis” OR “hallucination” OR “delusion” OR “schizophrenia” OR “delusional”
OR “schizoaffective”) NOT review NOT animal. Data collection adhered to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research
methods were registered with PROSPERO (CRD42024549204). Results: Out of a total of 4547 articles
identified, 4 met the inclusion criteria. We observed an important relationship between piperazine
abuse and the onset of acute psychotic episodes, marked by symptoms such as paranoia, auditory,
and visual hallucinations. Conclusion: The complex polyreceptor action mechanism of piperazines
may explain these psychopathological effects, similar to those observed with other NPS. Although
studies confirm a link between piperazine use and psychosis, data on long-term outcomes are limited.
Recovery is common following cessation and treatment. Further research into the effects of piperazine
abuse and the development of specific treatment protocols for substance-induced psychosis
is necessary.
effects, have gained prominence among novel psychoactive substances (NPS) and are frequently
associated with adverse psychiatric outcomes, including psychosis. Methods: A systematic review of
the literature available up to 23 May 2024 was conducted, using the PubMed, Scopus, and Web of
Science databases, in addition to the related gray literature, utilizing the following search strategy:
“piperazines” AND (“psychosis” OR “hallucination” OR “delusion” OR “schizophrenia” OR “delusional”
OR “schizoaffective”) NOT review NOT animal. Data collection adhered to the Preferred
Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The research
methods were registered with PROSPERO (CRD42024549204). Results: Out of a total of 4547 articles
identified, 4 met the inclusion criteria. We observed an important relationship between piperazine
abuse and the onset of acute psychotic episodes, marked by symptoms such as paranoia, auditory,
and visual hallucinations. Conclusion: The complex polyreceptor action mechanism of piperazines
may explain these psychopathological effects, similar to those observed with other NPS. Although
studies confirm a link between piperazine use and psychosis, data on long-term outcomes are limited.
Recovery is common following cessation and treatment. Further research into the effects of piperazine
abuse and the development of specific treatment protocols for substance-induced psychosis
is necessary.
| Original language | English |
|---|---|
| Article number | 5030040 |
| Pages (from-to) | 552–563 |
| Number of pages | 12 |
| Journal | Psychiatry International |
| Volume | 5 |
| Issue number | 3 |
| Early online date | 20 Sept 2024 |
| DOIs | |
| Publication status | E-pub ahead of print - 20 Sept 2024 |
Keywords
- NPs
- Piperazine
- psychosis
- drug misuse
- drug abuse
- schizophrenia
- substance-induced psychosis