Triggers of highly lethal seizures induced by novel stimulants:
A systematic review focused on synthetic cathinones and
phenethylamines

J 2026

Triggers of highly lethal seizures induced by novel stimulants: A systematic review focused on synthetic cathinones and phenethylamines

MACHÁČEK, Martin a Markéta BÉBAROVÁ

Základní údaje

Originální název

Triggers of highly lethal seizures induced by novel stimulants: A systematic review focused on synthetic cathinones and phenethylamines

Autoři

MACHÁČEK, Martin a Markéta BÉBAROVÁ

Vydání

NeuroToxicology, AMSTERDAM, ELSEVIER, 2026, 0161-813X

Další údaje

Jazyk

angličtina

Typ výsledku

Článek v odborném periodiku

Stát vydavatele

Nizozemské království

Utajení

není předmětem státního či obchodního tajemství

Odkazy

URL

Impakt faktor

Impact factor: 3.900 v roce 2024

Označené pro přenos do RIV

Organizační jednotka

Lékařská fakulta

Příznaky

Mezinárodní význam, Recenzováno

Změněno: 22. 1. 2026 08:36, Mgr. Tereza Miškechová

Anotace

V originále

Synthetic cathinones and phenethylamines are increasingly prevalent novel psychoactive substances with stimulant and hallucinogenic properties. They are associated with acute symptomatic seizures, often with lethal outcomes. Current management is usually limited to symptomatic therapy, as serotonin and sympathomimetic toxidromes are widely regarded as the main seizure-inducing mechanisms. However, intoxications frequently involve severe organ toxicities or metabolic disturbances with high epileptogenic potential, which may be preventable or treatable. This review aimed to assess seizure mechanisms beyond central monoaminergic toxicity to identify additional factors and improve seizure management. A systematic search of PubMed and Web of Science (2003–2024) identified reports describing individual human cases of acute intoxication with synthetic cathinones or phenethylamines, published in English and providing detailed clinical data. Inclusion criteria were met by 42 cases from 34 reports. A descriptive synthesis was performed to summarize observed patterns across substance groups. Most seizures occurred in previously healthy young adults and resulted in death in nearly 50 % of cases, with higher fatality among cathinone users. Serotonin and sympathomimetic toxidromes were present in most cases, supporting a primary role in seizure generation. However, intracranial hemorrhage and cerebral edema (often precipitated by hypertensive crisis), hypoglycemia, and hyponatremia likely contributed to seizures in several cases. Based on these findings, we recommend that young adults presenting with seizures and signs of monoaminergic toxicity, in whom synthetic cathinone or phenethylamine intoxication is confirmed or suspected, should be promptly assessed for focal brain injury and metabolic disturbances to identify treatable causes and potentially improve outcomes.

Návaznosti

GA23-05274S, projekt VaV

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Investor: Grantová agentura ČR, Terapeutická modulace exprese miRNA u epilepsie: dopad na excitabilitu a jiné procesy v mozku

LX22NPO5107, projekt VaV

Název: Národní ústav pro neurologický výzkum

Investor: Ministerstvo školství, mládeže a tělovýchovy ČR, Národní ústav pro neurologický výzkum, 5.1 EXCELES

MUNI/A/1641/2024, interní kód MU

Název: Od buňky k pacientovi II

Investor: Masarykova univerzita, Od buňky k pacientovi II

NU22-04-00366, projekt VaV

Název: Role neurodegenerace v patogenezi, manifestaci a prognóze MTLE/HS - in vivo, ex vivo a in vitro perspektiva

Investor: Ministerstvo zdravotnictví ČR, Role neurodegenerace v patogenezi, manifestaci a prognóze MTLE/HS - in vivo, ex vivo a in vitro perspektiva, Podprogram 1 - standardní

Citovat

MACHÁČEK, Martin a Markéta BÉBAROVÁ. Triggers of highly lethal seizures induced by novel stimulants: A systematic review focused on synthetic cathinones and phenethylamines. NeuroToxicology. AMSTERDAM: ELSEVIER, 2026, roč. 113, March 2026, s. 1-17. ISSN 0161-813X. Dostupné z: https://doi.org/10.1016/j.neuro.2026.103391.

@article{2549157,
   author = {Macháček, Martin and Bébarová, Markéta},
   article_location = {AMSTERDAM},
   article_number = {March 2026},
   doi = {https://doi.org/10.1016/j.neuro.2026.103391},
   language = {eng},
   issn = {0161-813X},
   journal = {NeuroToxicology},
   title = {Triggers of highly lethal seizures induced by novel stimulants: A systematic review focused on synthetic cathinones and phenethylamines},
   url = {https://www.sciencedirect.com/science/article/pii/S0161813X26000124?via%3Dihub},
   volume = {113},
   year = {2026}
}

TY  - JOUR
ID  - 2549157
AU  - Macháček, Martin - Bébarová, Markéta
PY  - 2026
TI  - Triggers of highly lethal seizures induced by novel stimulants: A systematic review focused on synthetic cathinones and phenethylamines
JF  - NeuroToxicology
VL  - 113
IS  - March 2026
SP  - 1-17
EP  - 1-17
PB  - ELSEVIER
SN  - 0161813X
UR  - https://www.sciencedirect.com/science/article/pii/S0161813X26000124?via%3Dihub
N2  - Synthetic cathinones and phenethylamines are increasingly prevalent novel psychoactive substances with stimulant and hallucinogenic properties. They are associated with acute symptomatic seizures, often with lethal outcomes. Current management is usually limited to symptomatic therapy, as serotonin and sympathomimetic toxidromes are widely regarded as the main seizure-inducing mechanisms. However, intoxications frequently involve severe organ toxicities or metabolic disturbances with high epileptogenic potential, which may be preventable or treatable. This review aimed to assess seizure mechanisms beyond central monoaminergic toxicity to identify additional factors and improve seizure management. A systematic search of PubMed and Web of Science (2003–2024) identified reports describing individual human cases of acute intoxication with synthetic cathinones or phenethylamines, published in English and providing detailed clinical data. Inclusion criteria were met by 42 cases from 34 reports. A descriptive synthesis was performed to summarize observed patterns across substance groups. Most seizures occurred in previously healthy young adults and resulted in death in nearly 50 % of cases, with higher fatality among cathinone users. Serotonin and sympathomimetic toxidromes were present in most cases, supporting a primary role in seizure generation. However, intracranial hemorrhage and cerebral edema (often precipitated by hypertensive crisis), hypoglycemia, and hyponatremia likely contributed to seizures in several cases. Based on these findings, we recommend that young adults presenting with seizures and signs of monoaminergic toxicity, in whom synthetic cathinone or phenethylamine intoxication is confirmed or suspected, should be promptly assessed for focal brain injury and metabolic disturbances to identify treatable causes and potentially improve outcomes.
ER  -

MACHÁČEK, Martin a Markéta BÉBAROVÁ. Triggers of highly lethal seizures induced by novel stimulants: A systematic review focused on synthetic cathinones and phenethylamines. \textit{NeuroToxicology}. AMSTERDAM: ELSEVIER, 2026, roč.~113, March 2026, s.~1-17. ISSN~0161-813X. Dostupné z: https://doi.org/10.1016/j.neuro.2026.103391.

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