Synthetic Cannabinoids : psychopharmacology, clinical aspects, and psy-chotic onset

Synthetic Cannabinoids (SC) are the widest and most diffused class of Novel Psychoactive Substances. SC are chemically heterogeneous and structurally dissimilar from delta-9-tetrahydrocannabinol, being full agonists of the endocannabinoid system receptors CB1 and CB2. Desired effects include euphoria, talkativeness, feelings of joy and laughter, relaxation. With respect to cannabis, SC intake may also be associated with quicker arise of the effects, shorter duration of action, and larger levels of hangover. SC are more psychoactive than cannabis: symptoms may include a wide range of clinically relevant posi-tive, negative and cognitive psychopathological symptoms that mimic symptoms of schizophrenia. The risk of two widespread symptoms of SC intoxication, namely agitation and cardiotoxicity, exceeds this of traditional cannabis of 3.8 and 9.2 times respectively. A number of deaths have been related to SC ingestion, either on their own or in combination with other recreational drugs. Prompt and reliable in-formation available for health professionals, more specific analytic techniques, and designed preventive strategies are all required to face this unprecedented challenge.