Piperazine Abuse and Psychosis: A Systematic Review of the Literature
Alessio Mosca, Stefania Chiappini, Andrea Miuli, Gianluca Mancusi, Clara Cavallotto, John Corkery, Livia Miotti, Mauro Pettorruso, Giovanni Martinotti, Fabrizio Schifano
Psychiatry International September 20, 2024 DOI: 10.3390/psychiatryint5030040 via OpenAlex
Summary
AI-generated from the abstractPiperazines, synthetic compounds with stimulant and hallucinogenic effects, are linked to acute psychotic episodes. A systematic review of 4 studies found that piperazine abuse frequently triggers symptoms such as paranoia, auditory, and visual hallucinations. The compounds' complex polyreceptor action may explain these effects, similar to other novel psychoactive substances. Recovery is common after cessation and treatment, but data on long-term outcomes are limited. Further research into piperazine abuse and specific treatment protocols for substance-induced psychosis is needed.
Study at a glance
| Characteristics | Systematic review Peer reviewed |
|---|---|
| Keywords | Psychosis Systematic review Piperazine Psychiatry Psychology |
| Citations | 5 |
| Key finding | Piperazine abuse is associated with acute psychotic episodes characterized by paranoia and hallucinations. |
Abstract
Background: 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.