1,2-Diarylethylamine- and Ketamine-Based New Psychoactive Substances

While phencyclidine (PCP) and ketamine remain the most well-studied and widely known dissociative drugs, a number of other agents have appeared since the late 1950s and early 1960s, when the pharmacological potential of this class was first realized. For example, hundreds of compounds have been pursued as part of legitimate research efforts to explore these agents. Some of these found their way out of the research labs and onto illicit markets of the 1960s and following decades as PCP analogs. Other "illicit analogs" apparently never appeared in the scientific literature prior to their existence on clandestine markets, thus originating as novel innovations in the minds of clandestine chemists and their colleagues. Like so much else in this world, new technologies changed this dynamic. In the 1990s individuals separated by vast geographical distances could now communicate nearly instantaneously with ease through the Internet. Some individuals used this newly found opportunity to discuss the chemistry and psychoactive effects of dissociative drugs as well as to collaborate on the design and development of novel dissociative compounds. Similar to modern pharmaceutical companies and academic researchers, these seekers tinkered with the structure of their leads pursuing goals such as improved duration of action, analgesic effects, and reduced toxicity. Whether all these goals were achieved for any individual compound remains to be seen, but their creations have been let out of the bag and are now materialized as defined compositions of matter. Moreover, these creations now exist not only in and of themselves but live on further as permutations into various novel analogs and derivatives. In some cases these compounds have made their way to academic labs where potential clinical applications have been identified. These compounds reached wider distribution when other individuals picked up on these discussions and began to market them as "research chemicals" or "legal highs". The result is a continuously evolving game that is being played between legislatures, law enforcement, and research chemical market players. Two structurally distinct classes that have appeared as dissociative-based new psychoactive substances (NPS) are the 1,2-diarylethylamines and β-keto-arylcyclohexylamines. Examples of the former include diphenidine and various analogs such as fluorolintane and N-ethyl-lanicemine, and examples of the latter are analogs of ketamine such as methoxetamine, deschloroketamine, and 2-fluoro-2-deschloroketamine. The subject of this chapter is the introduction to some of the dissociative NPS from these classes and their known pharmacology that have emerged on the market in recent years.

In vitro biochemical evidence that the psychotomimetics phencyclidine, ketamine and dizocilpine (MK-801) are inactive at cloned human and rat dopamine D2 receptors

Dopamine potently increased calcium mobilization in Chinese hamster ovary cells expressing human dopamine D2Long receptors (CHO-D2L cells), and increased guanosine-5'-O-(3-[35S]thio)-triphosphate binding to CHO-D2L cell and rat striatal membranes. These effects of dopamine were blocked by the dopamine D2 receptor antagonist (-)raclopride. In contrast to the findings of a recent controversial study, phencyclidine, ketamine and dizocilpine (MK-801) lacked dopamine D2 receptor full agonist, partial agonist and antagonist activity in these assays, suggesting their psychotomimetic effects, and activity in rodent models of schizophrenia, are associated with N-methyl-d-aspartate receptor blockade rather than a direct interaction with dopamine D2 receptors.

Dopamine receptor contribution to the action of PCP, LSD and ketamine psychotomimetics

Although phencyclidine and ketamine are used to model a hypoglutamate theory of schizophrenia, their selectivity for NMDA receptors has been questioned. To determine the affinities of phencyclidine, ketamine, dizocilpine and LSD for the functional high-affinity state of the dopamine D2 receptor, D2High, their dissociation constants (Ki) were obtained on [3H]domperidone binding to human cloned dopamine D2 receptors. Phencyclidine had a high affinity for D2High with a Ki of 2.7 nM, in contrast to its low affinity for the NMDA receptor, with a Ki of 313 nM, as labeled by [3H]dizocilpine on rat striatal tissue. Ketamine also had a high affinity for D2High with a Ki of 55 nM, an affinity higher than its 3100 nM Ki for the NMDA sites. Dizocilpine had a Ki of 0.3 nM at D2High, but a Kd of 1.8 nM at the NMDA receptor. LSD had a Ki of 2 nM at D2High. Because the psychotomimetics had higher potency at D2High than at the NMDA site, the psychotomimetic action of these drugs must have a major contribution from D2 agonism. Because these drugs have a combined action on both dopamine receptors and NMDA receptors, these drugs, when given in vivo, test a combined hyperdopamine and hypoglutamate theory of psychosis.

Dopamine agonist action of phencyclidine

Although the psychotomimetic action of phencyclidine is often used to model a hypoglutamate theory of psychosis or schizophrenia, work also exists showing that phencyclidine has a significant affinity for the dopamine D2 receptor. The present study was done to determine whether phencyclidine has a direct functional dopamine-like action on cells. The effect of phencyclidine was tested on the release of prolactin from rat cultured anterior pituitary cells. It was found that the release of prolactin was 50% inhibited by 4 nM phencyclidine. This strong dopamine-like agonist action at the functional high-affinity state of the dopamine D2 receptor by the phencyclidine psychotomimetic is consistent with the dopamine hypothesis of psychosis.