Effects of acute detoxification of the herbal blend ‘Spice Gold’ on dopamine D2/3 receptor availability: A [18F]fallypride PET study

• Published in: European neuropsychopharmacology Vol. 23; no. 11; pp. 1606 - 1610
• Main Authors: Rominger, Axel, Cumming, Paul, Xiong, Guoming, Koller, Gabriele, Förster, Stefan, Zwergal, Andreas, Karamatskos, Evangelos, Bartenstein, Peter, La Fougère, Christian, Pogarell, Oliver
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.11.2013
• Subjects: Addiction; Benzamides; Brain - diagnostic imaging; Brain - metabolism; Cannabinoid; Case-Control Studies; Dopamine D2/3 receptor; Fluorine Radioisotopes; Functional Neuroimaging; Humans; Inactivation, Metabolic; Internal Medicine; Male; PET; Plant Preparations - administration & dosage; Plant Preparations - adverse effects; Psychiatry; Radionuclide Imaging; Receptors, Dopamine D2 - metabolism; Receptors, Dopamine D3 - metabolism; Spice; Substance Withdrawal Syndrome - diagnostic imaging; Substance Withdrawal Syndrome - metabolism; Young Adult; Spice; Dopamine D2/3 receptor; Addiction; Cannabinoid; PET; Dopamine D 2/3 receptor; Dopamine D(2/3) receptor
• ISSN: 0924-977X; 1873-7862
• DOI: 10.1016/j.euroneuro.2013.01.009

We carried out dynamic [18F]fallypride PET scans to measure cerebral dopamine D2/3 receptor availability in a 23-year old patient experiencing a severe withdrawal syndrome upon voluntary abstinence from “Spice”, a pre-packaged herbal smoking thought to contain synthetic cannabinoids. Upon admission to the clinic, the patient experienced craving, affective symptoms and a range of somatic complaints, which resolved after several days' monitored abstinence. PET scans were performed on the day of admission, and one week later. Estimates of [18F]fallypride binding potential (BPND) were obtained in striatal and extrastriatal brain regions, and compared to results of age-matched healthy control subjects. Upon admission, [18F]fallypride BPND was reduced by 20% in the patient's striatum and also in extra-striatal regions. During short-term follow-up upon detoxification, the BPND increased to normal values. This study shows substantial short-term alterations of dopamine D2/3 receptor availability in a patient before and after acute detoxification from “Spice Gold”, thus providing first evidence of reversible effects on dopamine receptors of heavy use of a herbal smoking blend.