4.1 Article

The last two decades on preclinical and clinical research on inhalant effects

Journal

NEUROTOXICOLOGY AND TERATOLOGY
Volume 87, Issue -, Pages -

Publisher

PERGAMON-ELSEVIER SCIENCE LTD
DOI: 10.1016/j.ntt.2021.106999

Keywords

Inhalants; Solvents; Aerosols; Nitrites; Gases; Abuse; Dependence; Sensitization; Tolerance; Withdrawal; Mechanism of action; Treatment

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This paper reviews scientific evidence on the effects and mechanisms of action of commonly misused inhalants over the past two decades. It covers the definition, prevalence, characteristics, acute and chronic effects, and treatment of inhalant use. The paper also proposes a research agenda to further study the effects of inhalant use.
This paper reviews the scientific evidence generated in the last two decades on the effects and mechanisms of action of most commonly misused inhalants. In the first section, we define what inhalants are, how they are used, and their prevalence worldwide. The second section presents specific characteristics that define the main groups of inhalants: (a) organic solvents; (b) aerosols, gases, and volatile anesthetics; and (c) alkyl nitrites. We include a table with the molecular formula, structure, synonyms, uses, physicochemical properties and exposure limits of representative compounds within each group. The third and fourth sections review the direct acute and chronic effects of common inhalants on health and behavior with a summary of mechanisms of action, respectively. In the fifth section, we address inhalant intoxication signs and available treatment. The sixth section examines the health effects, intoxication, and treatment of nitrites. The seventh section reviews current intervention strategies. Finally, we propose a research agenda to promote the study of (a) solvents other than toluene; (b) inhalant mixtures; (c) effects in combination with other drugs of abuse; (d) age and (e) sex differences in inhalant effects; (f) the long-lasting behavioral effects of animals exposed in utero to inhalants; (g) abstinence signs and neurochemical changes after interrupting inhalant exposure; (h) brain networks involved in inhalant effects; and finally (i) strategies to promote recovery of inhalant users.

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