Arylcyclohexamine type drugs

Arylcyclohexamines are compounds that can have dissociative, anaesthetic, anticonvulsant, analgesic and euphoric effects. They primarily act by antagonism of N-Methyl-D-Aspartate (NMDA) receptors, but also have actions through dopamine transporters and opioid receptors. Their chemical structure is characterised by a cyclohexamine unit with an aryl moiety (typically a phenyl ring) attached to the same atom to which the amine group is linked. The archetypal arylcyclohexamines are ketamine and phencyclidine, both of these are used recreationally for their euphoric and dissociative effect; ketamine is also used therapeutically both pre- and in-hospital as an analgesic and anaesthetic, and there are emerging uses of ketamine for depression, post-traumatic stress and alcohol withdrawal. There are also several novel psychoactive substance (NPS) arylcyclohexamines which have emerged in recent years and been detected in patients presenting with “acute recreational drug toxicity”. This chapter will look at this family of drugs discussing their pharmacology; analytical detection; prevalence of use; acute and chronic toxicity; and potential for abuse and dependence.