Drugs Used in “Chemsex”/Sexualized Drug Behaviour—Overview of the Related Clinical Psychopharmacological Issues

<b>Background</b>: “Chemsex” involves the intake of a range of drugs (e.g., synthetic cathinones, gamma-hydroxybutyric acid/gamma-butyrolactone (GHB/GBL), ketamine, methamphetamine, “poppers”, type V phosphodiesterase (PDE) inhibitors, MDMA/ecstasy, cocaine, cannabis, and occasionally a...

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Main Authors: Fabrizio Schifano, Stefania Bonaccorso, Davide Arillotta, Amira Guirguis, John Martin Corkery, Giuseppe Floresta, Gabriele Duccio Papanti Pelletier, Norbert Scherbaum, Nicolò Schifano
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Language:English
Published: MDPI AG 2025-04-01
Series:Brain Sciences
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Online Access:https://www.mdpi.com/2076-3425/15/5/424
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author Fabrizio Schifano
Stefania Bonaccorso
Davide Arillotta
Amira Guirguis
John Martin Corkery
Giuseppe Floresta
Gabriele Duccio Papanti Pelletier
Norbert Scherbaum
Nicolò Schifano
author_facet Fabrizio Schifano
Stefania Bonaccorso
Davide Arillotta
Amira Guirguis
John Martin Corkery
Giuseppe Floresta
Gabriele Duccio Papanti Pelletier
Norbert Scherbaum
Nicolò Schifano
author_sort Fabrizio Schifano
collection DOAJ
description <b>Background</b>: “Chemsex” involves the intake of a range of drugs (e.g., synthetic cathinones, gamma-hydroxybutyric acid/gamma-butyrolactone (GHB/GBL), ketamine, methamphetamine, “poppers”, type V phosphodiesterase (PDE) inhibitors, MDMA/ecstasy, cocaine, cannabis, and occasionally a few other molecules as well, to enhance and prolong sexual experiences. This paper aims to provide an overview of the clinical pharmacology of the vast range of drugs that are being used for chemsex with a focus on both the medical and psychopathological disturbances that they can produce. <b>Methods</b>: A narrative literature review was conducted using Pubmed, Scopus, and Web of Science databases. A total of 273 papers published up to January 2025 were screened; articles were selected based on relevance to chemsex/sexualized used behaviour and related substances. Both human and preclinical studies were considered. <b>Results</b>: The use of stimulants is likely related to the need to increase as much as possible both sexual arousal and performance but also to increase social interactions. Furthermore, the empathogenic/entactogenic activities of some MDMA-like “love drugs” facilitate the occurrence of “feeling closer/more intimate” emotional sensations, and GHB/GBL may provide the user with a subjective sensation of disinhibition, hence facilitating condomless meetings with a higher number of random partners. Conversely, ketamine may be used to both enjoy its psychotropic dissociative characteristics and facilitate the potentially painful receptive anal intercourse and/or fisting experiences. Most typically, these drugs are consumed in combination, with polydrug exposure possibly facilitating the occurrence of serotonergic syndrome, seizures, drug–drug pharmacokinetics’ interaction, and sympathomimetic overstimulation. Following these polydrug exposures, a range of psychopathological conditions have at times been reported. These issues may lead to misuse of opiates/opioids, gabapentinoids, and/or antipsychotics. <b>Conclusions</b>: Further actions should aim at reducing the stigma that prevents individuals from accessing necessary healthcare and support services. A multidisciplinary approach that combines medical, psychological, and social support remains key to managing the complex challenges posed by chemsex-related drug use.
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spelling doaj-art-9e7b2f215cc047e0ba553d3fa12e052f2025-08-20T03:14:42ZengMDPI AGBrain Sciences2076-34252025-04-0115542410.3390/brainsci15050424Drugs Used in “Chemsex”/Sexualized Drug Behaviour—Overview of the Related Clinical Psychopharmacological IssuesFabrizio Schifano0Stefania Bonaccorso1Davide Arillotta2Amira Guirguis3John Martin Corkery4Giuseppe Floresta5Gabriele Duccio Papanti Pelletier6Norbert Scherbaum7Nicolò Schifano8Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UKNorth Islington Core Team, Academic Secretary RCPsych, London N7 8US, UKPsychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UKPharmacy, Medical School, The Grove, Swansea University, Swansea SA2 8PP, UKPsychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UKDepartment of Drug and Health Sciences, University of Catania, 95124 Catania, ItalyPsychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield AL10 9AB, UKDepartment of Psychiatry and Psychotherapy, LVR-University Hospital Essen, Medical Faculty, University of Duisburg-Essen, 45147 Essen, GermanyDepartment of Urology, ASST Sette Laghi-Ospedale di Circolo di Varese, 21100 Varese, Italy<b>Background</b>: “Chemsex” involves the intake of a range of drugs (e.g., synthetic cathinones, gamma-hydroxybutyric acid/gamma-butyrolactone (GHB/GBL), ketamine, methamphetamine, “poppers”, type V phosphodiesterase (PDE) inhibitors, MDMA/ecstasy, cocaine, cannabis, and occasionally a few other molecules as well, to enhance and prolong sexual experiences. This paper aims to provide an overview of the clinical pharmacology of the vast range of drugs that are being used for chemsex with a focus on both the medical and psychopathological disturbances that they can produce. <b>Methods</b>: A narrative literature review was conducted using Pubmed, Scopus, and Web of Science databases. A total of 273 papers published up to January 2025 were screened; articles were selected based on relevance to chemsex/sexualized used behaviour and related substances. Both human and preclinical studies were considered. <b>Results</b>: The use of stimulants is likely related to the need to increase as much as possible both sexual arousal and performance but also to increase social interactions. Furthermore, the empathogenic/entactogenic activities of some MDMA-like “love drugs” facilitate the occurrence of “feeling closer/more intimate” emotional sensations, and GHB/GBL may provide the user with a subjective sensation of disinhibition, hence facilitating condomless meetings with a higher number of random partners. Conversely, ketamine may be used to both enjoy its psychotropic dissociative characteristics and facilitate the potentially painful receptive anal intercourse and/or fisting experiences. Most typically, these drugs are consumed in combination, with polydrug exposure possibly facilitating the occurrence of serotonergic syndrome, seizures, drug–drug pharmacokinetics’ interaction, and sympathomimetic overstimulation. Following these polydrug exposures, a range of psychopathological conditions have at times been reported. These issues may lead to misuse of opiates/opioids, gabapentinoids, and/or antipsychotics. <b>Conclusions</b>: Further actions should aim at reducing the stigma that prevents individuals from accessing necessary healthcare and support services. A multidisciplinary approach that combines medical, psychological, and social support remains key to managing the complex challenges posed by chemsex-related drug use.https://www.mdpi.com/2076-3425/15/5/424chemsexsexualized drug behaviourdrug usesubstance misusedrug addiction
spellingShingle Fabrizio Schifano
Stefania Bonaccorso
Davide Arillotta
Amira Guirguis
John Martin Corkery
Giuseppe Floresta
Gabriele Duccio Papanti Pelletier
Norbert Scherbaum
Nicolò Schifano
Drugs Used in “Chemsex”/Sexualized Drug Behaviour—Overview of the Related Clinical Psychopharmacological Issues
Brain Sciences
chemsex
sexualized drug behaviour
drug use
substance misuse
drug addiction
title Drugs Used in “Chemsex”/Sexualized Drug Behaviour—Overview of the Related Clinical Psychopharmacological Issues
title_full Drugs Used in “Chemsex”/Sexualized Drug Behaviour—Overview of the Related Clinical Psychopharmacological Issues
title_fullStr Drugs Used in “Chemsex”/Sexualized Drug Behaviour—Overview of the Related Clinical Psychopharmacological Issues
title_full_unstemmed Drugs Used in “Chemsex”/Sexualized Drug Behaviour—Overview of the Related Clinical Psychopharmacological Issues
title_short Drugs Used in “Chemsex”/Sexualized Drug Behaviour—Overview of the Related Clinical Psychopharmacological Issues
title_sort drugs used in chemsex sexualized drug behaviour overview of the related clinical psychopharmacological issues
topic chemsex
sexualized drug behaviour
drug use
substance misuse
drug addiction
url https://www.mdpi.com/2076-3425/15/5/424
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