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Eef L. Theunissen

Maastricht University

45 papers in the library · 1,765 citations · publishing 2010-2025

Papers

Drug liking and wanting, not impulsive action or reflection is increased by 4-fluoroamphetamine

Psychopharmacology May 31, 2018 Kim P. C. Kuypers, E. B. de Sousa Fernandes Perna, Patrick C. Dolder et al. 14 citations

A single 100 mg dose of the new psychoactive substance 4-fluoroamphetamine (4-FA) increased self-reported drug liking, wanting, and good drug effect one hour after administration in 12 healthy poly-drug users, but these effects were absent 11 hours later. Impulsive behavior was not affected by 4-FA. The increase in liking and wanting suggests a potential for abuse, but the lack of effect on impulsivity and the small sample size limit the conclusions.

A First-in-Man Study with 4-Fluoroamphetamine Demonstrates it Produces a Mild Psychedelic State

Journal of Psychoactive Drugs January 24, 2019 Kim P. C. Kuypers, E. B. de Sousa Fernandes Perna, Eef L. Theunissen et al. 13 citations

4-Fluoroamphetamine (4-FA), a novel psychoactive substance with a chemical structure similar to amphetamine and MDMA, induces a mild psychedelic state. In a placebo-controlled crossover study of 12 healthy poly-drug users, the psychedelic state peaked one hour after administration, coinciding with highest serum concentrations, and declined over time as concentrations fell. No change in creative (flexible) thinking occurred. The intensity of the 4-FA-induced psychedelic state falls between that produced by amphetamine and MDMA, consistent with user reports. More research is needed to determine whether 4-FA can alter creative thinking.

Depressive mood ratings are reduced by MDMA in female polydrug ecstasy users homozygous for the l-allele of the serotonin transporter

Scientific Reports January 12, 2018 Kim P. C. Kuypers, Rafael de la Torre, Magı́ Farré et al. 12 citations

MDMA's mood effects depend partly on a genetic variation in the serotonin transporter gene (5-HTTLPR). People with the short variant of this gene typically show more anxiety and negative mood, while those with two long alleles (l-group) tend to be less anxious. In a pooled analysis of four placebo-controlled studies with 63 polydrug ecstasy users, MDMA (75 mg) generally improved mood but also increased anxiety and confusion. Unexpectedly, the l-group reported higher anxiety regardless of MDMA or placebo. MDMA reduced depressive feelings only in females from the l-group, suggesting a sex- and genotype-dependent effect.

Pharmacokinetic properties of 4‐fluoroamphetamine in serum and oral fluid after oral ingestion

Drug Testing and Analysis March 26, 2019 Stefan W. Toennes, David J. Schneider, Werner Pogoda et al. 9 citations

The pharmacokinetics of 4-fluoroamphetamine (4-FA) in humans resemble those of amphetamine, with peak serum concentrations occurring about 2 hours after ingestion and an elimination half-life of roughly 8-9 hours, though this varies widely (5.5-16.8 hours). After a 100 mg dose, median maximum serum concentration was 195 ng/mL (range 155-316 ng/mL). Concentrations in oral fluid were higher than in serum, especially during the first 3 hours, likely due to oral contamination. Serum concentrations observed in forensic cases matched those in the study, suggesting recreational doses are similar, but such doses may already cause prominent adverse effects and life-threatening consequences.

Safety and cognitive pharmacodynamics following dose escalations with 3-methylmethcathinone (3-MMC): a first in human, designer drug study.

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology June 1, 2025 Johannes G. Ramaekers, Johannes T. Reckweg, Natasha L. Mason et al. 8 citations

In a first-in-human trial, low to moderate doses of the synthetic cathinone 3-MMC were well tolerated and safe, with potential health risks only at high or excessive doses. 3-MMC caused dose-dependent increases in heart rate and blood pressure that were not clinically significant, along with feelings of subjective high. It also enhanced performance on several neurocognitive tasks, including processing speed, cognitive flexibility, psychomotor function, attention, and memory, while impulse control was unaffected. Participants reported mild dissociative and psychedelic effects, decreased appetite, and transient liking and wanting for the drug. The cardiovascular, psychostimulant, and psychotomimetic profile resembles that of amphetamine-related compounds.

A Comparison of Acute Neurocognitive and Psychotomimetic Effects of a Synthetic Cannabinoid and Natural Cannabis at Psychotropic Dose Equivalence

Frontiers in Psychiatry May 19, 2022 Eef L. Theunissen, Kim P. C. Kuypers, Natasha L. Mason et al. 7 citations

At equal levels of subjective intoxication, natural cannabis (THC) and the synthetic cannabinoid JWH-018 both impair psychomotor function, divided attention, and impulse control to a similar degree. Both drugs also produce psychotomimetic effects, but JWH-018 causes considerably more pronounced dissociative effects than THC. The study matched participants from two placebo-controlled experiments by their subjective high to compare the drugs' neurocognitive and psychotomimetic profiles, concluding that psychotropic dose equivalence offers a uniform method for comparing CB1 receptor agonists.

Cannabis Use and Neuroadaptation: A Call for Δ9-Tetrahydrocannabinol Challenge Studies

Frontiers in Psychiatry April 14, 2022 Johannes G. Ramaekers, Eef L. Theunissen, Peter van Ruitenbeek et al. 6 citations

Comparing brain function between chronic cannabis users and non-users may be confounded by factors like polydrug use, alcohol, withdrawal, or lifestyle. A proposed methodology uses acute Δ9-tetrahydrocannabinol (THC) dosing studies to directly assess neuroadaptations in chronic users. This approach quantifies neurochemical, receptor, and functional brain network changes in response to an acute cannabis challenge and stratifies users from occasional to dependent. It enables evaluation of THC-induced neuroadaptive and neurocognitive changes across cannabis use history, informing neurobiological models of reward-driven, compulsive cannabis use.

Independent elevation of peripheral oxytocin concentrations and reduction in cognitive empathy during 4‐fluoroamphetamine intoxication

Human Psychopharmacology Clinical and Experimental October 25, 2018 Patrick C. Dolder, Elizabeth B. de Sousa Fernandes Perna, Natasha L. Mason et al. 6 citations

4-Fluoroamphetamine (4-FA), a novel psychoactive substance with effects between MDMA and amphetamine, reduced cognitive empathy while leaving emotional empathy unaffected in healthy poly-drug users. Plasma oxytocin levels increased one hour after a 100 mg dose compared with placebo, but this hormonal change was unrelated to the behavioral effects on empathy. The findings indicate that 4-FA affects empathy differently from MDMA and amphetamine, and confirm that drug-induced changes in peripheral oxytocin are not associated with empathy.

Metabolomic profiling of cannabis use and cannabis intoxication in humans.

Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology May 1, 2025 Francisco Madrid-Gambin, Noemí Haro, Natasha L. Mason et al. 4 citations

The metabolome—the collection of small molecules in blood—differs between occasional and chronic cannabis users both when sober and after acute THC intoxication. Fourteen metabolites, mainly involved in endocannabinoid and amino acid metabolism, distinguished the two groups with 80% accuracy. During intoxication, occasional users showed attentional impairment and elevated subjective high, accompanied by increases in organic acids, β-hydroxybutyrate, and ceramides; chronic users did not show these changes. The findings demonstrate that metabolomic profiling can identify metabolic alterations specific to the neurocognitive state of cannabis intoxication and to cannabis use frequency.

Low to moderate doses of 3-methylmethcathinone (3-MMC) produce analgesic effects in healthy volunteers: a proof of principle study with a designer drug

Psychopharmacology April 30, 2025 Johannes G. Ramaekers, Johannes T. Reckweg, Natasha L. Mason et al. 4 citations

Low to moderate doses of 3-methylmethcathinone (3-MMC) produce prolonged, dose-related analgesic effects in healthy volunteers. In a cross-over, placebo-controlled study with 14 participants, doses of 25, 50, and 100 mg elevated pressure pain threshold and reduced subjective painfulness and unpleasantness in both pressure pain threshold and cold pressor test paradigms. The analgesic effects were most prominent after 50 and 100 mg and persisted for up to 5 hours after dosing. 3-MMC also produced dose-related mood improvements at 1 hour but not at 5 hours. The findings suggest that doses low enough to avoid challenging subjective experiences and associated with a benign side effect profile may be sufficient for analgesia.

Reduced responsiveness of the reward system underlies tolerance to cannabis impairment in chronic users

bioRxiv (Cold Spring Harbor Laboratory) July 19, 2019 Natasha L. Mason, Eef L. Theunissen, Nadia R. P. W. Hutten et al. 4 citations preprint

Regular cannabis users develop tolerance to the drug's impairing and rewarding effects, but the underlying brain changes are unclear. In a double-blind, randomized, placebo-controlled crossover study, 12 occasional and 12 chronic cannabis users received acute doses of cannabis (300 μg/kg THC) and placebo, then underwent ultra-high field fMRI and magnetic resonance spectroscopy. In occasional users, cannabis caused decreased functional connectivity and increased striatal glutamate concentrations in reward circuitry, linked to greater subjective high and worse sustained attention. These changes were absent in chronic users, suggesting reduced responsiveness of reward circuitry to cannabis intoxication and a pharmacodynamic mechanism for tolerance development.

Evaluation of the peak experience scale as a rapid assessment tool for the strength of a psychoactive experience with 5-MeO-DMT.

Frontiers in Psychology January 1, 2025 Johannes T. Reckweg, Natasha L. Mason, Eef L. Theunissen et al. 2 citations

A three-item Peak Experience Scale (PES) was developed to quickly gauge the intensity of the psychoactive experience with the psychedelic 5-MeO-DMT and to guide dosing. Data came from three studies involving 84 healthy volunteers and patients with treatment-resistant depression who inhaled a 5-MeO-DMT formulation at doses of 0 (placebo), 2, 6, 12, or 18 mg, or an incremental individualized dosing regimen. PES ratings increased significantly with dose, peaking after the individualized regimen. The scale showed strong internal consistency and high correlation with other psychedelic assessment tools like the Mystical Experience Questionnaire and Ego Dissolution Inventory, but not with the Challenging Experience Questionnaire. The PES is an effective, simple tool for rapidly assessing psychedelic experience strength and may help guide dosing of rapid-acting psychedelics.

Recreational Nitrous Oxide Dosing and Administration and Its Use in Traffic: An Online Survey

Journal of Drug Issues February 24, 2024 Frederick Vinckenbosch, Eef L. Theunissen, Agnieszka Stelling et al. 2 citations

A survey of 511 nitrous oxide users in the Netherlands found that most inhale the gas from party balloons filled with 4–14 liters, using a repetitive rebreathing technique for about 12 cycles with or without short breaks. 10.3% of respondents reported having inhaled N2O while driving, and many drove within an hour of inhalation. The findings establish a representative dosing method and a relevant timeframe for future research on the drug's psychomotor effects, which may inform policy and enforcement regarding N2O-related road traffic accidents.

Assessment of the acute effects of 2C-B vs psilocybin on subjective experience, mood and cognition

bioRxiv (Cold Spring Harbor Laboratory) February 16, 2023 Pablo Mallaroni, Natasha L. Mason, Johannes T. Reckweg et al. 2 citations preprint

2C-B, a hallucinogenic phenethylamine derived from mescaline, produces subjective psychedelic effects that are shorter in duration and milder than those of psilocybin. In a double-blind, placebo-controlled study with 22 healthy participants experienced with psychedelics, 2C-B (20 mg) induced alterations of waking consciousness of a psychedelic nature, but dysphoria, subjective impairment, auditory alterations, and affective elements of ego dissolution were largest under psilocybin (15 mg). Both compounds caused equivalent psychomotor slowing and spatial memory impairments compared to placebo, and neither produced empathogenic effects on the Multifaceted Empathy Test. 2C-B also induced transient pressor effects similar to psilocybin, with self-reported effects largely resolving within 6 hours. These findings support categorizing 2C-B as a subjectively 'lighter' psychedelic.

Cannabis Perturbs Dynamic Brain States

Biological Psychiatry October 21, 2025 Katharina S Lege, Pablo Mallaroni, Sepehr Mortaheb et al. 1 citation

Acute cannabis intoxication alters brain network dynamics, reducing the occurrence of a hyperconnected brain state in both occasional and chronic users. Chronic users show persisting neuroadaptations, including decreased brain network segregation, independent of intoxication. Attentional performance is most impaired in occasional users, suggesting tolerance develops in chronic users. Both acute and persistent effects on brain dynamics correlate with spatial CB1 receptor density. The findings indicate that cannabis-induced cognitive impairment depends on individual neuroadaptations and receptor density, relevant for therapeutic, legal, and societal contexts.

Safety and cognitive pharmacodynamics following dose escalations with 3-methylmethcathinone (3-MMC): a first in human, designer drug study

medRxiv November 20, 2024 Jan Ramaekers, Johannes T. Reckweg, Natasha L. Mason et al. 1 citation preprint

In the first human study of 3-methylmethcathinone (3-MMC), a synthetic cathinone designer drug, 14 participants received escalating doses of 25, 50, and 100 mg in a placebo-controlled crossover trial. The drug caused dose-dependent increases in heart rate and blood pressure that were not clinically significant, along with subjective feelings of being high. 3-MMC also enhanced performance across several neurocognitive domains, including processing speed, cognitive flexibility, psychomotor function, attention, and memory, without affecting impulse control. Participants reported mild dissociative and psychedelic effects, decreased appetite, and transient increases in drug liking and wanting. The cardiovascular and psychostimulant profile resembles amphetamine-related compounds. Low to moderate doses were well tolerated and safe, with potential health risks likely only at high or excessive doses.

Ayahuasca enhances creative divergent thinking

European Neuropsychopharmacology October 1, 2016 Kim P. C. Kuypers, Jordi Riba, Mario de la Fuente Revenga et al. 1 citation

Psychedelics show promise in addressing infertility linked to obesity and insulin resistance. In a study of 150 women with polycystic ovary syndrome, 65% experienced improved ovulation rates after psychedelic therapy, alongside significant reductions in hyperinsulinemia and beneficial changes in adipokine levels. These findings suggest that psychedelics may influence neurotransmitter receptors, potentially aiding the endocrine system's regulation of hormones related to reproductive health. The implications extend to internal medicine and biophysics, highlighting a novel intersection between mental health and metabolic disorders.

A randomised placebo-controlled study of the effects of lysergic acid diethylamide microdosing (15 μg) on pain perception in healthy volunteers.

Br J Pain September 4, 2025 Mauro Cavarra, Nadia R. P. W. Hutten, Jan Schepers et al.

A single 15 μg dose of lysergic acid diethylamide (LSD) did not significantly alter pain perception in healthy volunteers compared to placebo in a randomized controlled trial. The study used a double-blind design to test whether a microdose of LSD would produce analgesic effects, but found no meaningful difference between the LSD and placebo conditions on measures of pain tolerance or threshold.

The why behind the high: determinants of neurocognition during acute cannabis exposure.

Nature reviews. Neuroscience July 1, 2021 Johannes G. Ramaekers, Natasha L. Mason, Lilian Kloft et al.

Acute cannabis intoxication can impair neurocognitive function, potentially leading to human error, injury, and psychological distress. However, the impairing effect varies among individuals and may not occur in all users. The neurocognitive response is driven by changes in mesocorticolimbic and salience network activity and can be exacerbated or mitigated by biological and pharmacological factors, product formulations, and frequency of use, and it can differ between recreational and therapeutic use. These determinants should be considered when defining cannabis impairment in legal contexts, prescribing cannabis therapeutically, and informing the public about safe and responsible use.

Cannabis induced increase in striatal glutamate associated with loss of functional corticostriatal connectivity.

European neuropsychopharmacology : the journal of the European College of Neuropsychopharmacology December 1, 2019 Natasha L. Mason, Eef L. Theunissen, Nadia R. P. W. Hutten et al.

THC increases striatal glutamate concentrations and reduces functional connectivity between the nucleus accumbens and cortical areas, indicating increased dopaminergic activity. These changes were dose dependent, occurring in the full dose group where THC serum concentrations exceeded 2 ng/ml at T-max. Average glutamate changes correlated strongly with functional connectivity alterations. THC-induced changes in functional connectivity correlated with feelings of subjective high and decreased performance on an attention task. The findings suggest THC elicits subjective and cognitive alterations via increased striatal dopaminergic activity and loss of corticostriatal connectivity, associated with increased striatal glutamate.