Synthetic cathinones, or bath salts, are man-made drugs that act as both a stimulant and a hallucinogen. Bath salts have known mood side effects. However, some people using bath salts report improved mood symptoms after using bath salts while others report poor mood. In addition, low mood is common after the bath salt high has worn off. Some people may even use bath salts to self-medicate for depression, compounding their low mood problem. Therefore, it is important to understand how bath salts work on mood and how they can cause or worsen mood problems over time.

What Drugs Are Considered Bath Salts?

Bath salts are club drugs that have chemical structures like other drugs of abuse, such as ecstasy and amphetamine. Due to the potential for abuse, synthetic cathinones are considered illegal Schedule I drugs under the Controlled Substances Act.

  • A few types of bath salts include:

    • Mephedrone, also known as 4-methylmethcathinone or 4-MMC
    • Methylone
    • Ethylone
    • Butylone
    • Naphyrone
    • Cathinone
    • Methcathinone
    • Flephedrone
    • Pyrovalerone
    • Methylenedioxypyrovalerone, or MDPV

Synthetic Cathinones & Their Role as an Antidepressant

Some people may use bath salts to try to cope with depression symptoms. In fact, in the 1930s, similar chemicals were used as antidepressants in the Soviet Union. Even today, bupropion — a drug derived from cathinones — is used for depression.

People who use bath salts often say that they start to experience pleasant mood symptoms soon after using the drug. These effects start about 1.5 hours after taking the drug and can last for up to eight hours. Because of these pleasurable effects, one study showed that up to 74% of people who use bath salts find them to be enjoyable.

  • Some of the potentially pleasurable side effects of bath salts include:

    • Euphoria
    • Improved concentration
    • Ability to work faster
    • Increased energy
    • Talkativeness
    • Improved confidence

Three types of bath salts act on the 5-HT2A receptor in the brain: mephedrone, methcathinone, and flephedrone. Doctors believe this part of the brain plays a role in depression. Some antidepressants also act on the 5-HT2A receptor, although they affect it differently than bath salts.

However, doctors have found that some of the illicit substances people take alongside bath salts have similar positive effects on mood as bath salts. As a result, doctors suspect that some of the pleasant symptoms attributed to bath salts may be caused by other drugs, like:

  • Marijuana
  • Ecstasy/MDMA
  • Cocaine
  • Amphetamines
  • Mushrooms
  • Lysergic acid diethylamide, or LSD
  • Ketamine

Do Bath Salts Cause Depression?

Bath salts can have a variety of negative mental side effects, including depression. Unfortunately, these mental side effects are not just symptoms of coming off a bath salt high. In fact, the symptoms may be due to brain damage caused by bath salts. Doctors have studied brain images of people who use bath salts and suspect that some of the brain chemical changes linked to the drug may be permanent.

  • Some of the psychiatric side effects linked to bath salts include:

    • Agitation in up to 82% of people
    • Aggression in 57% of people
    • Hallucinations in up to 40% of people
    • Confusion in up to 34% of people
    • Anxiety in up to 17% of people
    • Insomnia in 4% of people
    • Trouble moving normally in 1% of people
    • Inability to feel pleasure
    • Trouble eating
    • Depression
    • Higher sex drive
    • Harm to self or others
    • Panic attacks
    • Feeling suicidal
    • Psychosis

When bath salts cause psychosis, it is often linked to MDPV. The most common psychotic symptoms caused by bath salt use are:

  • Paranoia
  • Auditory hallucinations
  • Visual hallucinations

Many people who use bath salts regularly seem to be aware of the negative mental side effects of the drug. One study showed that up to 67% of people who used bath salts thought the drug had a “bad comedown.” Regular bath salt use in the study was linked to symptoms that started within 24 hours, like:

  • Negative mood
  • Aches and pains
  • Persistent fatigue

Treatment Options for Comorbid Depression and Cathinone Dependence

No FDA-approved medication currently exists to help treat bath salt addiction. Fortunately, acute mental symptoms can be treated in hospitals. In some cases, long-term psychosis from bath salt use has been treated with electroconvulsive therapy.

Unfortunately, very little research has been conducted so far on treating co-occurring depression and cathinone dependence. Bath salt use itself may be an attempt to self-medicate depression symptoms.

However, there is at least one reported case of a man with depression who used bath salts. He was successfully treated using the antidepressant bupropion, which is a legal drug-related to cathinones. More research is needed to see if bupropion is a good option for other people with depression who take bath salts. It is important that people who use bath salts and also experience mood problems see a mental health professional to help them decide what treatment they need.

If you or a loved one struggle with bath salts — with or without low mood — The Recovery Village can help. Our experts are trained in helping people who struggle with substance use. Contact us today to learn more.