Book contents
- Recreational Drugs Repurposed for Medicinal Use
- Recreational Drugs Repurposed for Medicinal Use
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Introduction
- Chapter 2 Ritual to Relief: Ethical Frontiers in Repurposing Psychoactive Substances
- Chapter 3 Psilocybin and Hallucinogenic Mushrooms
- Chapter 4 Ayahuasca: Pharmacology, Safety, and Therapeutic Effects
- Chapter 5 Recreational Drugs Repurposed for Medicinal Use – Cannabis
- Chapter 6 Ketamine in Clinical Practice: Transitioning from Anesthetic Agent to Psychiatric Therapeutic
- Chapter 7 MDMA-Assisted Therapy: Challenges, Clinical Trials, and the Future of MDMA in Treating Behavioral Disorders
- Chapter 8 Central Nervous System Stimulants in Recreational and Medical Use
- Chapter 9 From Betel Nuts to Cobenfy: How an Ancient Recreational Drug Gave Rise to a New Class of Schizophrenia Medications
- Index
- References
Chapter 9 - From Betel Nuts to Cobenfy: How an Ancient Recreational Drug Gave Rise to a New Class of Schizophrenia Medications
Published online by Cambridge University Press: 24 July 2026
Book contents
- Recreational Drugs Repurposed for Medicinal Use
- Recreational Drugs Repurposed for Medicinal Use
- Copyright page
- Contents
- Contributors
- Foreword
- Chapter 1 Introduction
- Chapter 2 Ritual to Relief: Ethical Frontiers in Repurposing Psychoactive Substances
- Chapter 3 Psilocybin and Hallucinogenic Mushrooms
- Chapter 4 Ayahuasca: Pharmacology, Safety, and Therapeutic Effects
- Chapter 5 Recreational Drugs Repurposed for Medicinal Use – Cannabis
- Chapter 6 Ketamine in Clinical Practice: Transitioning from Anesthetic Agent to Psychiatric Therapeutic
- Chapter 7 MDMA-Assisted Therapy: Challenges, Clinical Trials, and the Future of MDMA in Treating Behavioral Disorders
- Chapter 8 Central Nervous System Stimulants in Recreational and Medical Use
- Chapter 9 From Betel Nuts to Cobenfy: How an Ancient Recreational Drug Gave Rise to a New Class of Schizophrenia Medications
- Index
- References
Summary
This chapter briefly describes the fascinating journey from ancient betel nuts to modern muscarinic therapeutics. The composite street drug, colloquially referred to as “betel” or “betel nut” or “betel quid,” is one of the most frequently used psychoactive substances in the world. It carries a cultural legacy spanning over 10,000 years and a current user base numbering in the hundreds of millions. Its primary psychoactive constituent is arecoline, a well-established parasympathomimetic agent. Now, developments in psychopharmacology and our growing understanding of neurochemical brain circuitry have unlocked a new mechanism of action by which arecoline-derived medications interact with dopaminergic processes to improve outcomes for schizophrenia patients. One such medication, xanomeline-trospium (Cobenfy), has emerged as the first such agent to receive FDA approval for the treatment of schizophrenia and represents an entirely new class of pro-cholinergic medication within the field of psychiatry.
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- Recreational Drugs Repurposed for Medicinal Use , pp. 169 - 177Publisher: Cambridge University PressPrint publication year: 2026
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