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How Does Flakka Affect Your Brain?

Flakka is a street drug that alters the brain by dramatically increasing dopamine, norepinephrine, and serotonin release.[1] This leads to intense euphoria, increased alertness, mood swings, and mood disorders as well as long-term damage, such as addiction, cognitive impairment, and mental health issues.

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Overstimulation of areas responsible for mood regulation, behavior management, and impulse control results in dangerously unpredictable behavior patterns that often prove harmful.

Flakka can cause profound changes to brain chemistry over time, potentially leading to long-term mental health issues.[1] Due to its unpredictable and potentially lethal effects, flakka should be considered a highly dangerous substance with serious implications for brain health.

Flakka’s Impact on Your Brain

Flakka’s effects on the brain are complex and remain poorly understood, but many of its negative impacts are well known.[1] Flakka belongs to a class of drugs called synthetic cathinones which is similar to amphetamines and bath salts, which work by blocking dopamine and serotonin reuptake within the brain.[2]

These are some of flakka’s impacts on the brain:[2-4]

Overstimulation of the Reward System

Flakka can overstimulate the reward system by flooding the brain with dopamine, the neurotransmitter responsible for pleasure and motivation. This overstimulation usually triggers the experience of a high that can be pleasurable and involve high energy levels.

As the high begins to wear off, the steep drop in these “feel-good” chemicals can cause extreme agitation, anxiety, and depression as well as intense cravings for more of the drug.

Disruption of the prefrontal cortex

The prefrontal cortex is responsible for executive functions, such as planning, decision-making, and impulse control. Flakka can disrupt these functions, leading to impaired judgment, increased impulsivity, and aggressive behavior. 

This effect can last long after the high wears off. With repeated or heavy use, it can be an ongoing problem.

Increase in stress hormones

Flakka use can lead to an increase in the production of stress hormones like cortisol and adrenaline, leading to physical and mental health problems like anxiety, paranoia, and aggression. In some cases, these feelings may define the experience of being high on flakka, with very little of the euphoria that some experience. 

With repeated and heavy use, the agitation and paranoia may encompass the entire experience, often continuing after the drug is no longer in the user’s system.

Flakka’s Long-Term Impacts on the Brain

Flakka can have serious, long-term cognitive impacts, both immediately and over time. These are some of the long-term ramifications of flakka use on the brain:[1-3,5-7]

Neurological Damage

Flakka can cause lasting neurological damage through its stimulant properties, overexciting neurons in the brain and altering pathways and functions permanently. This may result in impaired cognitive abilities, memory issues, and difficulties with concentration and attention.

Psychiatric Disorders

Flakka use has been linked with an increased risk of developing psychiatric disorders like depression, anxiety, and psychosis. The drug’s effect on neurotransmitters like serotonin and dopamine may cause persistent mood disturbances that eventually progress into long-term mental health issues that remain in effect even when the drug is not actively used.


Flakka can be highly addictive, leading to chronic use. Long-term drug abuse damages the reward system in the brain, making it increasingly difficult to experience pleasure from natural sources, leading to a cycle of worsening drug-seeking behaviors.

Cognitive Decline

With continued drug abuse, studies have demonstrated changes to brain volume in areas associated with decision-making and impulse control, potentially contributing to persistent behavioral and cognitive problems.

Flakka users may experience issues with memory, learning, and decision-making abilities despite discontinuing use of the drug. Some of this damage can be reversed with abstinence from the drug.

Permanent Psychosis

Long-term flakka use may result in psychosis or other serious mental health disorders that severely impair an individual’s daily functions and require ongoing medical treatment. Such conditions can severely impair a person’s life and require ongoing medical care and treatment.


Flakka is a toxin, so it contributes to inflammation in the brain and body when in use. Inflammation can build and worsen over time with regular use, creating physical ailments that impact every system in the body. 

Updated May 7, 2024
  1. Flakka: New dangerous synthetic cathinone on the drug scene Patocka J, Zhao B, Wu W, et al., International Journal of Molecular Sciences. 2020;21(21):8185.
  2. Synthetic cathinones (“bath salts”): legal and health care challenges. P & T: a peer-reviewed journal for formulary management. Gershman JA, Fass AD., 2012;37(10):571-595
  3. Flakka-induced prolonged psychosis Crespi C., Case Reports in Psychiatry. 2016;2016:1-2.
  4. Drug alert: Flakka (alpha-PVP) Get Smart About Drugs, Drug Enforcement Administration. Published 2021. Accessed October 3, 2023.
  5. Imaging the addicted human brain Fowler J, Volkow N, Kassed C, Chang L., Addiction Science & Clinical Practice. 2007;3(2):4-16.
  6. Psychoactive bath salts and neurotoxicity risk ALTUN B, ÇOK İ., Turkish Journal of Pharmaceutical Sciences. 2020;17(2):235-241.
  7. Neurocognitive dysfunction following repeated binge-like self-administration of the synthetic cathinone 3,4-methylenedioxypyrovalerone (MDPV). Sewalia K, Watterson LR, Hryciw A, Belloc A, Ortiz JB, Olive MF., Neuropharmacology. 2018;134:36-45
  8. The psychoactive designer drug and bath salt constituent MDPV causes widespread disruption of brain functional connectivity Colon-Perez LM, Tran K, Thompson K, et al., Neuropsychopharmacology. 2016;41(9):2352-2365.
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