Captagon effects: signs of use and the psychological and physical harms

What are the effects and signs of captagon? The short answer

The captagon effects that families usually notice are: long nights awake and unusually little sleep, loss of appetite and weight loss, and fast, excessive talk with extra energy, followed by exhaustion, irritability and mood swings, with gradual withdrawal from the family. With continued use, more serious psychological symptoms can appear, such as severe anxiety and suspicion of the people around them, sometimes reaching psychosis, while the heart and body are under constant strain.

Captagon is a stimulant pill from the amphetamine family, and it goes by many names that differ between countries: Abu Hilalain ("the one with two crescents"), Abu Qawsain ("the one with two brackets") and Lexus in Saudi Arabia and the Gulf, "zero-one pills" in Iraq, and names heard in more than one country such as habb al-rawaq ("the calm pill") and ya msahharni ("you who keep me up"). Some of these names, like ya msahharni, reflect the popular idea that it keeps you awake and gives energy for studying or work, an idea that hides a real risk of addiction.

An important note: every sign here has other possible causes, such as exam stress, depression or a health problem. Together, the signs raise suspicion but prove nothing, and the diagnosis is made by a doctor after an examination.

What is captagon, and what do the pills contain today?

The name was originally the brand name of an old medicine containing fenethylline, developed in the 1960s, whose medical use ended after it was placed under international control in 1986, as a scientific review published in Drug and Alcohol Dependence Reports in 2025 explains.

The pills sold today mostly do not contain that substance. According to a research brief released by the United Nations Office on Drugs and Crime (UNODC) with Naif Arab University for Security Sciences in December 2025, they are mostly a mix of amphetamine and caffeine, sometimes with added substances such as theophylline, quinine and paracetamol. The scientific review notes that some may contain methamphetamine, impurities and harmful adulterants, because they are made in clandestine labs with no oversight.

Signs of captagon use you may notice at home

Most signs come from the stimulant effect itself, and then from the "comedown" that follows:

• Sleep: several nights in a row without sleep and activity at unusual hours, then long sleep and severe exhaustion.
• Eating and weight: clearly eating less, with weight loss that becomes noticeable over time.
• Speech and movement: fast, excessive talk, overconfidence and restlessness.
• Mood: irritability and outbursts over trivial things, mood swings and anxiety.
• Physical signs: dilated pupils, dry mouth, teeth grinding, fast heartbeat and breathing, and sweating.
• Relationships: withdrawing from family time, isolating in their room, new friends, and secrecy about their phone and money.
• Study and work: a sudden burst of activity at first, then absences, lateness and falling performance.

Australia's Alcohol and Drug Foundation describes the two to four days after amphetamine use: disturbed sleep and exhaustion, headaches, mood swings and irritability, anxiety and depression, and sometimes paranoia, hallucinations and confusion. So within a few days you may see the same person energetic and talkative, then drained, irritable and flat.

Psychological effects of captagon: from anxiety to paranoia and psychosis

The psychological effects are what exhaust families most. The 2025 scientific review states that captagon can cause anxiety, agitation, paranoia, hallucinations and psychosis, especially with repeated or heavy use. The main symptoms:

• Anxiety and tension: constant unease, restlessness and insomnia.
• Suspicion: feeling that people are watching or plotting against them, and reading family members' actions as hostile.
• Morbid jealousy: a fixed belief that a wife or fiancée is unfaithful, without evidence.
• Hallucinations: hearing voices or seeing things that are not there.
• Aggression: bursts of anger that can escalate to violence.
• Depression after stopping: low mood, exhaustion and intense craving.

Two studies by doctors at Eradah Complex for Mental Health in Jeddah, published in Psychopharmacology Bulletin, add detail. The first (2022, comparing 78 men with captagon psychosis with 49 men who used it without psychosis) found that those with psychosis reported more stretches without sleep, and its authors concluded that sleep deprivation plays an important role in the onset of psychotic symptoms, although the study was small and relied on what patients themselves reported. The second (2023, on 101 men admitted to hospital with captagon psychosis) found that about a quarter of them (25.7%) developed delusions of infidelity, and that divorce was more common among them than among those with other types of delusions.

The reassuring news is that amphetamine-induced psychosis usually clears after stopping, as the Australian foundation explains. But it needs assessment by a psychiatrist from the start.

Captagon side effects on the brain, heart and body

Stimulants keep the body in a constant state of "emergency". According to the 2025 scientific review and the Alcohol and Drug Foundation, the harms include:

• Heart: fast heart rate and high blood pressure, with greater risk for people with heart disease or hypertension. Medical reports link long-term or heavy use with heart attack and damage to the heart muscle (cardiomyopathy).
• Brain: long-term or heavy use is linked to neurological harm and to addiction, and amphetamines increase the risk of stroke.
• Sleep: chronic insomnia and exhaustion, which paves the way for psychotic symptoms.
• Nutrition and mouth: weight loss, dry mouth and dental problems.
• Temperature and fluids: raised body temperature and dehydration.

The danger rises when it is mixed with alcohol, sedatives, other stimulants or opioids: the Australian foundation warns that mixing makes the effects unpredictable and increases the risk of alcohol poisoning, overdose, heart strain, stroke and stopped breathing.

Captagon vs methamphetamine, and what changed in the market after 2024?

Captagon and methamphetamine (known locally as shabu or ice) belong to the same family, amphetamine-type stimulants, and their psychological effects are similar. But the 2025 UN brief explains that methamphetamine is generally more potent and more harmful to health. Captagon is usually known as pills and methamphetamine as crystals or powder, although methamphetamine has also been found in the region as a liquid and in tablets. The signs of methamphetamine use are covered in detail in signs of crystal meth (shabu and ice) use.

The market has changed sharply since December 2024. According to UNODC, 80% of captagon seizures in the region between January 2019 and November 2025 pointed to Syria as the country of origin. After the change of regime there, the Syrian authorities dismantled 15 industrial-scale labs and 13 smaller storage facilities, and UNODC documented seizures of at least 177 million pills (about 30 tons) in the Arab region since December 2024.

The brief notes signs of shortage in several markets, rising prices in some Gulf countries and countries neighboring Syria, and falling pill purity where analyses were available. It also reports that seizures in 2024 and 2025 increasingly show methamphetamine being trafficked alongside captagon, and that in some countries methamphetamine now accounts for the largest share of drug-related treatment admissions. The World Drug Report 2026 adds that the price of a pill has doubled in some places, which may push people who use it toward methamphetamine, whose use has grown in the region.

What does this mean for your family? Someone used to captagon may move to methamphetamine when captagon becomes scarce or expensive. So if you notice a sudden rise in suspicion, sleeplessness or weight loss, do not assume things are unchanged.

How do you raise the subject with your husband or son?

An angry confrontation usually pushes someone into denial. The aim of the first conversation is not to extract a confession but to open the door to one step toward help:

1. Choose the moment: when he is calm and clear-headed, not under the influence or in the exhausted, irritable days that follow, and somewhere private, away from the children.
2. Start with what you see: "I've noticed you're not sleeping well and you've lost weight, and I'm worried about you", instead of "You're using drugs".
3. Don't argue with the suspicions: if he accuses you of infidelity, don't try to prove your innocence in the moment or raise your voice; the suspicion here is a symptom of illness, not a logical debate.
4. Offer a small step: a medical check-up about his sleep, heart and mood, rather than demanding he stop immediately.
5. Agree on one family position: clear limits, such as not giving money without a known reason, without threats you won't carry out.
6. Look after yourself too: even if he refuses, you can start with a therapy session for yourself with a psychologist.

If it concerns your husband, read my husband is using drugs: how do I deal with it?, and if your son refuses treatment, read my son is using drugs and refuses treatment.

When to get help, and where does treatment start?

Seek a medical assessment without waiting if you notice:

• Suspicion, morbid jealousy, hallucinations or aggression, even once.
• Several nights in a row without sleep, or rapid weight loss.
• Failed attempts to stop, or continued use despite losing studies or work.
• Depression or thoughts of self-harm after stopping.
• Chest pain or palpitations, or existing heart disease or high blood pressure.
• Use of other substances alongside it, such as alcohol, sedatives, pregabalin or tramadol.

Treatment starts with a full medical assessment covering the heart, the body, mental health and any other substances. The US National Institute on Drug Abuse (NIDA) explains that there is still no medication approved by the US Food and Drug Administration (FDA) for treating stimulant use disorder; a doctor may prescribe medicines for accompanying symptoms such as insomnia, depression or psychosis, and that decision is theirs alone.

The backbone of treatment is behavioral therapy: contingency management (a reward-based approach) which NIDA describes as the most studied, cognitive behavioral therapy, motivational interviewing and support groups. If alcohol, sedatives, pregabalin, tramadol or other opioids are also being used, withdrawal can be dangerous and needs medically supervised detox. The stopping period is covered in detail in captagon withdrawal symptoms and treatment.

In Oxygen Center's addiction treatment program this happens within a single plan, together with family counseling within the rehabilitation program, because home is part of recovery. Doctor appointments and therapy sessions at the center are for men and women aged 15 and over (under 18 with a guardian's consent), while inpatient stays such as detox are for males only. If you are unsure, call or WhatsApp +20 101 687 0711, or the 24/7 line +20 100 006 6752 at any hour. Recovery from captagon is possible, and the first step is a phone call or an appointment.