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The rapid onset of euphoria followed by a crash creates a vicious cycle, trapping users in the grip of addiction

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These articles were retrieved from PubMed and Google Scholar (Cals and Kotz, 2016) using the following combinations of keywords and MeSH terms (National Library of Medicine, 2020) were used: (i) addiction and neuropharmacology, (ii) arecoline and mAChRs, (iii) arecoline and nAChRs, (iv) arecoline and nicotine, (v) betel nut components and metabolic pathways, (vi) betel quid and betel nut, (vii) betel quid and its preparation (viii) monoamine oxidase ( MAO-A and MAO-B ), (ix) natural MAO inhibitors, (x) prevalence and epidemiology, (xi) treatment and cessation interventions

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[21] Non-selective MAOIs and MAO-B inhibitors have also been investigated in other neurological contexts, including neuroprotection and migraine prevention, but these uses vary by drug and indication