Clinical features and management of
intoxication due to hallucinogenic drugs
by
Leikin JB, Krantz AJ, Zell-Kanter M,
Barkin RL, Hryhorczuk DO
Department of Medicine,
Rush-Presbyterian-
St Luke's Medical Center, Chicago.
Med Toxicol Adverse Drug Exp 1989 Sep-Oct; 4(5):324-50

ABSTRACT

Hallucinogenic drugs are unique in that they produce the desired hallucinogenic effects at what are considered non-toxic doses. The hallucinogenic drugs can be categorised into 4 basic groups: indole alkaloid derivatives, piperidine derivatives, phenylethylamines and the cannabinols. The drugs reviewed include lysergic acid diethylamide (LSD), phencyclidine (PCP), cocaine, amphetamines, opiates, marijuana, psilocybin, mescaline, and 'designer drugs.' Particularly noteworthy is that each hallucinogen produces characteristic behavioural effects which are related to its serotonergic, dopaminergic or adrenergic activity. Cocaine produces simple hallucinations, PCP can produce complex hallucinations analogous to a paranoid psychosis, while LSD produces a combination of hallucinations, pseudohallucinations and illusions. Dose relationships with changes in the quality of the hallucinatory experience have been described with amphetamines and, to some extent, LSD. Flashbacks have been described with LSD and alcohol. Management of the intoxicated patient is dependent on the specific behavioural manifestation elicited by the drug. The principles involve differentiating the patient's symptoms from organic (medical or toxicological) and psychiatric aetiologies and identifying the symptom complex associated with the particular drug. Panic reactions may require treatment with a benzodiazepine or haloperidol. Patients with LSD psychosis may require an antipsychotic. Patients exhibiting prolonged drug-induced psychosis may require a variety of treatments including ECT, lithium and l-5-hydroxytryptophan.

LSD
PCP
DMT
MDMA
Opioids
Serotonin
Mescaline
Psychedelics
Cannabinoids
Benzodiazepines
Methamphetamine
Drug discrimination
MAOIs and hallucinogens
LSD and cosmic consciousness
Nexus, cathinone, BDB, and MDA
Hofmann's LSD: My Problem Child

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