hallucinogens, etc. Flashcards
Lysergic and diethylamide (LSD)
Indole
- typical dose: 25-500 micrograms; extremely potent!
- taken orally, either as a powder, as a solution, or blotted onto paper (“Blotter Acid”). It can also be absorbed through the skin to a limited extent.
- initial effects (30 minutes - 2 hours) mainly involve somatic and autonomic changes
Psilocybin and psilocin
Indole hallucinogens
found in hallucinogenic mushrooms - effects are qualitatively similar to those of LSD
Bufotenin
Indole hallucinogen
found in some mushrooms and in the skin of some amphibians - “Toad Licking”
Ibogaine
Indole hallucinogen
alkaloid found in the roots of an African shrub (Tabernanthe iboga).
It is a powerful hallucinogen that has recently been reported to suppress the craving for heroin cocaine and other drugs in addicted individuals. This is extremely controversial.
Mescaline
Phenylethylamine (hallucinogenic actions but also produce amphetamine- like stimulant effects)
Found in buttons of the peyote cactus, effects are similar to those of LSD but the somatic autonomic changes are more pronounced
Methylenedioxymethamphetamine (MDMA; Ecstasy)
Phenylethylamine (hallucinogenic actions but also produce amphetamine- like stimulant effects)
Now one of the more common hallucinogens.
Hallucinogen initial sympathomimetic effects (LSD as prototype)
pupillary dilation increase in BP tachycardia piloerection hyperflexia tremors increase in body temp
Hallucinogen initial Miscellaneous Somatic Effects
dizziness
weakness
paresthesias
nausea
Hallucinogen initial effects: Subjective Psychic Changes
anxiety
euphoria, giddiness
emotional lability
In general, the early stage subjective effects are usually perceived as pleasant
The hallucinogenic (psychogenic) effects develop more slowly (1-3 hours). This phase is characterized by:
- Sensory distortions: heightened awareness of sensory input, auditory and visual disturbances, hallucinations (primarily visual), synesthesias.
- Depersonalization - out of body experiences
- Difficulty differentiating drug effects from reality
- Anxiety, fear, paranoia, panic, emotional “lability”
- Panic reactions; psychotic reactions
do hallucinogens have a low or high margin of safety?
- have a high margin of safety in the sense that people don’t die of the overdose per se. Deaths from overdoses of LSD are rare but may be more common with the phenylethylamines
- deaths occur from the individual’s behavior while under the influence of the drug.
Signs of Acute Hallucinogen Poisoning (Bad Trip)
how to tx?
- Panic reactions (bad trips) are common.
- Symptoms are an extension of the major effects: fear, panic, and paranoia are prominent
- tx mainly involves calming and reassuring the pt, sensory input can be reduced by placing the patient in a quiet, dimly lit room. Anxiolytics may be helpful in severe cases. Antipsychotics can be used as a last resort.
Tolerance to the psychogenic effects of LSD develops slowly or rapidly?
cross tolerance?
very rapidly (i.e. after only 2 or 3 doses). Sensitivity returns after a similar drug free period There is considerable cross tolerance among the hallucinogens.
do most of the hallucinogens cause physical dependence?
No, i.e. there are no physical withdrawal syndrome following discontinuation of use
Possible exceptions may be some of the phenylethylamines (e.g. DOM or Ecstasy)
how are hallucinogens used in most cases?
how would dependence occur?
in a sporadic, experimental fashion. Such a pattern of use does not favor the development of physical dependence. However, psychologic dependence can develop in some
individuals.
