Hallucinogens Flashcards
1
Q
Hallucinogens
A
- hallucinogens =hallucinate (visual)
- psychedelics = mind-expanding
- features: hallucinations, altered perceptions, changes in though, emotion, and consciousness
2
Q
Many cases of hallucinogens
A
- serotonergic hallucinogens: classical psychedelics (LSD, psilocybin, mescaline)
- Methylated amphetamines: MDMA
- anticholinergic hallucinogens: atropine, scopolamine, amanita muscaria
- dissociative anaesthetics: phencyclidine (PCP), ketamine
3
Q
Serotinergic Hallucinogens
A
Natural
- many hallucinogenic plants
- ancient times
- religious purposes: entheogen
Synthetic
- LSD
4
Q
Psilocybin
A
- psilociben mushrooms
- aztec and mayan people: “teonanácatl”
5
Q
Mescaline
A
- peyote cactus
- aztecs and ancient tribes
6
Q
Lysergic Acid
A
- ergot fungus
- infested rye
- contaminated rye bread (middle ages)
- witches?
- ergotism (st anthonys fire)
- vasoconstriction
- hallucinations
- uses
- migrane
- uterine contractions
7
Q
Lysergic acid diethylamide (LSD)
A
- synthetic: derived from ergot fungus
- Hofmann, LSD-25
- adjunct to psychotherapy
- psychotomimetic
- break down ego defences
- aldous huxley: doors of perception
- timothy leary: turn on. tune in. drop put.
- hippie subculture of the 60s: music, art
- now: club drug
8
Q
Mechanism of Action: LSD-like drugs
A
- serotonin (5 hydroxytryptamine)
- many receptor sub-types
- 7 different receptors for serotonin
- agonist at 5HT 2A
- classical hallucinogen (5HT and visual)
- increase glutamate in the cortex: likely the cause of visual hallucinations
9
Q
Psychological Effects LSD-like drugs
A
- variable responses: drug, user, environment
- visual hallucinations
- kaleidoscopic explosions
- intense colors, brightness
- lattice patterns
- synesthesia
- stationary objects seem moving
- negative responses possible
- primary effects are visuals
- See things that are there in a different way, not random things that aren’t there
- Psychedelics = expanding mind: altered perception
- Synaesthesia: altered perception: perceive a sound as something visual: as a colour pattern
- art movement in the 60’s: insight while under the influence – reflections
10
Q
Psychological Effects LSD-like drugs
A
- mood effects
- overall sense of happiness and euphoria
- contemplative, emotional, dreamy
- spiritual or religious experiences
- impulsive and poor judgement
- vMicro dosing LDS: not enough for all hallucinations, but does stimulate creativity and focus: contemplation
- Entheogen
11
Q
Physiological Effects
A
- sympathomimetics
- fight or flight reaction
- vasoconstriction, slows digestion, increase heart rate
12
Q
Adverse Effects of LSD-like drugs
A
- bad trip: acute panic or paranoid
- flashbacks (HPPD)
- birth defects?
- danger in pregnancy
- psychiatric disorders
- Bad trip can lead to psychosis
- Trip can go from euphoric and nice and then switch to a bad trip can happen at any time
- Drug, user and setting dependent when already anxious more likely to get a bad trip
- Late 50’s gave prisoners LSD all killed themselves because they got so paranoid
- Very structured rigid environments trigger paranoia
- Give benzodiazepines if anxiety takes over too much
- Flashbacks: months or years later of LSD like experiences suddenly can be induced by stress, fatigue
- Hallucinogen Persisting Perceptive Disorder (HPPD) probably with long term heavy use idea that this can be treated with antiepileptics
- LSD damages chromosomes according to a finding only done with a few cells, not a whole organism no actual correlation with birth defects
- Can force a miscarriage or abortion due to LSD causing uterine contractions
- Polydrug use? Difficult to determine which drug causes the psychosis: also predispositions have to be taken into account (environmental switch)
- Charles Manson: heavy LSD use killed a bunch of people on LSD
13
Q
Pharmacokinetics: absorption
A
- oral: gel, tablet, blotter paper
- 20-60 min onset of action
- LSD most powerful of all studied drugs
- 100x more powerful than psilocybin
- 1000x more potent than Mescaline
14
Q
Pharmacokinetics: distribution
A
- readily crosses BBB
- about 12h duration of action
15
Q
Pharmacokinetics: metabolism and elimination
A
- Rapidly metabolized and eliminated (within 2 days) -
- Hard to detect
16
Q
Methylated Amphetamines
A
- MDMA
- “molly”: molecular, “pure”
- psychedelic amphetamine
- stimulant effects of amphetamine and hallucinogenic effects of mescaline
- Amphetamine with psychedelic effects
- Methylenedioxymethamphetamine - Structurally similar to mescaline and amphetamine
- Molly crystalline powder
- Stimulant effect of amphetamines and hallucinogenic effects of mescaline
17
Q
History and Epidemiology
A
- MDMA: 1914 Merck (hemostatic)
- 1960’s: MDA and rediscovered MDMA
- psychotherapy
- 1985: schedule I
- 1990s “rave” scene
- Trying to find something to stop blood flow: MDMA was found
- 60’s counterculture movement
- Psychotherapy: psych mimetic, pull down ego defences, MDMA very successful to get patients more empathetic “love drug”, couples therapy, anxiety, depression
- Still some therapeutic use: PTSD, preparation for death
- Pretty late on Schedule I
- 1990 techno scene: feelings of love, no aggression at all
18
Q
Mechanism of Action MDMA
A
- blocks reuptake of MAs: serotonin more than dopamine
- leads to increase of Monoamines
- also increased release
- pleasure and reward
- after several hours: comedown, depression, anxiety, stress, residual empathy and closeness (afterglow)
- Not sure, but amphetamine’s might also stimulate the release of NT, not only blocking the reuptake
- Comedown not as severe as with methamphetamine moody Tuesday
- Depression due to dopamine and serotonin depletion
- Also increasein norepinephrine
19
Q
Effects of MDMA
A
- sympathomimetics
- anorectic effects
- behavioral effects
- elation and mood elevation
- emotional warmth and empathy
- enhanced talkativeness and sociability
- increased alertness and arousal
- mild psychedelia
- Loss appetite
- Special for MDMA: increase in body temperature, well-being
- Bruxism: grinding of the teeth
- Nystagmus: eyes rolling back
- Also called empathogens due to increase of empathy
- No visual hallucinations, but colours and sounds are enhanced
20
Q
Toxicity
A
- dehydration (elevated body temperature), heart stroke and heat exhaustion
- hyponatremia
- possibly toxic adulterants
- long-term side effects: neurotoxicity (serotinergic) and psychiatric and behavioural problems
- addiction potential
- Drink too much low on sodium: hyponatremia can kill as well
- But important to drink much, maybe better with Aquarius
- A lot of the pills don’t actually contain MDMA, but MDA which is more toxic (derivative)
- Some of the pills might even contain heroin or bath salts
- Lots of toxic reports, probably because of contaminates more than MDMA
- Huge vary of dose between samples
- Long-term: long lasting damage to neurons that produce serotonin: shown in animal studies anatomical changes, less production of serotonin no studies with humans
- Heavy users do describe serotonin related problems: sleep, mood, memory, cognition not easy to say of MDMA or contaminates induce these effects
- Addiction potential not particularly high
21
Q
Anticholinergic Hallucinations
A
- atropine and scopolamine (belladonna/deadly nightshade)
- amanita muscaria (fly agaric)
- Block acetylcholine
- Huge pupil dilation
- Blocking parasympathetic nervous system: block acetylcholine sympathetic nervous system gains effect: pupil dilation
- Some delium aspects
- used in clinics to dilate pupils
- Magic mushrooms
22
Q
Anticholinerigic hallucinations
A
- dreamlike trance / stupor, vivid visions
- deliriants: confusion and inability to control actions
- antagonist at ACh receptor
- nerve gas antidote
- Block acetylcholine
- Dreamlike trance with higher doses
- Deliriants differ from other hallucinogens
- Nerve gas as antidote for anticholinergic hallucinogens
23
Q
Dissociatives
A
- PCP and ketamine
- i.v. anaesthetic: sedation, immobility, amnesia, and market analgesia. Subjects may experience a strong feeling of dissociation from the environment
- veterinary medicine: too many SEs in humans
- smoking, orally, injection
- Phencyclidine 1950 as anaesthetic gas
- Ketamine also anaesthetic
- Pain relief
- But too many side effects: hyperexcitability, delirium, visual disturbances
- Strong feeling of dissociative feeling from one own body
- Used for veterinary medicine
24
Q
Effects of PCP and Ketamine
A
- euphoria and numbness
- aggressive and hyperactive
- distortions of space, time and body image
- sympathomimetic effects
