Hallucinogens

Question 1

Psychedelics

Answer 1

-alter cognition and perception

5HT2A receptor agonists: LSD, Peyote, Psilocybin
Serotonin releasing: MDMA

• few physical withdrawal symptoms
• stimulate sympathetic

Question 2

Dissociatives

Answer 2

-distort visual and auditory perception

NMDA receptor antagonists: PCP, Ketamine

Question 3

Ketamine

Answer 3

similar mechanism to PCP
-binds MOR

low dose- tachycardia, hypertension
high dose- dreamlike states and hallucinations, respiratory depression, delirium

DXM is an antitussive, at high doses has dissociative effects similar to ketamine (loss of sense of time, visual distortion, stimulant like euphoria)

Question 4

PCP

Answer 4

noncompetitive NMDA block

• anticholinergic
• 4 to 6 hr but can last longer (weeks) when in fat
• paranoid delusions, hallucinations, anesthesia, amnesia
• exam may suggest cerebellar injury w ataxia, dysarthria, and nystagmus

SE: neuroleptic malignant syndrome- mute, catatonic, muscle rigidity, fever, rhabdomyolysis, seizure

Question 5

MDMA

Answer 5

relaxed euphoric, emotional openness, warmth, empathy

-n/v, sweating, teeth clench, cramps, interfere with temperature regulation

3-6 hr

-blocks vesicular monoamine transporter (increase 5HT, DA, NE)

can be addictive

Question 6

LSD

Answer 6

12 hr

synesthesia, delusions, visual hallucinations

HPPD (flashbacks persist)

-inhibits nigrostriatal and mesocortical dopamine systems

Question 7

Peyote and Psilocybin

Answer 7

synesthesia, hyperacusis, senses heightened

long term may cause negative symptoms of schizophrenia