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CHAPTER 2-95: LYSERGIC ACID DIETHYLAMIDE (LSD) AND OTHER HALLUCINOGENS

Patil Armenian

INTRODUCTION

Patients who seek medical care after self-administering mind-altering substances may have used any of a large variety of compounds. Several of these agents are discussed elsewhere in this manual (eg, amphetamines, cocaine, marijuana, phencyclidine and ketamine, and toluene). Many of the drugs discussed in this chapter are entactogens ("to touch within"), enhancing sensations and promoting illusions (eg, LSD, MDMA). Others have primarily sympathomimetic characteristics, with hallucinations a smaller part of the overall experience (eg, cathinones, PMA). Several have been used widely for personal experimentation as well as clinically to facilitate psychotherapy. Although the use of traditional hallucinogens such as LSD has declined over the past decades, there is a current resurgence of hallucinogen use from novel compounds, such as the 2C-NBOMe series and synthetic cathinones. Table II–35 lists some common and uncommon hallucinogens.

TABLE II–35.HALLUCINOGENS
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TABLE II–35. HALLUCINOGENS
Common Name(s) Chemical Name Classificationa Comments
Bufotenine 5-Hydroxy-N, N-dimethyltryptamine N, T From skin and secretions of the toad Bufo alvarius (Colorado river toad), which may also contain cardiac glycosides.
DMT N, N-Dimethyltryptamine N, S, T Smoked, insufflated, injected or ingested in combination with MAOIs (harmaline, harmine) in ayahuasca.
DOB 2,5-Dimethoxy-4-bromoamphetamine S, Ab Long time to onset (up to 3 h), may last up to 24 h. Potent ergot-like vasoconstriction may result in ischemia, gangrene.
DOM, STP ("Serenity, Tranquility, Peace") 2,5-Dimethoxy-4-methylamphetamine S, P Potent sympathomimetic.
Harmaline 4,9-Dihydro-7-methoxy-1-methyl-3-pyrido-(3,4)-indole N, M South American religious and cultural drink called yage or ayahuasca (along with DMT). Prevents metabolism and enhances effects of DMT in ayahuasca. Sympathomimetic effects.
LSD, "Acid" Lysergic acid diethylamide S, E Potent hallucinogen. Average dose of 50–150 mcg in tablets, blotter papers. Effects may last up to 12 h.
MBDB n-Methyl-1-(1,3-benzodioxol-5-yl)-2-butanamine S, Ab Nearly pure entactogen without hallucinosis or sympathomimetic stimulation.
MDA 3,4-Methylenedioxyamphetamine S, Ab Potent sympathomimetic. Several hyperthermic deaths reported. MDMA analog and metabolite. Sometimes found in "Ecstasy" tablets.
MDE, MDEA, "Eve" 3,4-Methylenedioxy-N-ethylamphetamine S, Ab MDMA analog but reportedly less pronounced empathogen. Sometimes found in "Ecstasy" tablets.
MDMA, "Ecstasy, " "Molly, " "Adam" 3,4-Methylenedioxy-methamphetamine S, Ab Sympathomimetic: hyperthermia, seizures, cerebral hemorrhage, and arrhythmias reported; hyponatremia. Associated with interpersonal closeness, emotional awareness, euphoria.
MDPV, "Energy 1," "Ivory wave" 3,4-Methylenedioxypyrovalerone S, C Stimulant drug sold as "bath salts" or "research chemicals" but really intended for ingestion or inhalation.
Mephedrone, "Bubbles, " "M-Cat, "Meow-Meow" 4-methylmethcathinone S, C Stimulant drug sold as "bath salts" or "research chemicals" but really intended for ingestion or inhalation.
Mescaline 3,4,5-Trimethoxyphenethylamine N, S, P Derived from peyote cactus. Used by some Native Americans in religious ceremonies. GI distress common.
Methylone 3,4-Methylenedioxymethcathinone S, C Stimulant drug sold as "bath salts" or "research chemicals" but really intended for ingestion or inhalation.
Morning glory, Ipopmoea violacea D-Lysergic acid amide (LSA) N, E Seeds contain LSA, a close relative of LSD.
Myristicin, nutmeg Methoxysafrole N, ...

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