Hallucinogens - University of Toronto

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Hallucinogens

Slides by: Bruna Brands, PhD

Centre for Addiction and Mental Health

Department of Pharmacology

University of Toronto

Live Dramatic Interpretation by:

Wende Wood, B.A., B.S.P., B.C.P.P.

Drug Information and Drug Use Evaluation

Pharmacist

Centre for Addiction and Mental Health

Definition

group of substances that produce changes in thought, perception and/or mood

term hallucinogen derived from

Latin alucinari - “to wander in the mind”

Classes

indolealkylamines (similar to 5-HT)

phenylethylamines (similar to nor-ep)

anticholinergics

miscellaneous category

Clinical Manual of Chemical Dependence

Street Names of Hallucinogens

LSD

Morning glory seeds

Psilocybin

DMT, DET

Peyote/mescaline

Acid, blotter, blue devils, California sunshine, haze, microdot(s), mickeys, Mr. Natural, paper acid, purple haze, sunshine, wedges, window panes(s)

Flying saucers, licorice drops, heavenly gates, pearly gates

Magic mushroom, mushroom

Businessman’s lunch, snuff

DOM

MDA

MDMA

MDEA

Button(s), cactus, mesc, mescal, mescal buttons, moon, peyote

Golden eagle, STP, psychodrine, tile

Love drug

Adam, ecstasy, MDM, XTC

Eve

Note LSD = lysergic acid diethylamide DMT = N,N -dimethyltryptamine DET = N,N -diethyltryptamine

DOM = 2,5-dimethoxy-4-methamphetamine MDA = methylenedioxyamphetamine

MDMA = methylenedioxymethamphetamine DEA = 3,4-methylendioxyethamphetamine

Edited by D.A. Ciraulo and R.I. Shader

Indolealkylamines

LSD (d-lysergic acid diethylamide,semi- synthetic substance derived from ergot)

LSA (d-lysergic acid amide, from morning glory seeds)

psilocybin and psilocin ( isolated from hallucinogenic mushroom genus Psilocybe)

DMT( N,N-dimethyltryptamine), found in trees of genus Virola

History of LSD

hallucinogenic and psychotomimetic effects of LSD discovered by Hofmann who accidentally ingested a minute quantity of ergot derivatives

ergot alkaloids are produced by rye- plant inhabiting fungus (Claviceps

purpurea)

outbreaks of ergotism in Middle Ages

History of LSD cont’d

two types

gangrenous ergotism

gangrene of limbs, loosened before death

convulsive ergotism

erythema, diarrhea, vomiting, formication, burning sensation in limbs, convulsions, maniacal excitement, death

Tryptamine-Related Hallucinogens

(Indolealkylamines)

naturally-occurring plant alkaloids (ex ergot alkaloids, Claviceps purpurea)

chemically synthesized derivatives (LSD)

Tryptamine-Related Hallucinogens-

LSD-Neuropharmacology

acts primarily through 5-HT receptor subtypes

antagonist or partial agonist at 5-

HT

2 and 5-HT

1c at multiple 5-HT receptors, agonist

1 receptors

cannot attribute hallucinogenic effects to one 5-HT receptor subtype

Tryptamine-Related

Hallucinogens-Pharmacology

well-absorbed from GI tract

LSD most potent (20-25  g produces marked sympathomimetic effects)

5 morning glory seeds a high of 12 hours or longer

LSD longer acting (8-12h) and more potent than psilocybin or psilocin (4-12h)

1-2 mushrooms hallucinosis for 4-12h

all compounds mainly cleared by liver; excreted in feces

LSD no active metabolites

psilocybin is hydrolyzed to psilocin (active hallucinogen)

Clinical Symptoms of LSD

Intoxication

usual doses 30-400  g (20  g clinically detectable symptoms)

tolerance occurs over time

symptoms within 30 min

maximum effects at 1-4h, symptoms subside after

8-16h

lower doses autonomic nervous system changes and mood changes:  HR and BP and body temp,

 appetite, nausea, vomiting etc

higher doses perceptual distortions and body image changes

Clinical Symptoms of LSD

Intoxication (cont’d)

subjective experience depends on personality of user, expectations, setting

perception: visual distortions, blurred vision, perception of distance and depth

synesthesia, colours are visible

delusions of supernatural abilities, suicide

euphoria or frightening experience may occur

flashbacks

prolonged adverse reactions: psychosis, paranoid states, depression

Other Tryptamine related

Hallucinogens

similar to LSD

intensity of effects related to dose

restlessness, nausea and autonomic hyperactivity

visual disturbances more common

Psilocybe mushrooms: ataxia, hyperkinesis, anticholinergic effects

(symptoms within 15-30 min)

Phenylethylamine Hallucinogens

close structural resemblance to catecholamines, nor-ep and DA

mescaline naturally occurring substance found in peyote cactus

modification of mescaline molecule led to synthetic amphetamine derivatives with hallucinogenic action

one dried flower top (mescal button) contains

6-45mg of active compound

ingested fresh or as a powder

Mescaline-Pharmacokinetics

<potent than LSD (5mg vs 1  g)

readily absorbed from GI tract

concentrated in liver, spleen, kidney

clinical symptoms similar to LSD

nausea and vomiting 30 min to 2h after ingestion

mydriasis, diaphoresis, hypertension, dizziness, chills

hallucinogenic effects peak at 5-6h

vivid colours, kaleidoscopic visions, synesthesias

Phenylalkylamine

Hallucinogens-cont’d

substituted phenethylamines-

“designer drugs”

structural similarities to amphetamine and mescaline

MDMA

Chemical Structure of MDMA

( 3-4 methylenedioxy-methamphetamine )

Clinical Toxicology of

Hallucinogenic Amphetamine

Derivatives

effective dose of MDMA 50-150mg

well absorbed

peak effect at 1-5h

Anticholinergics

plants: Solanum dulcamara, Atropa belladonna

(belladonna alkaloids: atropine and scopolamine)

Jimsonweed (Datura stramonium), seeds contain 4% anticholinergic alkaloids

(scopolamine, hyoscyamine and atropine)

Anticholinergics cont’d

low doses of scopolamine- mild euphoria, sedation, drowsiness

much higher doses intense cns and pns effects:

clinical findings: muscarinic effects: dry mouth, decreased GI motility, urinary retention, tachycardia, dry mouth, hyperpyrexia with dry, flushed skin

CNS effects: visual, auditory and tactile hallucinations; disorientation and confusion, memory loss, dilation of pupils, seizures

entire episode may last for 24 to 48 hours

Belladonna Alkaloids

atropa belladonna (deadly nightshade)

berries used as poison (Atropa, after

Atropos, one of Greek Fates who cut the thread of life and was responsible for death)

belladonna means beautiful woman – refers to putting a drop of the juice of the plant to dilate pupils

also used by witches in Middle Ages

Datura stramonium

Jimson weed (“locoweed”, thorn apple)

Solanaceae family

all parts of plant are poisonous

seeds contain 4% anticholinergic alkaloids

(scopolamine, hyposcyamine and atropine)

leaves can be eaten raw, prepared as tea or smoked

as little as 4-5g of crude leaf may be lethal for children

adolescents smoke the dried leaves or consume dried seeds to induce toxic delirium

effects dose dependents

Miscellaneous Category

PCP and Ketamine

dissociative anesthetics

both drugs produce hallucinogenic effects at low levels

PCP can produce stimulant, depressant, analgesic, anesthetic, and hallucinogenic effects (dose-dependent)

Medical Uses

ketamine:anesthetic

atropinic alkaloid: to control smooth- muscle spasms, hyperirritability of the

GI tract, excessive salivation and bronchial secretions etc

scopolamine for motion sickness

no medical uses for LSD, MDMA etc

Undesirable Effects

acute; usually mild and transient feelings of physical discomfort, anxiety, depression

sometimes intense anxiety, panic, paranoia; rarely toxic psychosis

“bad trips” not always related to dose

PCP and LSD are hallucinogens most frequently associated with serious and lethal accidents

atropine, scopolamine, hyoscyamine dangerous at high doses

PMA highly lethal

Undesirable Effects (Cont’d)

deaths associated with MDA, MDMA, PCP

flashbacks

brain damage

tolerance develops to psychoactive effects of many hallucinogens (ex LSD)

psychological dependence may develop to some

development of physical dependence not supported by literature

Salvia divinorum

mint family

main active ingredient is Salvinorin A

used in spiritual practices for its psychoactive properties by Mazatecs of Oazaca, Mexico

no actions on 5-HT hallucinogens)

2A serotonin receptors

(principal molecular target for classical

structurally distinct from DMT, psilocybin, mescaline and synthetic hallucinogens such as

LSD and ketamines

Pharmacology

not active orally, usually smoked

most potent naturally occurring hallucinogen (as potent as LSD)

effective dose in humans 200-1000 μg range when smoked

intense hallucinatory experiences

duration of action: several minutes to 1hr or so

potent and selective κ opioid receptor agonist

first non-alkaloid opioid receptor subtype selective drug

Potential Therapeutic Use

- psychomimetic selective for κ opioid receptors, therefore κ opioid selective antagonists may be helpful to treat diseases which involve perceptive disorders (e.g., schizophrenia, dementia, and bipolar disorders)

Issues

most of these drugs are produced in illicit laboratories

purity varies, adulterants

misrepresentation on the street

street drugs and driving

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