Chapter 11 - Hallucinogenics

What is the primary mechanism of action for serotonergic hallucinogens?

They stimulate 5-HT2A (serotonin) receptors and increase serotonin activity in the brain.

What are three common examples of serotonergic hallucinogens?

LSD, Psilocybin, and Mescaline.

What is 'synaesthesia' in the context of hallucinogen use?

The melding of the senses, where a user might perceive sounds as colors or tastes as shapes.

How does the dosage of a hallucinogen typically relate to the intensity of the experience?

Dosage does not necessarily correlate with greater intensity; rather, it increases the unpredictability of the experience.

What are the two most important nonpharmacological factors influencing a hallucinogen experience?

Expectations of the user and the setting in which the drug is taken.

What are the primary physical effects of serotonergic hallucinogens on the sympathetic nervous system?

Increased blood pressure, heart rate, and body temperature, along with dilated pupils, sweating, and sleeplessness.

What is the primary pharmacological difference between MDMA and typical serotonergic hallucinogens?

MDMA acts like an amphetamine by increasing dopamine release, while also increasing serotonin activity.

What are common physical side effects associated with MDMA use?

Increased heart rate and blood pressure, pupil dilation, insomnia, appetite suppression, muscle tension, bruxism (teeth grinding), and elevated body temperature.

Which neurotransmitter system do anticholinergic hallucinogens antagonize?

They act as acetylcholine receptor antagonists.

What are two common plant-based sources of anticholinergic hallucinogens?

Nightshade and other common plants containing atropine and scopolamine.

What are the primary risks of high-dose anticholinergic use?

Paralysis, convulsions, and death.

How do dissociative anaesthetics like PCP and ketamine affect the brain?

They act as NMDA glutamate receptor antagonists, effectively blocking these receptors.

What is a 'k-hole'?

A term used to describe a 'bad trip' or highly adverse reaction to ketamine.

What are the primary effects of low-to-moderate doses of dissociative anaesthetics?

Dream-like pleasant feelings, sensations of floating, trances, or out-of-body experiences.

What is the duration of action for Salvia divinorum when smoked?

It is very brief, typically lasting only 20 to 30 minutes.

How is Salvia divinorum classified in terms of US drug scheduling?

It is currently not scheduled.

What is the primary cause of death associated with serotonergic hallucinogen use?

Death is usually due to poor judgment and accidental injury rather than direct toxicity of the drug.

What withdrawal symptoms are specifically associated with MDMA?

Depression, insomnia, and physical pain.

Why is atropine used medically in the context of nerve gas attacks?

It acts as an antidote because it counteracts the effects of nerve gas, which inhibits the breakdown of acetylcholine.

What is the typical duration of action for LSD?

6 to 12 hours.

What is the primary mechanism of tolerance for serotonergic hallucinogens?

Rapid tolerance develops due to the downregulation of 5-HT2A receptors.

Which hallucinogen is currently being researched for the treatment of PTSD?

MDMA.

Which hallucinogen is currently being researched for the treatment of depression?

Ketamine.

What are the common physical symptoms of a 'bad trip' on hallucinogens?

Confusion, paranoia, disorientation, agitation, panic, and terror.