PUBH 3003 1st Edition Lecture 17Outline of Last Lecture Last Lecture was the Exam Outline of Current Lecture Current Lecture:I. Hallucinogens a. Effectsb. HistoryII. LSDa. Other similar hallucinogensb. PCPIII. MDMADid you know….- In the past LSD was used by psychiatrists to assist in psychotherapy- Ecstasy has been tested in in FDA approved clinical trials for use in treating PTSD- Ketamine has been proposed as an antidepressant - LSD does not tend to be physically addicting What is a hallucinogen?- Drugs that changes/ distorts one’s thought processes emotions or perceptions- Most common:o LSD (acid, yellow sunshine, blue heaven) o Mushrooms (psilocybin)o Mescaline (Peyote, cactus)o PCP (angel dust)Effects: Absorption and Experience - More fat soluble  more quickly it enters the brain - More slowly it gets degraded  longer the trip- Effects of hallucinogens are highly variable and unreliable - Physical effects:These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.o Dilated pupils, elevated body temp, increased heart rate and blood pressure, sleepiness, tremors, headache, nausea, sweating, etc.- Psychological Effects:o Hallucinations, illusions, amplification of senses, alterations of thinking and selfawareness, separation from body, etco Bad trip possibilitySensory and Psychological Effects- Altered senses, including timeo Synesthesiao Distorted figures, colors, sense of distance, etc.- Loss of Controlo User cannot determine whether the psychedelic trip will be pleasant or a bad tripo Flashbacks – replay of frightening trip- Self- Reflectiono Makes conscious the unconscious - Loss of Identity and cosmic mergingo Loss of personal boundaries between self, others and worldo Mystical spiritual aspect of drug experience Short-term General effects of Hallucinogens - Sensory Effectso Hallucinations, including seeing, hearing, touching or smelling things in a distorted way or perceiving things that do not existo Intensified feelings and sensory experiences (brighter colors, sharper sounds)o Mixed senses (seeing sounds or hearing colors)o Changes in sense or perception of time (time goes slowly) - Physical Effectso Increased energy and heart rateo NauseaLong – Term effects of Hallucinogens- Persistent Psychosis o Visual disturbances o Paranoiao Mood Disturbances o Disorganized thinking - Hallucinogen Persisting Perception Disorder (HPPD)o Hallucinations o Other visual disturbances (such as seeing halos attached to moving objects)o Symptoms sometimes mistaken for neurological disorders (such as stroke or brain tumor)Historic Usage- Thousands of years of use- Naturally growing plants producing hallucinogenic events- Religious experience (trance, meditation, dreams)- Used to facilitate healing, communication with spirits, coming of age ceremonies - 1938: Hofmann accidentally absorbs tiny bit of LSD through skin (looking or migraine meds)- 1940s: scientific interest- 1966: US bans all psychedelic drugs - Small quantities of LSD applied to squares of absorbent blotter paper to be chewed or swallowed LSD types of agents - Chemical structure similar to serotonin- Massive increase in neural activity in some brain regions (electrical storm)- Activates sympathetic nervous system (rise in body temp, heart rate, blood pressure)- Rapid tolerance. Not physically dependent, but psychological dependency can occurBelladonna Alkaloids- Can be prescribed for treatment of cramping/ spasms in stomach and intestines. Also has been used to treat stomach ulcers- Newer recreation abuse, often from tea prepared with leaves Jimsonweed - Prevents action of acetylcholine at many of its synapses and can increase heart rate and body temp to dangerous levels Mescaline- Mescaline is most active drug in peyote; induces intensified perception of colors and euphoria effects include: dilation of pupils, increase in body temp, anxiety, visual hallucinations, alterations of body image, vomiting, muscle relaxation, streetsamples rarely authenticPCP- Approved as anesthetic in humans until 1965- patients were agitated, delusional and irrational- Dissociative drug- distorts perception of sight and sounds and feelings of detachment (dissociation) from the environment and self- Gained a reputation as drug with bad reactions not worth the risk in the 60s but some continue to use due to feelings of strength, power and invulnerability (and numbing effect on mind)General Common effects on dissociative drugs- Low to moderate doses:o Numbnesso Loss of coordination, disorientation and confusiono Dizziness, nausea, vomitingo Changes in sensory perceptions (such as sight, sound, shapes, time and body image)o Hallucinationso Feelings of detachment from self and environment o Increase in blood pressure, heart rate, respiration, and body temp- High Doseso Hallucinationso Memory losso Physical distress, including dangerous changes in blood pressure, heart rate, respiration and body temperatureo Marked psychological distress, including feelings of extreme panic, fear, anxiety, paranoia, invulnerability, exaggerates strength and aggression o Use with high doses of alcohol or other CNS depressants can lead to respiratoryarrest, resulting in deathKetamine’s Potential- “..given intravenously, might be the most important breakthrough in antidepressant treatment…”- Many questions regarding best dose, route of administration, and long term efficacy and safetyMDMA (“Ecstasy” or “Molly”)- Synthetic, psychoactive drug similar to stimulant amphetamine and hallucinogen mescaline- Feelings of energy, euphoria, emotional warmth, and empathy towards others, distortions in sensory and time perception- Often taken orally as a capsule/tablet  effects last 3-6 hours- Increases activity of serotonin, dopamine and norepinephrine in the braino Large amounts of serotonin influences mood, appetite and sleep) and triggers release of oxytocin + vasopressin o The surge of serotonin caused by taking MDMA depletes the brain of this important chemical, however causing negative after effects- including confusion, depression, sleep problems, drug craving and anxiety that may occursoon after taking the drug or during the weeks after - Some users experience long lasting confusing, sleep issues, problems with attention/ memory and depression (but may be due to use of other drugs in combination)- Psychological effects: