Pharmacological Aspects

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The effects of LSD may be observed for 8 hours. The specific acute effects of a drug like LSD include euphoria, depersonalization, enhanced awareness of sensory input, alterations in the perception of time or space or body image, and to some extent, minor stimulant effects. Sometimes the dreamlike quality of the experience produces relaxation, good humor, and a sense of wonder or euphoria.

Often the effect is a function of expectation and environmental conditions. Someone who is anxious about the use of the hallucinogen may have drug-induced anxiety, panic, or even paranoid ideation. The loss of individuality can be perceived as a disintegration of the person and can lead to a panic attack. Even if the drug experience initially is euphoric, tremendous mood swings can occur and suddenly plunge the abuser into emotions of great anxiety or terror. These negative phenomena are not always precipitated by an unexpected or sudden frightful event but can be a function of the labile mood induced by the drug.

The visual hallucinations are often composed of extremely vivid colors of geometric patterns, such as cones, spirals, or cobweb-like structures. Other types of hallucinations are possible. A true hallucination involves the belief by the individual that the (altered) sensations and perceptions actually represent reality. However, generally the person abusing LSD and related drugs retains the ability to test reality versus illusion and knows that the experience is not real. Thus, the typical drug-induced hallucinatory state would be more appropriately termed a pseudohallucination, though real hallucinations are possible. The subjective or psy-chotomimetic changes are those considered to be changes in mood. These effects are somewhat more variable than the hallucinatory effects or changes in sensory perception. Though these effects can occur with LSD, they seem to be more common with other specific hallucinogens, such as MDMA and MDA.

MDMA (XTC, or ecstasy) possesses hallucinogenic activity similar to that of mescaline but also produces stimulant activity similar to that of amphetamine. Initially MDMA produces euphoria, increases the ability to communicate with others, increases the degree of intimacy one feels toward others in the surroundings, increases self-esteem and mood, and generally appears reduce perceived intensity of psychological problems. Hallucinatory activity occurs at higher doses. One residual effect of abuse is the MDMA hangover, which is the occurrence on the second day after abuse of drowsiness and sore jaw muscles along with other possible side effects due to the stimulant properties of the drug.

MDA, which is similar to MDMA, has been termed the love drug because it produces a feeling of closeness to others. Typically, a dose of 75 mg produces the primary psychotomimetic effects, while a dose of 150 mg produces LSD-like effects, and a dose of 300 mg produces amphetaminelike CNS stimulation. The amphetaminelike stimulation of the CNS and periphery is prominent with both MDA and MDMA. To a lesser degree this stimulation also occurs with LSD. The effects that can be produced by stimulatory doses of hallucinogens include tachycardia, hypertension, and arrhythmias.

PCP is unique in terms of its hallucinogenic properties and its other pharmacological effects. It possesses CNS stimulatory actions, but it is also a dissociative anesthetic. It induces a wide variety of psychotomimetic and hallucinatory effects during emergence from anesthesia. Because it possesses CNS stimulant properties comparable with those of amphetamine, it does not produce depression of the cardiovascular system like other anesthetics, though it does depress the respiratory system. At a low dose, individuals believe they are thinking and acting rapidly and efficiently. The general mood is happiness, though (especially at higher doses) the individual can vacillate between euphoria and depression. It primarily produces auditory hallucinations. At higher doses the stimulatory effects are more pronounced and the likelihood of tremendous mood swings more likely. At near anesthetic doses, it produces more typical depressant effects, including motor incoordination, catalepsy, vacant stare, or even amnesia. Coma is produced subsequent to respiratory depression.

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