Journal of Neuroendocrinology
February 6, 2016
Petra Strajhar, Yasmin Schmid, Evangelia Liakoni et al.
129 citations
A single 200 microgram dose of LSD increases several stress-related steroid hormones in the blood, particularly glucocorticoids like cortisol and corticosterone, in healthy adults. In a randomized, double-blind, placebo-controlled crossover study with 16 participants, LSD raised plasma levels of cortisol, cortisone, corticosterone, and 11-dehydrocorticosterone compared to placebo, with peak cortisol levels occurring about 2.5 hours after dosing. LSD also increased the androgen dehydroepiandrosterone but did not affect other androgens, progestogens, or mineralocorticoids. The rises in glucocorticoids closely tracked blood LSD concentrations and the intensity of the psychedelic experience, without signs of acute tolerance.
Medicine
January 31, 2018
Evangelia Liakoni, Chris Yates, Alison M. Dines et al.
38 citations
Self-reported substance use by patients arriving at emergency departments with acute recreational drug toxicity matches toxicological analysis best for heroin (86.1% agreement) and cocaine (74.1% agreement). Inhalants, poppers, and magic mushrooms were self-reported but never detected analytically. Immunoassays accurately identified methadone (100% agreement) and cocaine (95.5% agreement) but were less consistent for amphetamines (81.8% agreement). Mass spectrometry confirmed MDMA, amphetamine, methamphetamine, and new psychoactive substances in many cases where immunoassays were negative, and revealed multiple-substance use. Diagnosis of new psychoactive substance use relied primarily on self-report.
BMC pharmacology & toxicology
May 26, 2016
Evangelia Liakoni, Patrick C Dolder, Katharina M Rentsch et al.
24 citations
Of 50,624 emergency department visits at a Swiss university hospital over one year, 210 were due to acute recreational drug toxicity. Patients averaged 33 years old, 73% were male. Cocaine (33%), cannabis (32%), and heroin (14%) were the most reported substances; analytical testing confirmed cannabis (33%), cocaine (27%), and opioids excluding methadone (19%) most often. Only two cases involved novel psychoactive substances (NPS): one severe intoxication with PMMA and one minor with 2C-P. Common symptoms included tachycardia (28%), anxiety (23%), nausea or vomiting (18%), and agitation (17%). Severe outcomes included two deaths, two heart attacks, 13 seizures, and six psychosis cases. Most patients (76%) were discharged; 10% required intensive care. Classic drugs like cocaine and cannabis caused most problems, while NPS were rarely seen despite their increased detection elsewhere.
Journal of analytical toxicology
January 1, 2017
Adrian Stoller, Patrick C Dolder, Michael Bodmer et al.
19 citations
A 19-year-old male was admitted to the emergency department with severe hallucinations, dilated pupils, rapid heart rate, agitation, and confusion after using a substance sold as 2C-B. Laboratory analysis using liquid chromatography-mass spectrometry detected the more potent synthetic phenethylamine derivative 2C-P instead. Based on two blood samples, the estimated elimination half-life was 19 hours. The case illustrates how small structural variations in the 4 position of the phenyl ring, such as a propyl group in 2C-P versus bromine in 2C-B, can lead to significant differences in drug potency and duration of action, contributing to adverse effects.
Swiss Medical Weekly
July 1, 2025
Samuel E Christen, Elias Bekka, Yasmin Schmid et al.
3 citations
Caffeine, nicotine, cannabis, and psilocybin are naturally occurring psychoactive substances that alter perception, consciousness, cognition, and emotions. Their natural origins have led to long histories of human use and cultural significance. Caffeine and nicotine are widely available as everyday stimulants, while psilocybin is strictly regulated and cannabis is legal in some regions. Their pharmacological and toxicological properties are well known, but ongoing research investigates therapeutic use for specific diseases and disorders. This narrative review provides an overview of these four substances, summarizing evidence on therapeutic potential, health benefits, and associated risks.