The effects of psychoactive substances on driving performance depend on dose, tolerance, and medical condition. Therapeutic amphetamine and methylphenidate can improve psychomotor function and safety in patients with ADHD, while recreational or high-dose methamphetamine and MDMA impair coordination and increase impulsivity. Opioid effects vary: small therapeutic fentanyl doses in chronically treated patients do not notably impair driving, but methadone and tramadol commonly cause somnolence, slowed reactions, and higher accident risk. The review confirms that substance impact is multifactorial and supports individualized pharmacotherapy and further research for evidence-based guidelines.
Psilocybin and psilocin enhance the force of contraction and increase phospholamban phosphorylation in isolated mouse hearts that overexpress human 5-HT4 receptors, but have little effect in hearts overexpressing human H2 receptors. LSD increases both force and phosphorylation in hearts with either receptor. Ergometrine and ergotamine only increase force in H2-receptor-overexpressing hearts, with ergometrine also increasing phosphorylation. None of these substances affect force or phosphorylation in wild-type mouse hearts. The findings suggest that phospholamban phosphorylation partly explains the positive inotropic and relaxant effects of these hallucinogenic compounds in these animal models.