Pharmacologic Similarities and Differences Among Hallucinogens

Hallucinogens are a diverse class of substances that alter thoughts, perceptions, and mood through various biological mechanisms. Classical hallucinogens like lysergic acid diethylamide, psilocybin, and N,N-dimethyltryptamine act primarily on serotonin receptors, while others work through N-methyl-D-aspartate receptor antagonism, opioid receptor agonism, or inhibition of monoamine reuptake (serotonin, norepinephrine, dopamine). This article compares the pharmacologic similarities and differences among hallucinogens and reviews their physical and psychiatric effects, including potential life-threatening and long-term toxicities.

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Abstract

Abstract Hallucinogens constitute a unique class of substances that cause changes in the user's thoughts, perceptions, and mood through various mechanisms of action. Although the serotonergic hallucinogens such as lysergic acid diethylamide, psilocybin, and N,N‐ dimethyltryptamine have been termed the classical hallucinogens , many hallucinogens elicit their actions through other mechanisms such as N‐methyl‐D‐aspartate receptor antagonism, opioid receptor agonism, or inhibition of the reuptake of monoamines including serotonin, norepinephrine, and dopamine. The aim of this article is to compare the pharmacologic similarities and differences among substances within the hallucinogen class and their impact on physical and psychiatric effects. Potential toxicities, including life‐threatening and long‐term effects, will be reviewed.