Chapter 51. Hallucinogen-Related Disorders

Hallucinogens are a class of psychoactive drugs, either synthetic or plant-derived, that produce auditory or visual hallucinations and alter thought, mood, and perception. Depending on dosage, user expectation (set), and environment (setting), they can also induce euphoria or a state similar to a transcendental experience. Some hallucinogens, like jimsonweed, cause delirium with disturbances in judgment and memory, while others, such as LSD, psilocybin, DMT, and mescaline, alter consciousness without delirium or sedation. These serotonergic hallucinogens primarily affect the serotonin receptor system. Other plant products with hallucinogenic activity include morning glory seeds and Hawaiian baby woodrose seeds, which contain lysergic acid derivatives.

Study at a glance

Abstract

The hallucinogens are a class of psychoactive drugs, either synthetic or plant products, that produce auditory and/or visual hallucinations as well as thought, mood, and perceptual changes. Depending on dosage, expectation (set), and environment (setting), they also can induce euphoria and a state similar to a transcendental experience. These hallucinations can be present as part of a delirium (e.g., from jimsonweed [ Datura stramonium ]) when accompanied by disturbances in judgment, orientation, intellect, memory, and emotion. Delirium also can result from drug withdrawal (e.g., associated with sedative-hypnotic and/or alcohol withdrawal). When used in the context of substance abuse, the term hallucinogen generally refers to a compound that alters consciousness without producing delirium, sedation, excessive stimulation, or impairment of intellect or memory. Hallucinogens that are abused include the prototype hallucinogen d -lysergic acid diethylamide (LSD); other indolealkylamines such as psilocybin ("magic mushrooms") and dimethyltryptamine (DMT, also contained in the South American beverage ayahuasca); and the phenalkylamines, including mescaline and dimethoxymethylamphetamine (DOM, also called STP). LSD, DMT, DOM, psilocybin, and mescaline are sometimes characterized as serotonergic hallucinogens on account of their predominant effect on that receptor system. Other plant products with hallucinogenic activity that are abused include the seeds of the morning glory ( Ipomoea ), which contain lysergic acid derivatives, and seeds of the Hawaiian baby woodrose ( Argyreia nervosa ), which contain lysergic acid amide. Cannabinoid agonists; ≡ agonists; antimuscarinic agents; dissociative anesthetics such as phencyclidine (PCP); and designer drugs such as methylenedioxymethamphetamine (MDMA or ecstasy), which are sometimes classified as hallucinogens, are covered elsewhere in this volume.