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Hallucinogens and Psychedelics01:27

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Hallucinogens are psychoactive substances that profoundly alter perceptual experiences, generating unreal visual and sensory images. Often referred to as psychedelic drugs — a term derived from the Greek words "psyche" (mind) and "delos" (revealing) — these substances include marijuana and lysergic acid diethylamide (LSD), among others. These drugs vary in intensity and effects.
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Hallucinogens, also known as psychedelic drugs, are a class of substances known for their ability to alter perception, cognition, and emotions. Despite their profound effects on the mind, these drugs are non-addictive, setting them apart from many other abused substances. The mechanism of action of these drugs lies in their impact on the 5-HT2A receptor in the brain. Upon activation, this receptor couples to Gq-type G proteins, triggering a cascade that releases intracellular calcium. This...
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Altered states of consciousness represent significant deviations from one's normal mental state. These deviations can range from subtle changes in awareness to profound transformations in perception, thought processes, and sensory experiences. Altered states of consciousness can be triggered by various factors, including drug use, meditation, hypnosis, illness, or even intense fatigue.
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Psychoactive drugs impact brain function, influencing perception, mood, consciousness, cognition, and behavior. These substances are grouped based on their effects and the mechanisms by which they act.
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Antipsychotic drugs are a crucial treatment method for acute and chronic psychoses, bipolar illness, and behavioral disorders. The selection of these drugs depends on several factors, including the state of the disease, clinical judgment, possible drug interactions, and the patient's sensitivity to adverse effects. In immediate scenarios, such as delirium and dementia, short-term treatment with low doses of high-potency typical or atypical agents can effectively manage symptom exacerbation.
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Trip killers: Addressing a critical knowledge gap in psychedelic research.

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Psychedelic drugs can cause intense distress. This review evaluates medications to manage "bad trips," focusing on serotonin antagonists and other agents to restore stability when non-pharmacological methods fail.

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Area of Science:

  • Psychopharmacology
  • Emergency Medicine
  • Mental Health Therapeutics

Background:

  • Psychedelic drugs are increasingly researched for therapeutic use and recreationally. Adverse psychological distress, or "bad trips," can necessitate emergency medical care.
  • Managing acute psychedelic distress requires careful consideration, prioritizing non-pharmacological interventions. Pharmacological options are needed when these are insufficient.

Purpose of the Study:

  • To systematically evaluate potential pharmacological interventions for terminating acute psychedelic experiences.
  • To identify and appraise candidate medications for managing adverse psychedelic events in acute care settings.

Main Methods:

  • Literature review and critical appraisal of pharmacological agents.
  • Evaluation of candidate medications including serotonin antagonists, antipsychotics, and anxiolytics/antidepressants.
  • Assessment of mechanisms of action, pharmacokinetics, safety profiles, and clinical applicability.

Main Results:

  • Candidate medications include serotonin antagonists, drugs for psychosis, and select anxiolytics/antidepressants.
  • Key considerations for abortive agents are molecular binding strength, receptor blockade potency, and favorable safety profiles.
  • No systematic evaluation of pharmacological interventions for terminating psychedelic experiences currently exists.

Conclusions:

  • A provisional framework for the pharmacologic management of adverse psychedelic experiences is proposed.
  • Further research is needed to establish evidence-based pharmacological treatments for acute psychedelic distress.
  • Effective management strategies are crucial given the rising use of psychedelic substances.