Mescaline toxicity: Difference between revisions
ClaireLewis (talk | contribs) (Created page with "==Background== thumb|Peyote *Psychedelic phenethylamine , naturally occurring in peyote and other cacti *Similar to, but chemically distinct from and less...") |
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==Background== | ==Background== | ||
[[File:Peyote.jpg|thumb|Peyote]] | [[File:Peyote.jpg|thumb|Peyote]] | ||
*Psychedelic phenethylamine , naturally occurring in peyote and other cacti | *Psychedelic phenethylamine , naturally occurring in peyote cactus (''Lophophora williamsii'') and other cacti | ||
*Similar to, but chemically distinct from and less potent than [[LSD]] | *Similar to, but chemically distinct from and less potent than [[LSD]] | ||
*Thought to be a serotonin agonist | *Thought to be a serotonin agonist | ||
*Sold as dried cactus parts or "buttons" | *Sold as dried cactus parts or "buttons" | ||
*Used in religious ceremonies by some indigenous Central and South american peoples. | *Used in religious ceremonies by some indigenous Central and South american peoples. | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 18:04, 21 December 2020
Background
- Psychedelic phenethylamine , naturally occurring in peyote cactus (Lophophora williamsii) and other cacti
- Similar to, but chemically distinct from and less potent than LSD
- Thought to be a serotonin agonist
- Sold as dried cactus parts or "buttons"
- Used in religious ceremonies by some indigenous Central and South american peoples.
Clinical Features
- Onset 30-60 minutes, lasts 5-12 hours (though wide individual variability)
- Euphoria, energy, esoteric/spiritual experiences
- Altered sensorium, altered sense of time, extreme focus or distractibility, hallucinations
- Nausea/vomiting, abdominal pain
- Adrenergic stimulation: mydriasis, mild tachycardia, mild hypertension, hyperthermia
- Dizziness, headache
Differential Diagnosis
Hallucinations
Serotonin-Like Agents
- Lysergic acid diethylamide (LSD)
- Psilocybin ("magic mushrooms")
- N,N-Dimethyltryptamine (DMT)
- 5-methoxy- dimethyltryptamine (5-MeO-DMT)
- 25C-NBOMe
Enactogens
- Designer amphetamines
- Bath salts
- Ecstasy (MDMA)
- Mescaline (peyote)
- Synthetic cannabinoids
Dissociative Agents
- Phencyclidine (PCP)
- Ketamine
- Dextromethorphan
- Nitrous oxide
Plant-based Hallucinogenics
- Marijuana
- Salvia
- Absinthe
- Isoxazole Mushrooms
- Hawaiian baby woodrose (Argyreia nervosa)
- Hawaiian woodrose (Merremia tuberosa)
- Morning glory (Ipomoea violacea)
- Olili- uqui (Rivea corymbosa)
Organic causes
- Delirium
- Intracranial mass to occipital or temporal lobes
- Encephalitis, limbic encephalitis, anti-NMDA receptor encephalitis
- Migraine
- Seizure
- Hypocalcemia/Hypercalcemia
- Rift valley fever
- Rabies
- Syphilis
- Vitamin B7 deficiency
- Pellagra
- Dementia
Other Toxicologic Causes
- Alcohol withdrawal
- Anticholinergic Toxicity
- Tricyclic (TCA) Toxicity
- Synthetic cannabinoids
- Inhalant abuse
- Nitrogen narcosis
- GHB withdrawal
- Hydrocarbon toxicity
- Heavy metal toxicity
- Multiple medications: montelukast, doxapram, hyoscyamine, tizanidine, peramivir, amantadine, rimantadine, bromocriptine, methylergonovine, benztropine, doxepin, voriconazole, acyclovir, valacyclovir, ganciclovir, cimetidine, penicillin G Procaine, clarithromycin, metoclopramide
- Inhalant abuse
Psychiatric Causes [1]
- Schizophrenia, schizoaffective disorder, schizophreniform disorder
- Depression with psychotic features
- Bipolar disorder
- Charles Bonnet Syndrome (in the visually impaired)
Dissociative drugs
- Dextromethorphan
- Ketamine
- Nitrous oxide
- Phencyclidine (PCP)
- Alcohol Withdrawal
- Anticholinergic Toxicity
- Tricyclic (TCA) Toxicity
- Ertapenem Toxicity
- Encephalitis
- Hypocalcemia/Hypercalcemia
- Schizophrenia, schizo-affective Disorder
- Dementia
- Delirium
- Migraine
- Seizure
- Parkinson's Disease
Evaluation
- Not detected on routine drug screens
- Evaluate for other organic causes of hallucinations or hyperadrenergic symptoms
- Evaluate for co-ingestions
Management
- Supportive care
- Not usually associated with significant morbidity/mortality
Disposition
See Also
External Links
References
- ↑ Visual Hallucinations: Differential Diagnosis and Treatment. PMID PMC2660156