Psilocybin toxicity: Difference between revisions
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==Background == | ==Background == | ||
[[File:Psilocybe semilanceata.jpg|thumb|''Psilocybe semilanceata'']] | |||
A compound found in over 200 mushrooms that has mind altering properties similar to LSD. Commonly known as "magic mushrooms" or "shrooms". The mushroom are often taken recreationally for the euphoric and hallucinogenic effects. Typically grown in the Pacific Northwest and southern regions of the United States. For a typical dose (1mg) symptoms will last 1-3 hours. | A compound found in over 200 mushrooms that has mind altering properties similar to LSD. Commonly known as "magic mushrooms" or "shrooms". The mushroom are often taken recreationally for the euphoric and hallucinogenic effects. Typically grown in the Pacific Northwest and southern regions of the United States. For a typical dose (1mg) symptoms will last 1-3 hours. | ||
=== Toxicity === | === Toxicity === | ||
* Low | *Low | ||
* 280mg/kg | *280mg/kg | ||
* Therapeutic index of 641 | *Therapeutic index of 641 | ||
== Clinical Features== | == Clinical Features== | ||
* Euphoria | *Sensory/psychiatric | ||
* Visual hallucinations | **Euphoria | ||
* Lethargy | **Visual [[hallucinations]], synesthesia | ||
**[[Lethargy]], [[Depression]] | |||
* | **[[Anxiety]], agitation | ||
**[[Confusion]], disorientation | |||
**Above may lead to accidental [[trauma]] | |||
*Sympathetic effects | |||
**Mydriasis | |||
* [[ | **[[Tachycardia]] | ||
* [[ | **[[Hypertension]] | ||
* [[ | *[[Nausea]] | ||
*[[Hypotension]] | |||
* | |||
* | |||
* | |||
* | |||
* | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
| Line 39: | Line 34: | ||
==Evaluation== | ==Evaluation== | ||
* Clinical | *Clinical diagnosis | ||
* Urine | *[[Urine drug screen]] if concerned about co-ingestion | ||
== Management == | == Management == | ||
* Supportive | *Supportive care | ||
* Place patient in a calm and quiet environment | *Place patient in a calm and quiet environment | ||
* | *[[Benzodiazepines]] for worsening tachycardia/hypertension or agitation | ||
==Disposition== | ==Disposition== | ||
* Discharge when clinically sober | *Discharge when vitals normalize and clinically sober | ||
==See Also== | ==See Also== | ||
Revision as of 00:35, 11 December 2016
Background
A compound found in over 200 mushrooms that has mind altering properties similar to LSD. Commonly known as "magic mushrooms" or "shrooms". The mushroom are often taken recreationally for the euphoric and hallucinogenic effects. Typically grown in the Pacific Northwest and southern regions of the United States. For a typical dose (1mg) symptoms will last 1-3 hours.
Toxicity
- Low
- 280mg/kg
- Therapeutic index of 641
Clinical Features
- Sensory/psychiatric
- Euphoria
- Visual hallucinations, synesthesia
- Lethargy, Depression
- Anxiety, agitation
- Confusion, disorientation
- Above may lead to accidental trauma
- Sympathetic effects
- Mydriasis
- Tachycardia
- Hypertension
- Nausea
- Hypotension
Differential Diagnosis
- Hypoglycemia
- TBI
- CO poisoning
- Meningitis/Encephalitis
- Opioid intoxication
- Antihistamines/Anticholinergic toxicity
Drugs of abuse
- 25C-NBOMe
- Alcohol
- Amphetamines
- Bath salts
- Cocaine
- Ecstasy
- Gamma hydroxybutyrate (GHB)
- Heroin
- Inhalant abuse
- Hydrocarbon toxicity
- Difluoroethane (electronics duster)
- Marijuana
- Kratom
- Phencyclidine (PCP)
- Psilocybin ("magic mushrooms")
- Synthetic cannabinoids
- Chloral hydrate
- Body packing
Evaluation
- Clinical diagnosis
- Urine drug screen if concerned about co-ingestion
Management
- Supportive care
- Place patient in a calm and quiet environment
- Benzodiazepines for worsening tachycardia/hypertension or agitation
Disposition
- Discharge when vitals normalize and clinically sober
See Also
References
- Nichols DE. Hallucinogens. Pharmacol Ther 2004; 101:131.
- UpToDate
- van Amsterdam J, Opperhuizen A, van den Brink W (2011). "Harm potential of magic mushroom use: a review" (PDF). Regulatory Toxicology and Pharmacology. 59 (3): 423–9. doi:10.1016/j.yrtph.2011.01.006. PMID 21256914.
- Merck Index, 11th Edition, 7942
- "Comparison of acute lethal toxicity of commonly abused psychoactive substances" (PDF). Addiction. 99 (6): 686–96. doi:10.1111/j.1360-0443.2004.00744.x. PMID 15139867.
- Passie T, Seifert J, Schneider U, Emrich HM (2002). "The pharmacology of psilocybin". Addiction Biology. 7 (4): 357–64. doi:10.1080/1355621021000005937. PMID 14578010.
- "Comparison of acute lethal toxicity of commonly abused psychoactive substances" (PDF). Addiction. 99 (6): 686–96. doi:10.1111/j.1360-0443.2004.00744.x. PMID 15139867.
- Halpern JH1. "Hallucinogens and dissociative agents naturally growing in the United States." Pharmacol Ther. 2004 May;102(2):131-8.