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Hallucinogen Use Medication

  • Author: Brooke S Parish, MD; Chief Editor: Eduardo Dunayevich, MD  more...
 
Updated: Nov 23, 2015
 

Medication Summary

The goals of pharmacotherapy are to neutralize the effects of the toxic agent, to reduce morbidity, and to prevent complications.

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Benzodiazepines

Class Summary

Lorazepam and diazepam, in particular, are the DOCs for hallucinogen ingestion. Anxiolytic and sedating properties calm agitated patients and help blunt coexisting hypertension and tachycardia.

Lorazepam (Ativan)

 

Sedative hypnotic with short onset of effects and relatively long half-life. Increasing the action of GABA, which is a major inhibitory neurotransmitter in the brain, may depress all levels of CNS, including limbic and reticular formation. When patients need to be sedated for longer than a 24-h period, this medication is excellent.

Diazepam (Valium)

 

Depresses all levels of CNS (eg, limbic and reticular formation), possibly by increasing activity of GABA.

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Neuroleptics

Class Summary

For severe agitation and/or psychosis. May decrease seizure threshold.

Haloperidol (Haldol)

 

Butyrophenone noted for high potency and low potential for causing orthostasis. Downside is high potential for EPS/dystonia.

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Antidotes

Class Summary

Basic approach to treat patients with altered mental status includes administration of dextrose (or demonstration of normal blood glucose level), thiamine, and naloxone.

Dextrose (D-glucose)

 

Monosaccharide absorbed from the intestine and then distributed, stored, and used by the tissues.

Thiamine (Thiamilate)

 

To correct thiamine deficiency.

Naloxone (Narcan)

 

Prevents or reverses opioid effects (hypotension, respiratory depression, sedation), possibly by displacing opiates from their receptors.

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Contributor Information and Disclosures
Author

Brooke S Parish, MD Associate Professor, Department of Psychiatry, University of New Mexico School of Medicine

Brooke S Parish, MD is a member of the following medical societies: American College of Physicians, American Psychiatric Association

Disclosure: Nothing to disclose.

Coauthor(s)

Scott Cameron, MD Consulting Staff, Department of Emergency Medicine, Regions Hospital

Scott Cameron, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association

Disclosure: Nothing to disclose.

Michael E Richards, MD, MPA Associate Professor and Chair, Department of Emergency Medicine, University of New Mexico School of Medicine

Michael E Richards, MD, MPA is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Eduardo Dunayevich, MD Executive Director, Clinical Development, Amgen

Eduardo Dunayevich, MD is a member of the following medical societies: Schizophrenia International Research Society

Disclosure: Received salary from Amgen for employment; Received stock from Amgen for employment.

Acknowledgements

Ronald C Albucher, MD Chief Medical Officer, Westside Community Services; Consulting Staff, California Pacific Medical Center

Ronald C Albucher, MD is a member of the following medical societies: American Psychiatric Association

Disclosure: Nothing to disclose.

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