Hallucinogen Use Workup

Updated: Sep 28, 2020
  • Author: Jeffrey S Forrest, MD, FAPA; Chief Editor: Glen L Xiong, MD  more...
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Laboratory Studies

In general, laboratory studies do not play a large role in the diagnosis and treatment of hallucinogen poisoning.

  • Only a few hallucinogenic agents show up on standard toxicological screens. These include MDMA (positive for amphetamines), PCP, and marijuana.
  • Treatment of hallucinogen poisoning is rarely affected by drug screen results.
  • Dextromethorphan (as in Robitussin DM) may cause a false-positive result for the presence of PCP.

Metabolic abnormalities should be sought and aggressively treated.

  • MDMA may cause hyponatremia.
  • PCP and MDMA may cause rhabdomyolysis and subsequent myoglobinuric renal failure. Check the creatine kinase level.
  • Always exclude hypoglycemia as a cause of altered mental status.

Imaging Studies

A CT scan of the head is indicated in all patients with an unexplained alteration in mental status.