Hallucinogens

Question 1

altered state of consciousness

Answer 1

classical - plant derived substances, synthetic drugs
dissociative - anaesthesia, altered state consciousness, NMDA receptor antagonists

Question 2

5 dimensions

Answer 2

• oceanic boundlessness
• anxious ego - disintegration
• visionary
• restructuralisation
• acoustic alterations

Question 3

subjective experience

Answer 3

• less predictable
• dependent on expectation and the environment
• cannot be predicted - Groff

Question 4

serotonergic neurons

Answer 4

1. meta analysis of neuroimaging
2. SERT changes - decreased in NMDA users
3. ppts heavy users

Question 5

treatment of neuropsychiatric disorders

Answer 5

• psychotherapy to facilitate experience
• depression and alcohol dependence
• potential for bad trips
• MDMA toxicity for serotonergic neurons

Question 6

ketamine treatment for resistant depression

Answer 6

• duration is variable
• not all patients respond
• potential adverse effects
• nasal spray but not approved for NHS funding

Question 7

historical background

Answer 7

• used as part of rituals
• entered main stream in 20th century
• ketamine is a safer alternative
• clinically exploited in Europe and North America
• 1960s - associated with counter culture
• ketamine as antidepressant in 2019

Question 8

ecstasy

Answer 8

• MDMA effects serotonin transmission
• stimulant properties
• use in psychotherapy
• 0.4% 16-59 year olds take LSD

Question 9

harmfulness

Answer 9

• virtually no physical harm or dependence
• ecstasy does > degeneration
• 130 ecstasy related deaths

Question 10

legal restrictions

Answer 10

• 3 classes to determine penalties
• 5 schedules regulate clinical use of controlled substances

Question 11

classical hallucinogens

Answer 11

activate serotonin and 5HT2A receptor activation is main contributor to psychological effects
primary neuropharmacological mechanism is stimulation of 5HT receptors

Question 12

serotonin system and 5HT2A

Answer 12

• serotonergic raphe nuclei in midbrain
• 5HT2A are G protein - coupled stimulatory effects on neurons
• stimulate excitatory neurons, crucial for hallucinogenic effects

Question 13

MDMA

Answer 13

• stimulates serotonin release and dopamine releas

Question 14

dissociative anaesthetics

Answer 14

1. primary neuropharmacological blockade of channel pore
2. increase neural excitation
3. stimulate PFC and NA dopamine release

Question 15

adverse effects

Answer 15

• dependence
• neurodegeneration
• ketamine bladder