Hallucinogens

Pharmacokinetic and Pharmacodynamic Aspects of Peyote and Mescaline: Clinical and Forensic Repercussions

BACKGROUND

Mescaline (3,4,5-trimethoxyphenethylamine), mainly found in the Peyote cactus (Lophophora williamsii), is one of the oldest known hallucinogenic agents that influence human and animal behavior, but its psychoactive mechanisms remain poorly understood.

OBJECTIVES

This article aims to fully review pharmacokinetics and pharmacodynamics of mescaline, focusing on the in vivo and in vitro metabolic profile of the drug and its implications for the variability of response.

METHODS

Mescaline pharmacokinetic and pharmacodynamic aspects were searched in books and in PubMed (U.S. National Library of Medicine) without a limiting period. Biological effects of other compounds found in peyote were also reviewed.

RESULTS

Although its illicit administration is less common, in comparison with cocaine and Cannabis, it has been extensively described in adolescents and young adults, and licit consumption often occurs in religious and therapeutic rituals practiced by the Native American Church. Its pharmacodynamic mechanisms of action are primarily attributed to the interaction with the serotonergic 5-HT2A-C receptors, and therefore clinical effects are similar to those elicited by other psychoactive substances, such as lysergic acid diethylamide (LSD) and psilocybin, which include euphoria, hallucinations, depersonalization and psychoses. Moreover, as a phenethylamine derivative, signs and symptoms are consistent with a sympathomimetic effect. Mescaline is mainly metabolized into trimethoxyphenylacetic acid by oxidative deamination but several minor metabolites with possible clinical and forensic repercussions have also been reported.

CONCLUSION

Most reports concerning mescaline were presented in a complete absence of exposure confirmation, since toxicological analysis is not widely available. Addiction and dependence are practically absent and it is clear that most intoxications appear to be mild and are unlikely to produce lifethreatening symptoms, which favors the contemporary interest in the therapeutic potential of the drugs of the class.

Immunological consequences of in vitro exposure to lysergic acid diethylamide (LSD)

The ability of lysergic acid diethylamide (LSD) to alter immune function after direct in vitro exposure was examined. It was demonstrated that LSD is able to suppress the proliferation of B-lymphocytes; the production of the cytokines IL-2, IL-4, and IL-6; and the induction of cytotoxic T-lymphocytes at a concentration of 100 microM. In vitro exposure to LSD had differential effects on natural killer (NK) cell activity, with significant enhancement of both basal and IL-2-augmented NK cell function at concentrations between 0.0001 and 0.1 microM, and suppression of NK response at 100 microM. These results demonstrate that LSD may have a direct effect on components of the immune system at concentrations that may be reached upon human exposure.

Substance abuse in adolescent mothers: strategies for diagnosis, treatment and prevention

Adolescent drug addiction and alcohol abuse are on the rise in this country. Teenagers of all races, socioeconomic groups and both genders have become avid experimenters with a full spectrum of substances, including alcohol, marijuana, stimulants, cocaine and hallucinogens. A diagnosis of addiction requires familiarity with the normative trends of adolescent behavior, as well as deviations from these trends. Moreover, an adolescent mother with a drug addiction problem confronts the additional burden of fostering adaptive developmental patterns in her infant. Treatment techniques such as previewing, which empowers through the representation and enactment of future outcomes, have helped addicted teenage mothers relinquish drug use and adopt more mature caregiving behaviors.

The phenomenon of abusable psychotropic use among North American youth

Abusable psychotropic use can, and does, affect all North American youth, either directly or indirectly, regardless of age, gender, culture, ethnic background, education, race, or socioeconomic status. Over the last decade, the morbidity and mortality associated with abusable psychotropic use among youth have become staggering. A current overview of the phenomenon of abusable psychotropic use among youth in North America, including the use of alcohol, cannabis, cocaine, LSD, nicotine, and polyabusable psychotropic use, is presented with attention to the expanding role of clinical pharmacologists in relation to both prevention and treatment. The Mega Interactive Model of Abusable Psychotropic Use Among Youth is presented as a heuristic device to assist clinical pharmacologists, and other health care providers, in addressing the multifactorial interactive aspects of this complex phenomenon as observed in the pediatric age group. In this regard, attention is given to the interaction of the Abusable Psychotropic Dimension, including the Abusable Psychotropic Variables (e.g., pharmacokinetics, abuse potential) and Pattern of Use Variables (e.g., social use, abuse, compulsive use), with the Young Person, Societal, and Time Dimensions.