Fast Five Quiz: Psilocybin and Other Hallucinogenic Drugs

Richard H. Sinert, DO

Disclosures

September 07, 2021

The entire poisoning episode usually subsides in 6-8 hours; some symptoms may take up to several days to fully resolve. If patients are severely agitated, anxiolytics may be needed. Benzodiazepines may be used for sedation and treatment of panic attacks, hallucinations, and seizures. Psychiatric consultation and evaluation may be needed for persistent psychotic symptoms.

Symptomatic patients may be treated with supportive measures. Gastric lavage can be considered if ingestion occurred within approximately 1 hour of presentation; however, no data support the efficacy of the procedure in this setting.

Consider oral administration of activated charcoal if the patient presents within 1 hour of ingestion; however, adsorption to activated charcoal has not been demonstrated, and no evidence suggests that routine administration of multiple doses of activated charcoal is useful. If vomiting becomes prominent (a rare occurrence) or signs of volume depletion are present, intravenous fluids may be administered. Ipecac syrup should generally be avoided. Fever in this setting should not be treated with antipyretics; it is most likely the result of agitation and increased motor activity.

Read more about management of hallucinogenic mushroom toxicity.

This Fast Five Quiz was excerpted and adapted from the Medscape Drugs & Diseases articles Hallucinogen Use, Hallucinogenic Mushroom Toxicity, LSD Toxicity, and PCP Toxicity.

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