N,N-Dimethyltryptamine: Difference between revisions
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==Background== | ==Background== | ||
*Also known as DMT | |||
*Serotonergic hallucinogen | |||
*Naturally occurring in several plant species | |||
*Usually smoked, less frequently combined with MAOI and ingested orally | |||
*Produces rapid onset, short, but ''extremely'' intense trip | |||
==Clinical Features== | ==Clinical Features== | ||
*Onset within 2m, effects last ~20-60m | |||
*Notorious for producing intense, intricate psychedelic experiences | |||
**Dissociation, sensory enhancement/distortions, visual [[hallucinations]] | |||
**Paranoia, fear/anxiety | |||
*Adrenergic stimulation: mydriasis, mild tachycardia, mild hypertension, hyperthermia | |||
*[[Nausea/vomiting]] | |||
*[[Seizure (rare)]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Hallucinogen types}} | |||
{{Dissociative drugs types}} | |||
*[[Alcohol Withdrawal]] | |||
*[[Anticholinergic Toxicity]] | |||
*[[Tricyclic (TCA) Toxicity]] | |||
*[[Ertapenem]] Toxicity | |||
*[[Encephalitis]] | |||
*[[Hypocalcemia]]/[[Hypercalcemia]] | |||
*Schizophrenia, schizo-affective Disorder | |||
*[[Dementia]] | |||
*[[Delirium]] | |||
*[[Migraine]] | |||
*[[Seizure]] | |||
*[[Parkinson's Disease]] | |||
==Evaluation== | ==Evaluation== | ||
*Not detected on drug screens | |||
*Evaluate for other organic causes of hallucinations or hyperadrenergic symptoms | |||
*Evaluate for co-ingestions | |||
==Management== | ==Management== | ||
*Supportive care | |||
==Disposition== | ==Disposition== | ||
==See Also== | ==See Also== | ||
*[[Hallucinogens]] | |||
==External Links== | ==External Links== | ||
*https://erowid.org/chemicals/dmt/ | |||
==References== | ==References== | ||
Revision as of 21:44, 11 August 2017
Background
- Also known as DMT
- Serotonergic hallucinogen
- Naturally occurring in several plant species
- Usually smoked, less frequently combined with MAOI and ingested orally
- Produces rapid onset, short, but extremely intense trip
Clinical Features
- Onset within 2m, effects last ~20-60m
- Notorious for producing intense, intricate psychedelic experiences
- Dissociation, sensory enhancement/distortions, visual hallucinations
- Paranoia, fear/anxiety
- Adrenergic stimulation: mydriasis, mild tachycardia, mild hypertension, hyperthermia
- Nausea/vomiting
- Seizure (rare)
Differential Diagnosis
Hallucinations
Serotonin-Like Agents
- Lysergic acid diethylamide (LSD)
- Psilocybin ("magic mushrooms")
- N,N-Dimethyltryptamine (DMT)
- 5-methoxy- dimethyltryptamine (5-MeO-DMT)
- 25C-NBOMe
Enactogens
- Designer amphetamines
- Bath salts
- Ecstasy (MDMA)
- Mescaline (peyote)
- Synthetic cannabinoids
Dissociative Agents
- Phencyclidine (PCP)
- Ketamine
- Dextromethorphan
- Nitrous oxide
Plant-based Hallucinogenics
- Marijuana
- Salvia
- Absinthe
- Isoxazole Mushrooms
- Hawaiian baby woodrose (Argyreia nervosa)
- Hawaiian woodrose (Merremia tuberosa)
- Morning glory (Ipomoea violacea)
- Olili- uqui (Rivea corymbosa)
Organic causes
- Delirium
- Intracranial mass to occipital or temporal lobes
- Encephalitis, limbic encephalitis, anti-NMDA receptor encephalitis
- Migraine
- Seizure
- Hypocalcemia/Hypercalcemia
- Rift valley fever
- Rabies
- Syphilis
- Vitamin B7 deficiency
- Pellagra
- Dementia
Other Toxicologic Causes
- Alcohol withdrawal
- Anticholinergic Toxicity
- Tricyclic (TCA) Toxicity
- Synthetic cannabinoids
- Inhalant abuse
- Nitrogen narcosis
- GHB withdrawal
- Hydrocarbon toxicity
- Heavy metal toxicity
- Multiple medications: montelukast, doxapram, hyoscyamine, tizanidine, peramivir, amantadine, rimantadine, bromocriptine, methylergonovine, benztropine, doxepin, voriconazole, acyclovir, valacyclovir, ganciclovir, cimetidine, penicillin G Procaine, clarithromycin, metoclopramide
- Inhalant abuse
Psychiatric Causes [1]
- Schizophrenia, schizoaffective disorder, schizophreniform disorder
- Depression with psychotic features
- Bipolar disorder
- Charles Bonnet Syndrome (in the visually impaired)
Dissociative drugs
- Dextromethorphan
- Ketamine
- Nitrous oxide
- Phencyclidine (PCP)
- Alcohol Withdrawal
- Anticholinergic Toxicity
- Tricyclic (TCA) Toxicity
- Ertapenem Toxicity
- Encephalitis
- Hypocalcemia/Hypercalcemia
- Schizophrenia, schizo-affective Disorder
- Dementia
- Delirium
- Migraine
- Seizure
- Parkinson's Disease
Evaluation
- Not detected on drug screens
- Evaluate for other organic causes of hallucinations or hyperadrenergic symptoms
- Evaluate for co-ingestions
Management
- Supportive care
Disposition
See Also
External Links
References
- ↑ Visual Hallucinations: Differential Diagnosis and Treatment. PMID PMC2660156