Deliriant

Deliriants are a class of hallucinogen. The term was introduced by David F. Duncan and Robert S. Gold to distinguish these drugs from psychedelics and dissociatives, such as LSD and ketamine respectively, due to their primary effect of causing delirium, as opposed to the more lucid states produced by such other hallucinogens as are represented by psychedelics and dissociatives.[1] The term is generally used to refer to anticholinergic drugs which are substances that inhibit the function of the neurotransmitter acetylcholine. Typical or common examples of deliriants include Datura as well as higher than recommended dosages of Diphenhydramine (Benadryl, Unisom).[2][3]

Attractive but highly toxic berry of Atropa belladonna

Effects

The delirium produced, particularly by anticholinergics is characterized by stupor, agitation, confusion, confabulation, dysphoria, akathisia, realistic visual hallucinations or illusions (as opposed to the pseudohallucinations experienced on other classes of hallucinogens) and regression to "phantom" behaviors such as disrobing and plucking.[4] Other commonly reported behaviors include holding full conversations with imagined people, finishing a complex, multi-stage action (such as getting dressed) and then suddenly discovering one had not even begun yet, and being unable to recognize one's own reflection in a mirror.

The effects have been likened to delirious fevers, sleepwalking, a fugue state or a psychotic episode (particularly in that the subject has minimal control over their actions and often has little to no recollection of the experience). This is a notable departure from the effects of serotonergic psychedelics.

Deliriant substances

Naturally-occurring deliriants are found in plant species such as Atropa belladonna (deadly nightshade), various Brugmansia species (Angel's Trumpets), Datura stramonium (Jimson weed), Hyoscyamus niger (henbane), and Mandragora officinarum (mandrake) in the form of tropane alkaloids (notably scopolamine, atropine, and hyoscyamine). Synthetic compounds such as diphenhydramine (Benadryl) and dimenhydrinate (Dramamine) are also deliriants. Nutmeg (although purportedly not as strong or as unpleasant feeling as diphenhydramine or scopolamine) is also considered a deliriant due to its propensity to cause anticholinergic-like symptoms when taken in large doses.[5] These effects are caused by the compounds myristicin and elemicin which are found in nutmeg's essential oil and can last up to several days in their effects similarly to the aforementioned tropane alkaloids found in datura.[6][7] Additionally, the mushroom referred to as fly agaric and its active principles ibotenic acid and muscimol may also be considered deliriants, albeit more hypnotic and with a unique mechanism of action.[8][9]

Recreational use

Despite the fully legal status of several common deliriant plants and OTC medicines, deliriants are largely unpopular as recreational drugs due to the severe dysphoria, uncomfortable and generally damaging cognitive and physical effects as well as the sometimes unpleasant nature of the hallucinations produced.[10]

User reports of recreational deliriant usage on the drug resource website Erowid generally indicate a firm unwillingness to repeat the experience.[11] In addition to their potentially dangerous mental effects (accidents during deliriant experiences are common)[12] some tropane alkaloids; such as those found in plants of the Datura genus are poisonous and can cause death due to tachycardia-induced heart failure, hypoventilation and hyperthermia even in small doses.[13] Anticholinergics have also been shown to increase the risk of developing dementia with long-term use even at therapeutic doses, therefore they are presumed to carry an even greater risk when used at hallucinogenic dosages.[14][15] Scopolamine in particular has been implemented in scientific models used to study the cholinergic hypothesis for Alzheimer's disease and other related dementias.[16]

Occultism and folklore

Deliriants such as henbane, mandrake, Jimson weed and fly agaric are featured in many stories in European mythology.

Tropane-based nightshades have also played an integral role in Old World folklore and European witchcraft.[17][18][19] Henbane in particular is reputed as having been used in Greco-Roman magic during ancient times as well as being associated with black magic and maleficium during the Late Middle Ages.[20] During this period in medieval Europe, the scopolia carniolica plant was also used as an admixture in love potions.[21] The belladonna plant genus, Atropa is named after the Greek Fate, Atropos, who cut the thread of life.[22] Mandrake (the root of the mandragora officinarum plant) is mentioned twice in the Bible,[23] and was also frequently mentioned as a typical ingredient in flying ointment recipes since at least as far back as the Early Modern Period.[24]

Classes of deliriants
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See also

References
  1. Duncan, D. F., and Gold, R. S. (1982). Drugs and the Whole Person. New York: John Wiley & Sons
  2. "Datura reports on Erowid". Retrieved 2013-05-07.
  3. Forest E (27 July 2008). "Atypical Drugs of Abuse". Articles & Interviews. Student Doctor Network. Archived from the original on 27 May 2013.
  4. Bersani, F. S.; Corazza, O.; Simonato, P.; Mylokosta, A.; Levari, E.; Lovaste, R.; Schifano, F. (2013). "Drops of madness? Recreational misuse of tropicamide collyrium; early warning alerts from Russia and Italy". General Hospital Psychiatry. 35 (5): 571–3. doi:10.1016/j.genhosppsych.2013.04.013. PMID 23706777.
  5. Demetriades, A. K.; Wallman, P. D.; McGuiness, A.; Gavalas, M. C. (2005). "Low Cost, High Risk: Accidental Nutmeg Intoxication". Emergency Medicine Journal. 22 (3): 223–225. doi:10.1136/emj.2002.004168. PMC 1726685. PMID 15735280
  6. Ehrenpreis, J. E.; Deslauriers, C; Lank, P; Armstrong, P. K.; Leikin, J. B. (2014). "Nutmeg Poisonings: A Retrospective Review of 10 Years Experience from the Illinois Poison Center, 2001–2011". Journal of Medical Toxicology. 10 (2): 148–151. doi:10.1007/s13181-013-0379-7. PMC 4057546. PMID 24452991
  7. Bliss, M. (2001). "Datura Plant Poisoning" (PDF). Clinical Toxicology Review. 23 (6).
  8. Hallucinogenic mushrooms an emerging trend case study (PDF). Lisbon: European Monitoring Centre for Drugs and Drug Addiction. 2006. ISBN 978-92-9168-249-2.
  9. Satora, L.; Pach, D.; Butryn, B.; Hydzik, P.; Balicka-Slusarczyk, B. (June 2005). "Fly agaric (Amanita muscaria) poisoning, case report and review". Toxicon. 45 (7): 941–3. doi:10.1016/j.toxicon.2005.01.005. PMID 15904689
  10. Grinspoon, Lester and Bakalar, James B. (1997). Psychedelic Drugs Reconsidered. The Lindesmith Center
  11. "Datura reports on Erowid". Retrieved 2013-05-07.
  12. "Datura Items". Retrieved 2011-01-04.
  13. Beaver, Kathleen M; Gavin, Thomas J (1998). "Treatment of acute anticholinergic poisoning with physostigmine". The American Journal of Emergency Medicine. 16 (5): 505–507. doi:10.1016/S0735-6757(98)90003-1.
  14. "Study suggests link between long-term use of anticholinergics and dementia risk". Alzheimer's Society. 2015-01-26. Archived from the original on 2015-11-12. Retrieved 2015-02-17.
  15. Flicker C, Ferris SH, Serby M (1992). "Hypersensitivity to scopolamine in the elderly". Psychopharmacology. 107 (2–3): 437–41. doi:10.1007/bf02245172. PMID 1615141.
  16. More SV, Kumar H, Cho DY, Yun YS, Choi DK (September 2016). "Toxin-Induced Experimental Models of Learning and Memory Impairment". International Journal of Molecular Sciences. 17 (9): 1447. doi:10.3390/ijms17091447. PMC 5037726. PMID 27598124
  17. Rätsch, Christian, The Encyclopedia of Psychoactive Plants: Ethnopharmacology and Its Applications pub. Park Street Press 2005
  18. Peters, Edward (2001). "Sorcerer and Witch". In Jolly, Karen Louise; Raudvere, Catharina; et al. (eds.). Witchcraft and Magic in Europe: The Middle Ages. Continuum International Publishing Group. pp. 233–37. ISBN 978-0-485-89003-7.
  19. Hansen, Harold A. The Witch's Garden pub. Unity Press 1978 ISBN 978-0913300473
  20. Rätsch, Christian, The Encyclopedia of Psychoactive Plants: Ethnopharmacology and Its Applications pub. Park Street Press 2005
  21. Starý, František, Poisonous Plants (Hamlyn colour guides) – pub. Paul Hamlyn April, 1984, translated from the Czech by Olga Kuthanová.
  22. Griffin WJ, Lin GD (March 2000). "Chemotaxonomy and geographical distribution of tropane alkaloids". Phytochemistry. 53 (6): 623–37. doi:10.1016/S0031-9422(99)00475-6. PMID 10746874.
  23. "Genesis 30:14–16 (King James Version)". Bible Gateway. Retrieved 6 January 2014.
  24. Schultes, Richard Evans; Hofmann, Albert (1979). The Botany and Chemistry of Hallucinogens (2nd ed.). Springfield Illinois: Charles C. Thomas. pps. 261-4.
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