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Phencyclidine ingestion: drug abuse and psychosis.

M S Jacob, P L Carlen, J A Marshman, E M Sellers

International Journal of the Addictions May 1981 DOI: 10.3109/10826088109038866 (opens in new tab)

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AI-extracted from the abstract
Characteristics Case series Case report Peer reviewed
Sample size 9
Population Patients admitted with unintentional phencyclidine (PCP) overdose
Key findings In nine admitted PCP overdose patients, consciousness ranged from alert to comatose, and all showed a prolonged recovery with agitation and toxic psychosis, including severe behavior disorder, paranoid ideation, and amnesia for the entire hospital stay. Very high doses produced shallow respiratory excursions, apnoea and cyanosis coinciding with generalized extensor spasm and neck-muscle spasm, plus excessive bronchial secretions, gross ataxia, opisthotonic posturing, and grimacing. The authors argue that PCP toxic psychosis should be considered in drug-abusing patients with schizophrenic-like symptoms or bizarre behavior regardless of self-reported PCP use.

Abstract

Phencyclidine (PCP) is a popular illicit drug often misrepresented as some other hallucinogenic substance and distributed in widely varying dosage forms and strengths. Users of hallucinogenic drugs may present with unintentional PCP overdoses. Toxicological laboratory analyses are essential to establish the diagnosis. In nine admitted overdose patients, the consciousness level ranged from alert to comatose on presentation, and all showed a prolonged recovery phase with agitation and toxic psychosis. Severe behavior disorder, paranoid ideation, and amnesia for the entire period of in-hospital stay are characteristic. In very high dose patients, shallow respiratory excursions and periods of apnoea and cyanosis coincided with generalized extensor spasm and spasm of neck muscles. Excessive bronchial secretions, gross ataxia, opisthotonic posturing, and grimacing occur. PCP toxic psychosis should be considered in drug-abusing patients presenting with schizophrenic-like symptoms, psychosis, or other bizarre behavior, whether or not they admit to taking PCP.

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