Abstract
In this article, we will discuss the history, pharmacodynamics, and neurotoxicity
of psychostimulants and hallucinogens. The drugs discussed are widely used and have
characteristic toxidromes and potential for neurological injuries with which the practicing
clinician should be familiar. Psychostimulants are a class of drugs that includes
cocaine, methamphetamine/amphetamines, and cathinones, among others, which produce
a crescendoing euphoric high. Seizures, ischemic and hemorrhagic strokes, rhabdomyolysis,
and a variety of movement disorders are commonly encountered in this class. Hallucinogens
encompass a broad class of drugs, in which the user experiences hallucinations, altered
sensorium, distorted perception, and cognitive dysfunction. The experience can be
unpredictable and dysphoric, creating a profound sense of anxiety and panic in some
cases. Recognizing the associated neurotoxicities and understanding the appropriate
management is critical in caring for these patient populations. Several of these agents
are not detectable by standard clinical laboratory analysis, making identification
and diagnosis an even greater challenge.
Keywords
drugs of abuse - neurotoxicology - stimulants - hallucinogenic - toxicology
