User talk:Thoric/diagram references

Let's bold things that are at odds with Thoric's chart so he can change/defend their placement.

If an argument has been resolved, cross out whichever position has been defeated.Jolb 06:11, 17 July 2007 (UTC)

THC

• Report of the Australian Government, 1996: "Cannabis has been erroneously classified as a narcotic, as a sedative and most recently as an hallucinogen. While the cannabinoids do possess hallucinogenic properties, together with stimulant and sedative effects, they in fact represent a unique pharmacological class of compounds. Unlike many other drugs of abuse, cannabis acts upon specific receptors in the brain and periphery. The discovery of the receptors and the naturally occurring substances in the brain that bind to these receptors is of great importance, in that it signifies an entirely new pathway system in the brain."

• Sedative, stimulant, and other subjective effects of marijuana: relationships to smoking techniques, Pharmacol Biochem Behav. 1998 Feb;59(2):405-12: "Paradoxical subjective effects were observed in that subjects reported some stimulation as well as sedation after smoking marijuana"

• Drugs of Abuse, Antipsychotics, Antidepressants - Lecture 11, Elon University: "Marijuana - cannabis -- (flowering tops and leaves of hemp plants) classified as a hallucinogen/stimulant/sedative (thus in its own class)"

• Abnormal Psychology, 5th Edition, Ronald J. Comer: "When smoked, cannabis produces a mixture of hallucinogenic, depressant, and stimulant effects"

So far, this supports that THC should be in hallucinogen, stimulant, and depressant categories. Jolb 05:50, 17 July 2007 (UTC)

Cannabis

• Cannabis' primary constituents are THC (5-30%) and CBD (< 5%). [1] The CBD content contributes to minor anti-psychotic effects.

Thoric, please tell us where this citation is from. Jolb 06:22, 17 July 2007 (UTC) Thank you. Jolb 19:06, 18 July 2007 (UTC)

Atomoxetine

• Strattera was originally intended to be a new antidepressant drug; however, in clinical trials, no such benefits could be proven -- this lends support to putting it close to other antidepressant drugs.
• Some patients tend to feel lightheaded, dizzy, or "buzzed" as a minor side effect along with the drowsiness. To diminish these side effects, which can interfere with daytime work, study, etc., dosing time is sometimes changed to just before bed; as Strattera is long-acting, it does not "wear off" overnight. Mild hallucinations can be experienced under high doses (300mg) -- this lends support to putting it close to cannabis.
• However, rats, pigeons and monkeys trained to distinguish cocaine or methamphetamine from saline indicate that atomoxetine produces effects indistinguishable from low doses of cocaine or methamphetamine, but not at all like high doses of cocaine -- this lends support to Atomoxetine being a mild enough stimulant not to be considered a sedative.
• Atomoxetine was/is being examined by NIDA for use in treating cannabis dependence. The medication given for substance dependence most often produces a similar (yet not as enjoyable) effect as the substance being substituted to ease withdrawal.

These are just quotes, not citations to sources. WTF?!? Please cite the actual sources. BenB4 21:04, 18 July 2007 (UTC)

Alcohol

• Alcohol produces stimulant and sedative effects, and both types of effect are thought to influence drinking practices.

Thats suggest that alcohol should be in an overlap between stimulant and sedative/depressant. Jolb 05:50, 17 July 2007 (UTC)

All medical literature classifies alcohol as a depressant, and more specifically as a sedative/hypnotic. This is its most prominent effect in its used form (as a drink), and plays a major role when considering interactions with other depressants, which can cause serious combined effects, leading to overdose and death. Any stimulant effects alcohol has are greatly overshadowed by the strong depressant effects. --Thoric 21:07, 17 July 2007 (UTC)

• "Alcohol is a sedative hypnotic" [2]
  • Not peer-reviewed. BenB4 20:40, 18 July 2007 (UTC)

• Alcohol: Depressant, Intoxicant [3]
  • Not peer-reviewed. BenB4 20:40, 18 July 2007 (UTC)

True, but I believe it is possible for something to exhibit the effects of both stimulants and depressants (like THC). So again we have references saying it IS a sedative and it IS a stimulant... therefore it should go in an overlap. If you don't think it's a stimulant, find a source saying it ISN'T a stimulant. Jolb 22:10, 17 July 2007 (UTC)

THC doesn't particularly impart strong stimulant or depressant qualities. Alcohol on the other hand does have strong depressant qualities. Claims of minor stimulant properties are dwarfed by this. As for references saying that alcohol is not a stimulant, there are plenty:

• Q: Is alcohol a stimulant? A: No. Alcohol is a depressant. It acts on the central nervous system like an anesthetic to lower or depress the activity of your brain. [4]
  • Not peer-reviewed. BenB4 20:40, 18 July 2007 (UTC)

• When a person drinks, he may do things he might not otherwise do. this is not because alcohol is a stimulant, but rather because it is a depressant. The first area of the brain alcohol affects is the area which regulates inhibitions, judgment and self-control. It is the lack of such restraints that causes the apparently "stimulated" or uninhibited behavior. [5]
  • Not peer-reviewed. BenB4 20:40, 18 July 2007 (UTC)

• Alcohol is a depressant drug; this means it slows down (or depresses) the Central Nervous System. Some people mistakenly think it is a stimulant because initially it reduces inhibitions, encouraging some people to do things they might not do otherwise. [6]
  • Not peer-reviewed. BenB4 20:40, 18 July 2007 (UTC)

• Alcohol is actually a depressant. It can appear to be a stimulant because it initially depresses the part of the brain that controls inhibitions. [7]
  • Not peer-reviewed. BenB4 20:40, 18 July 2007 (UTC)

• Alcohol is a stimulant? False! Alcohol is a depressant. Depressants slow the vital functions of the body, such as heart rate and blood pressure. Even though alcohol may seem to make you more talkative and out-going, it slows your body. That is why it is so important not to drink and drive. Your reaction time is dramatically slowed when you drink. More than 75 percent of all car accidents are alcohol related. [8]
  • Not peer-reviewed. (You are citing BaptistOnline.org for medical information?) BenB4 20:40, 18 July 2007 (UTC)

• Alcohol is a depressant. In small quantities, it loosens inhibitions and may appear to be a stimulant. But with higher doses, its depressant effects predominate, reducing judgement and concentration. [9] --Thoric 03:46, 18 July 2007 (UTC)
  • Not peer-reviewed. BenB4 20:40, 18 July 2007 (UTC)

Great, I'm satisfied. Jolb 05:14, 18 July 2007 (UTC)

Here is what peer-reviewed medical literature says: "Alcohol produces stimulant and sedative effects, and both types of effect are thought to influence drinking practices." BenB4 20:43, 18 July 2007 (UTC)

The above were examples of government and health websites clearly stating that alcohol is not a stimulant. I can also provide plenty of peer-reviewed sources stating that alcohol is a depressant. --Thoric 20:45, 18 July 2007 (UTC)

You have been unable to produce a single peer-reviewed citation in support of your position that alcohol is not a stimulant. Here is another peer-reviewed medical journal article showing that it is. I am astonished that you would consider government sources accurate on the matter of psychoactive drugs. In any case WP:RS clearly states that peer-reviewed sources are superior. BenB4 20:55, 18 July 2007 (UTC)

Fine. Peer reviewed citation:

• alcohol is not a stimulant. but like other general anaesthetics is. a primary and continuous depressant. of the C.N.S Oxford Journals --Thoric 21:08, 18 July 2007 (UTC)

That is the same reference I gave immediately above, and although I can't read the full text, the abstract clearly states, "At low doses alcohol produces excitation—intoxication". BenB4 21:14, 18 July 2007 (UTC)

I've uncrossed the objection since BenB4 has rightfully noticed that your citations aren't as reliable as they should be. Jolb 15:11, 19 July 2007 (UTC)

MDMA (and other empathogens-enactogen MDxes)

Stimulant-like properties of methylenedioxy-methamphetamine (MDMA) have been reported in locomotor paradigms, drug discrimination procedures, and human subjective questionnaires. (From PMID 2574478)

That suggests that MDMA should be within stimulants. Jolb 05:53, 17 July 2007 (UTC)

Ketamine (and other NMDA receptor antagonists)

• This paper narrates the psychedelic and psychotic effects of ketamine in two ketamine dependent patients who have presented to the psychiatric service. These effects were dose-related and comprised multimodal hallucinatory experiences, a sense of slowing, paranoid ideation and enhancement of sexual, musical and sensory enjoyment. (From PMID 12762561)

• This review describes the medical, research and recreational uses of ketamine, an anaesthetic derivative of phencyclidine that has dissociative, analgesic and psychedelic properties....At low doses, stimulant effects predominate and the effect of environmental conditions are significant; with higher doses, psychedelic effects predominate and the effect of the environment diminishes. (From PMID 16529526)

This suggests that Ketamine should be considered "psychedelic", "psychotic" (or, more understandably, "psychomimetic"), and "hallucinatory," so it should be somewhere within hallucinogenic and psychedelic. Jolb 06:00, 17 July 2007 (UTC)

The second reference also suggests that ketamine is a stimulant at lower doses and a psychedelic at higher doses, so it should be between psychedelic and stimulant.

Ketamine is medically classified as a dissociative anesthetic. Therefore it should remain as a dissociative. At very high dosages it can cause respiratory or even cardiac failure. [10] --Thoric 21:15, 17 July 2007 (UTC)

Well, we have references saying that it IS a dissociative, it IS a stimulant, it IS a depressant, and it IS a psychedelic. So it should be in an overlap between all of those, right? I've seen no sources saying that it ISN'T any of those. Jolb 22:05, 17 July 2007 (UTC)

The "psychedelic" region in the diagram refers to stimulating, mind-releasing (psychelytic) drugs. This is the version of psychedelic that is being employed here. Ketamine produces its hallucinogenic effect only when used in a high enough dosage to have a dissociative effect. All the drugs on this diagram are placed according to their primary effects at commonly used dosages, otherwise items would have to exist in multiple dosage-dependent locations. Ketamine is considered to be a dissociative anesthetic, not a stimulant, and only referred to as a "psychedelic" by those using a very loose definition of psychedelic, which I am not using in this diagram. --Thoric 20:23, 18 July 2007 (UTC)

This illustrates my strongest objection to the diagram. You use labels and then turn around and say that the labels aren't supposed to mean what the dictionary says they mean. That has to be fixed in a verifiable way or the issue of inclusion is strictly non-negotiable as far as I am concerned. BenB4 21:06, 18 July 2007 (UTC)

Well, Thoric, since you admit that there are several definitions for "psychedelic," I don't think it should be used as a classification of drugs. I've suggested time and again that you change it to a more universal and less objective term like "5-HT2A agonists". Jolb 01:11, 19 July 2007 (UTC)

With regards to what I said right ^ there, I added my psychedelic argument at the bottom of the page. Jolb 15:12, 19 July 2007 (UTC)

Fluoxetine (and other SSRIs)

• fluoxetine does not exhibit stimulant activity of the amphetamine type (from PMID 1338386)

This suggests that fluoxetine should not be within the stimulant bubble. Jolb 06:10, 17 July 2007 (UTC)

Incorrect -- this only means that fluoxetine isn't like an amphetamine -- neither is caffeine, but it is still a stimulant. Side effects of fluoxetine include anxiety, agitation, panic attacks, insomnia, irritability, hostility, aggressiveness, impulsivity, akathisia, among others. BTW, these are the same sort of side effects that amphetamines can produce. Please also note that amphetamines are sometimes prescribed for depression when other antidepressants aren't doing the trick. --Thoric 21:22, 17 July 2007 (UTC)

"this only means that fluoxetine isn't like an amphetamine..." so provide a citation saying that it is a "stimulant." I don't think having those side effects automatically makes it a stimulant. Jolb 22:08, 17 July 2007 (UTC)

One of the current references on the chart is to a book which classifies SSRIs as stimulants. Here's some info from a doctor who is an expert on the stimulant effects of SSRIs (especially fluoxetine):

• "Prozac acts as a stimulant to the nervous system" - Breggin PR and Breggin GR, Talking back to Prozac: What doctors aren't telling you about today's most controversial drug. New York, St. Martin's Press, 1994, p. 121 [11] Dr. Breggin adds that nearly all of the side effects of Prozac listed in the Physician's Desk Reference "fit into the stimulant profile."

I'm satisfied. Jolb 18:59, 18 July 2007 (UTC)

• NOT PEER-REVIEWED! Why the hell do people think that you can trump a peer-reviewed source with something from GaryNull.com for goodness sake?!? What the hell is going on here? BenB4 21:08, 18 July 2007 (UTC)

That page contains a large number of references to peer-viewed sources. I didn't know you wanted me to copy them all over to here, but I can if you like. I could probably cite half a dozen books written by doctors which describe SSRIs as stimulant-like drugs, and I have one already cited on the diagram introduction itself. --Thoric 21:18, 18 July 2007 (UTC)

• I agree with Jolb. Serotonin increases things like sleep and decrease aggressiveness. ADRs might include aggressiveness and things like that, but it does nothing toward dopamine, epinephrine, or norepinephrine (unlike bupropion, MAOIs, etc.) Stimulants which increase serotonin work by different mechyanisms than prozac: i.e. MDMA and its relatives aren't even tryptamines but phenethylamines, thus affecting dopamine, epinephrine, or norepinephrine, and MAO affects all the MAs- serotonin, adrenaline (epinephrine), dopamine, etc. thus having a stimulant effects. Stimulants like caffeine, cocaine, modafinil, ardofinil, and nicotine aren't phenethylamines or tryptamines so SSRis dont work like that either. as SSRIs are tryptamines.

Bupropion

Someone mentioned bupropion is misplaced:

• The authors describe the development of acute psychoses in four patients treated with bupropion, a unicyclic aminoketone antidepressant. In two of the cases the psychoses seemed to be affected by dose. (From PMID 3934991)

That suggest that bupropion is primarily an antidepressant but can overlap with a pro-psychotic (or psychomimetic/hallucinogen). Jolb 07:06, 17 July 2007 (UTC)

Most stimulating antidepressants have pro-psychotic potential, as do the amphetamines. --Thoric 21:16, 17 July 2007 (UTC)

So we agree? Then it should be moved to an overlap between antidepressant and psychomimetic. Jolb 22:07, 17 July 2007 (UTC)

No, it should not be moved. All stimulants can induce mania and psychosis with overuse. This is not their primary effect. Bupropion is prescribed as an antidepressant. It is a stimulant-like antidepressant (as are the SSRIs like Prozac), but it is even closer to the other stimulants because it is chemically similar. It is in the correct location. Otherwise all stimulants (especially the amphetamines) would be grouped with LSD. Just because a super-high (potentially dangerous) dose of methamphetamine can induce a similar manic mindstate to what LSD may possibly induce in a certain mindset, does not mean that LSD and methamphetamine should be in the same place on the chart. We're talking about primary effects here. Most psychoactives have the potential (at some particular dosage level) to produce a wide range of effects. We are primarily concerned with the effects observed from standard dosages; the only exception being substances which are taken in higher dosages for recreational purposes (i.e. DXM and the antihistamines). --Thoric 15:40, 18 July 2007 (UTC)

I'm on the hedge here. We need a third opinion. Jolb 19:00, 18 July 2007 (UTC)

Antidepressant / antipsychotic grouping

While a better term may exist to group the mental-illness medications, the same problem exists with the hallucinogens group. This is a limitation of the terminology, and I would like to make it clear that this chart plots a continuum from antipsychotic to hallucinogen as well as from stimulant to depressant. Additionally I would like to point out that doctors routinely cross-prescribe antipsychotics and antidepressants. Here are some references of how antipsychotics and antidepressants have similar actions:

• Clozapine and several other antipsychotic/antidepressant drugs preferentially block the same 'core' fraction of GABA(A) receptors. [12]

(this is a research paper looking at primarily antipsychotic drugs on a receptor not thought to be the main receptor involved and so is tenuously related at best)

• In prefrontal cortex, 5-hydroxytryptamine2A (5-HT2A) receptors have been linked to the action of hallucinogens and atypical antidepressant/antipsychotic drugs [13]

(again clozapine and several other atyicals block serotonin, while antidepressants increase levels - opposite effect)

• Medications for mental illness are divided into four large categories—antipsychotic, antimanic, antidepressant, and antianxiety medications [14]

(and the point is....)

The point is that these medications do have a larger inclusive medical grouping, if anyone knows a single term that means "medications for mental illness", please let me know. --Thoric 21:57, 26 July 2007 (UTC)

• Clinical observations have shown that patients who do not respond to antidepressants may show dramatic improvement if atypical antipsychotics are added to their regimen [15]

(there is considerable doubt about the homogeneity of many psych illnesses. Furthermore this says nothing about antidepressants having antipsychotic effects)

This shows antipsychotics improving the antidepressant effects of antidepressants (synergism). --Thoric 21:57, 26 July 2007 (UTC)

• Amoxapine (a tricyclic antidepressant) shows atypical antipsychotic effects in patients with schizophrenia: results from a prospective open-label study [16]

(Amoxapine has always been recognised as unusual)

Just showing that the similarities aren't limited to the SSRIs --Thoric 21:57, 26 July 2007 (UTC)

• Ziprasidone's 5-hydroxytryptamine (HT)1D-antagonist and 5-HT(1A)-agonist activity are consistent with a potential for antidepressant and anxiolytic activity beyond its antipsychotic effects [17]
• Risperidone in the Treatment of Psychotic Depression [18]

(Both last 2 studies propose antidepressant properties for antipsychotics, not the other way around)

I was showing how the two classes have overlap in both directions. --Thoric 21:57, 26 July 2007 (UTC)

?? - but you're not - as I said - from the isolated affinities shown above to your lumping antidepressants in this broad category 'antipsychotics' (which you yourself concede may need a different name) is a pretty big leap.cheers, Casliber (talk · contribs) 00:32, 27 July 2007 (UTC)

But there's overlap between antidepressants and hallucinogens. Ketamine, ecstasy, salvinorin-A, THC, and many other psychotomimetic drugs are all associated with antidepressant effects. If you want references I'll give you them, but many references are cited on those wiki articles. Jolb 22:11, 26 July 2007 (UTC)

That overlap is visible for some of those on the current diagram (cannabis, mdma, ghb), many drugs can improve mood, and actually most stimulants are also antidepressants, so it all depends on context and point of view. As I mentioned I think I'm going to give this thing a complete overhaul once we reach some more consensus on placement, and keep it to a simple X/Y plot of stimulation/excitation vs. depression/sleepy/dreaminess, and antipsychotic/tranquility vs. propsychotic/novelty with some Venn circles for solid medical established groupings. --Thoric 22:43, 26 July 2007 (UTC)

Hallucinogens - alternate label?

To make the y-axis spectrum more clear, do you think that it might be more appropriate to change the term "Hallucinogens" on the chart to "Psychotomimetics?" I feel that psychotomimetic makes the distinction a little more black and white. Also, using "psychomimetic" would help with those drugs in the hallucinogen bubble that do not strictly cause hallucinations (those that cause other kinds of changes in perception) like THC or MDMA. Jolb 19:04, 18 July 2007 (UTC)

This is certainly a possibility. My original intention was to stick to widely understood terms that were most commonly used to describe these drugs, but seeing as one only needs to click on a link to understand what it means, it might not be bad to use something more "scientific". Psychotomimetic isn't bad, but the stub article is lacking, and should likely redirect to Psychedelics, dissociatives and deliriants. --Thoric 20:01, 18 July 2007 (UTC)

I would agree with that change, but the top of the y-axis needs a similar correction much more desperately. BenB4 21:10, 18 July 2007 (UTC)

Okay, we have 3 unanimous opinions. Change it. Jolb 15:20, 19 July 2007 (UTC)

Psychedelic

I feel that psychedelic is a controversial term with several meanings, and it is not a suitable term for a class of drugs since the term is sometimes used very generally and sometimes used very specifically in medical literature. I think that Thoric's use of the term on the chart is POV, as it represents only one of the many possible definitions, and it was his POV to use only that one. I feel that many drugs, especially those within dissociatives, can be considered psychedelic. This is a topic Thoric and I have debated for months, so prepare for a ton of citations.

• Subanesthetic doses of ketamine produce psychedelic effects in healthy volunteers. (From PMID 9447860)
• the term psychedelic drugs includes both classic hallucinogens [i.e., indolalkylamines and phenylalkylamines, such as lysergic acid diethylamide (LSD) and mescaline, respectively], "dissociative" drugs [i.e., arylcyclohexamines, such as phencyclidine (PCP) and ketamine]...(The American College of Neuropsychopharmacology. Neuropsychopharmacology:The Fifth Generation of Progress by Henry David Abraham, Una D. Mccann, And George A. Ricaurte. [19] Chapter 108])
• The term 'psychedelic,' taken from Osmond (1957), is used here to refer to a group of substances whose primary effect on human subjects is the radical alteration of consciousness, perception, and mood. They have been variously called 'psychotomimetic,' 'hallucinogenic,' 'psychotogenic,' 'consciousness-expanding,' or 'mysticomimetic.'...The relationship of these drugs to Ditran and Sernyl is less well understood, but they are alike in producing 'psychotic-like' hallucinatory episodes in which contact is maintained and which may result in reintegration and insight (English, 1962). For the purposes of this paper, they will be assumed to be sufficiently alike to warrant searching for common or parallel pharmacological mechanisms. ( From The Pharmacology of Psychedelic Drugs, by Ralph Metzner (found in Issue 1 of Psychedelic Review, Summer 1963, pp. 69-100)
• Dextromethorphan, contained in many non-prescription cough medicines, will produce a heavy psychedelic trip, but the nausea characteristic of opiates may constitute a problem. (p. 165 of Psychedelic Chemistry, Michael Valentine Smith; contained in the chapter "Miscellaneous Psychedelics")
• A VARIETY of names have been proposed for the group of drugs most popularly called "hallucinogens." Names such as psychotomimetic, psycholytic, psychedelic, schizophrenogenic, cataleptogenic, phantastica, or mysticomimetic have been suggested at one time or another to emphasize a particular aspect of the reactions....From a chemical point of view, we can classify the hallucinogens roughly into three groups....he third group is a chemically heterogeneous group and its psychological effect in man is distinctly different from that of mescaline or LSD. Among the many pi-peridyl glycollates, the one called "ditran" in doses of 10-20 mg. produces a pattern of somatic and psychological symptoms which is distinctly different from the pattern produced by the typical hallucinogens. The most striking difference is a complete loss of contact with the environment and a considerable amnesia for the hallucinatory period. (Szara, The Hallucinogenic Drugs-Curse or Blessing?, American Journal of Psychiatry, Vol 123, June 12, 1967, 1513-1518)

He goes on to include not only ditran (an anticholinergic) but also THC and PCP.

• The State of Sensory Awareness is produced by any psychedelic drug - LSD, mescaline, psilocybin, MDA, yaje, hashish, Sernyl, DMT... (Timothy Leary, The Politics of Ecstasy, p. 45, 1998 edition, Ronin publishing)

Sernyl was a 1950's name for PCP.

• At present, a definition of psychedelics, acceptable to the majority of qualified experts, does not exist...[t]here seems to be agreement about the 'recognition' of LSD, mescaline and derivatives such as TMA, psilocybin (the chief active ingredient of the magic or sacred mushroom of Mexico) as well as psilocin, dimethyltryptamine (DMT), Ditran (or JB-329), Sernyl (or phencyclidine), DET, peyote buttons, and morning glory seeds. In the "doubtful" category are other substances and compounds, such as harmine, harmaline, adrenolutin, adrenochrome, carbon dioxide, nitrous oxide. And the oldest of all consciousness-altering drugs, marihuana (hashish), is in the process of revaluation. (Bates, Psychedelics and the Law, The Psychedelic Review, volume 1, number 4, 1964)

PCP isn't even in the "doubtful" category.

• Widespread use of phencyclidine as a psychedelic agent by the drug subculture in the United States is now generally acknowledged. (Domino, Neurobiology of Phencyclidine; [20])
• Presents a brief history of the clinical and street use of phencyclidine. The physiological effects of the drug are noted to vary widely with dose, from alcohol-like intoxication at low doses to analgesia and anesthesia at large doses. The effects on psychological functioning appear to be progressive disintegration with the S reporting decreasing ability to integrate his experiences and sensations. Ss reported increasing apathy and feelings of isolation. Research comparing the state produced by phencyclidine with that of schizophrenia is noted. Clinical management of phencyclidine intoxication is outlined. (Reed, Alan; Kane, Andrew W; Phencyclidine (PCP): Another illicit psychedelic drug., Journal of Psychedelic Drugs, 1972 Fall Vol. 5(1) 8-12))

Note the article title and the name of the journal in which it appears.

• Certain features of the PCP psychosis, namely the neurologic abnormalities, dose-related severity of symptoms, and regularity of the length of illness, are not noted with other psychedelic drugs (Fauman, Beverly; Aldinger, Glenn; Fauman, Michael; Rosen, Peter, Psychiatric sequelae of phencyclidine abuse., Clinical Toxicology, 1976 Vol 9(4) 529-538)
• Police and federal drug agents capped a yearlong probe with the seizure of a gallon of the psychedelic known as PCP, said to be worth at least $30,000, and the arrest of three men in a major drug distribution ring. (Coakley, Tom, Raids Allegedly Crack Top 'Angel Dust' Ring, Boston Globe, Sep 4 1990; p 48 col 5)
• Known as angel dust in the 1970s, PCP, or phencyclidine, gave users superhuman strength and a numbing calm. But the addictive, psychedelic drug also made many paranoid, violent and completely out of touch with reality; they leapt off roofs and broke out of handcuffs with their bare hands. (Smalley. Suzanne; Rosenberg, Debra, 'I Felt Like I Wanted to Hurt People', Newsweek, July 22, 2002)
• From Peter Stafford's Psychedelic Encyclopedia:

Stafford discusses a number of substances I do not consider psychedelics.

In the years intervening since the last edition, ketamine hydrochloride has come to be regarded by many of those involved in this area of study as a unique, significant, and bona fide - if somewhat hazardous - psychedelic. Therefore new front matter of additional information about this compound appears in this volume. (III-24)

In the section Notes on Ketamine: [A]nother [user] reports a battle while under the effects of this psychedelic with persistent anal bleeding, the result being a two-month remission of the condition. Interest in ketamine has recently grown within the psychedelic and alternative spirituality movements as well as in "recreational" contexts ... ketamine has nonetheless earned a reputation as something of a "psychedelic heroin" in spite of its apparent positive potentialities. (III-55)

• ...Ketamine is a very powerful psychedelic substance... (Grof, The Adventure of Self-Discovery, p. 281)
• Ketamine hydrochlorid [sic], a substance combining anesthetic and psychedelic properties, is extremely interesting from the heuristic point of view. It opens access to most extraordinary realms of experiences, offers remarkable philosophical and spiritual revelations, and mediates fascinating insights into the cosmic processes by which reality itself is created. ... Ketamine ... seems to be the least interesting psychedelic substance from the therapeutic point of view... (Ibid. pp. 295-296)
• It is sometimes said that ketamine is not a psychedelic drug because it has anesthetic and addictive properties not seen with LSD, DMT, psilocybin, and mescaline. Nevertheless, it can access all of the realms of consciousness mapped out by psychiatrist Stanislav Grof on the basis of LSD research. (Jansen. Ketamine: Dreams and Realities., p. 42)
• The substance referred to in the second edition of this book as "Vitamin K" is Ketamine, a short acting psychedelic recommended for use in the isolation tank. (Lilly, The Scientist, third edition, p. xv)
• Psychedelic therapy has shown enormous potential to decouple minds from various kinds of captivity. Ketamine has been used successfully in St. Petersburg, Russia, to separate heroin addicts from their abusive habits. (Tikkun magazine's March/April 2007 edition)
• Last year two top journals, the Archives of General Psychiatry and the Journal of Clinical Psychiatry, published papers showing clear benefits from the use of psychedelics to treat mental illness. Both were small studies, just 27 subjects total. But the Archives paper--whose lead author, Dr. Carlos Zarate Jr., is chief of the Mood and Anxiety Disorders Research Unit at NIMH--found "robust and rapid antidepressant effects" that remained for a week after depressed subjects were given ketamine (colloquial name: Special K or usually just k). (From Time magazine May 2007)
• This review describes the medical, research and recreational uses of ketamine, an anaesthetic derivative of phencyclidine that has dissociative, analgesic and psychedelic properties....At low doses, stimulant effects predominate and the effect of environmental conditions are significant; with higher doses, psychedelic effects predominate and the effect of the environment diminishes. (From PMID 16529526)

I'm absolutely sure that no matter how you look at it, dissociatives are referred to as "psychedelic" in the medical literature. The term is NOT suitable as a definite classification of drugs. I suggest you replace "psychedelic" with "5-HT2A Agonist", and you exclude the "borderline" psychedelics like THC and MDMA (which aren't even really hallucinogenic, bringing us back to the psychotomimetic argument). Jolb 14:56, 19 July 2007 (UTC)

Text from a discussion about the Osmond defense

Thoric has repeatedly cited Humphry Osmond to defend his organization. Here's the text from an argument we recently had about that:

Also, I feel that "psychedelic" is not a real classification of drugs, and there's no universal scientific definition for it. Its meaning has changed substantially over time since it was coined before the advent of psychopharmacology, and it's taken on a whole new meaning that could apply to: 1) a specific group of 5-HT2A drugs or 2) a broader definition including THC and salvia or 3) any kind of mind-manifesting drug or 4) any kind of visionary state or 5) trippy music/art/movies. Because "psychedelic" is never used consistently, I say that it's less POV to use unequivocal pharmacological classifications... Why shouldn't we scrap that term as a class and use something less POV?

"Psychedelic" does have an inclusivity that is agreed upon by many authoritative experts in the field. While I agree that some have a wider inclusivity, and some have a more narrow one, you will have to agree that the most narrow is #1, and that #2 is fairly conservative and would be acceptable to the majority. --Thoric 07:26, 17 July 2007 (UTC)

I don't know... My guess is that most experts would say #3, and within that, there'd be an argument for what drugs are indeed mind-manifesting. Alternatively, I'd say #1 is the most widespread, since #2 (in the middle of those) seems outdated and arbitrary because we now know that the pharmacology of drugs like THC and Salvinorin are completely different from LSD, the archetype for that kind of "psychedelic" drug. Honestly, Thoric, you must realize that if you consider smoking weed a "psychedelic drug experience," then why isn't smoking opium? I bet that most people would agree that opium (and the opium "nod") is more hallucinatory and mind-manifesting than being stoned (Ask Samuel Taylor Coleridge, who wrote about his visionary opium dreams). Most psychedelics are also entheogens... but not weed. Weed is also euphoric, relaxing, and conducive to watching Beavis and Butthead--not much like LSD, in my opinion.

Opium is not far off from the dissociatives. What separates it is the narrow window of achieving the "nod", the high risk of addiction, as well as the risk of respiratory failure from overdose. "Weed" does not carry the risk of death. --Thoric 08:24, 17 July 2007 (UTC)

Oh, I see now... You're going by the Lester Greenspoon definition? I think that his definition is kind of narrow... It's also just one definition among MANY possible definitions, and I don't think you should favor it over others. Jolb 14:27, 17 July 2007 (UTC)

When you cross reference the narrow definitions with the wide spectrum definitions, the end result is the definition which I am going by. --Thoric 16:16, 17 July 2007 (UTC)

I think that qualifies as original research... Jolb 17:38, 17 July 2007 (UTC)

Not if I can cite publications which support the same conclusion. --Thoric 19:13, 17 July 2007 (UTC)

Well then do so. Show me all the citations that led to this organization. It's a pity it isn't already cited. Jolb 02:32, 18 July 2007 (UTC)

Seriously, the only reason THC and other drugs that aren't 5-HT2A agonists are considered "psychedelic" is because Humphry Osmond used the term to describe all his favorite drugs years before anybody understood psychopharmacology. I think any neuroscientist would laugh at a group of drugs that consists entirely of serotonergic hallucinogens except for ONE cannaboid receptor agonist and ONE kappa-opioid receptor agonist thrown in. So I'd say #1 is specific enough to not have random drugs thrown in, and #3 is general enough to include most mind-manifesting drugs. #2 is like a European Union that includes Australia. Jolb 07:53, 17 July 2007 (UTC)

Humphry Osmond coined the term, therefore I would consider him more authoritative than most. As for salvia, it is not under my psychedelic grouping. I have told you time and time again that it is a dissociative. THC is currently riding the line between psychedelic and dissociative. The only reason that is fell into the "psychedelic" side of things is because of its strong synergism with the serotonergic psychedelics, that its effects rarely involve putting one into an unresponsive stupor, and also its strong association with everything "psychedelic". --Thoric 08:24, 17 July 2007 (UTC)

He did coin the term, but under his definition, a bunch of disparate drugs are "psychedelic." Look at some Osmond quotes from 'A Review of the Clinical Effects of Psychotomimetic Agents:

• The great William James endured much uncalled-for criticism for suggesting that in some people inhalations of nitrous oxide allowed a psychic disposition that is always potentially present to manifest itself briefly. Has our comparative neglect of these experiences, recognized by James and Bergson as being of great value, rendered psychology stale and savorless?
• There are such substances as soma, hashish, cohoba, ololiuqui, peyote, the Syrian rue, the caapi vine, the fungus teonanacatl, the two Amanitas, pantherina and muscaria...
• Methedrine, as I have already indicated, prolongs and reactivates the LSD-25 model. According to a drug addict, Benzedrine in large doses, dissolved in black coffee, is very like mescaline in effect.

So according to Osmond, psychedelic includes: psilocybin, DMT, LSA, mescaline, but also THC, muscimol, nitrous oxide, amphetamine, and methamphetamine. It's clear that his initial papers didn't have a fully-formed view of what a "psychedelic drug" was... That or he was a proponent of the #3 definition. Jolb 14:27, 17 July 2007 (UTC)

While Osmond recognized the potential for psychedelic effect and experience from many substances beyond the original mescaline, LSD and psilocybin, this does not mean that he considered them to all be referred to as "psychedelic drugs". --Thoric 16:13, 17 July 2007 (UTC)

Well, I can find no other places where he explained what he considered "psychedelic drugs." I don't think such a list exists aside from the ones I cited. If I'm right on that assumption (that he never made a list), even though he is an authority, he never published anything to support your #2 definition, but my citations point to the #3 definition. Jolb 17:38, 17 July 2007 (UTC)

Also, the association between weed and everything psychedelic seems to me to be more of a historical phenomenon than an actual similarity between the drugs. The only thing psychedelic about weed is that it does at least alter perception a little without the risk of death or serious addiction, something the early hippies sucked into their grand "psychedelic" movement, but the same thing could be said of other drugs like nitrous oxide (which the hippies have latched onto now.) Jolb 14:33, 17 July 2007 (UTC)

I consider cannabis to be between the psychedelics and the dissociatives, and only leaning towards psychedelic for the reasons I mentioned. It does have the potential to cause a full blown psychedelic experience in some people when ingesting large doses. --Thoric 16:13, 17 July 2007 (UTC)

Alcohol also has the potential to cause full blown psychedelic experiences. So does a knock on the head. So do ketamine, PCP, and DXM.

Correct. I do not personally consider THC (on its own) to be what I would personally call as "psychedelic drug". I would call it either a "fringe psychedelic" or a quasi-psychedelic. It is only based upon consensus that the psychedelic category is where it fit best (as opposed to dissociative or deliriant). --Thoric 19:12, 17 July 2007 (UTC)

My humble opinion is that the cannabis experience is completely unique, but if anything, it is closest to the likes of ecstasy because of enhanced sensations like music euphoria, food tasting delicious, and sensitivity to being touched. Jolb 17:38, 17 July 2007 (UTC)

If we consider MDMA to be psychedelic, then why not cannabis? I feel both MDMA and cannabis to be "fringe" psychedelics. As the term was coined to refer to mescaline-like drugs, such drugs (mescaline, LSD, psilocybin) should be at the heart of the radius. The less similar a drug is to those, the further it should be away from the center, and the more towards another classification it should be. This is why THC is in the middle between psychedelics and dissociatives, and also why MDMA is closer to the stimulants. --Thoric 19:12, 17 July 2007 (UTC)

I do not consider MDMA any more of a psychedelic than THC. To me, both of them fall under the #3 definition, but they obviously do not fall under the #1 definition. These two substances highlight the need for a different term for that category of drugs. Jolb 15:39, 19 July 2007 (UTC)

Dissociative

I also have a problem with the dissociative category. I think it should only include NMDA receptor antagonists.

I'll copy over the discussion that Thoric and I recently had at Talk:Psychedelics, dissociatives and deliriants#Big problem with this article:

Big problem with this article

In line with the constant disputes Thoric and I have had, I feel that this article is incomplete due to its POV classification of "Psychedelics." The Dissociatives category serves as a catch-all for anything that doesn't qualify as a psychedelic, and therefore drugs like PCP, ketamine, and DXM, which are medically considered "dissociative anesthetics" [21], are grouped with deliriants, salvinorin A, and muscimol.

The "dissociative" group includes all dissociatives, of which the "dissociative anesthetics" are given their own special subgroup. Why are you unable to understand the concept of subgroups? Is it beyond your ability to understand that a tangerine and a lemon are both citrus fruits even though they taste completely different? --Thoric 18:08, 16 July 2007 (UTC)

A case can be made for those drugs, and I've seen what Thoric has to say, but I believe none of them qualify as true dissociatives--true dissociatives have a definite medical pathway through the NMDA systems. See NMDA receptor antagonist. Since the definition for dissociative anesthesia is clearly synonymous with NMDA receptor antagonism, anticholinergics, kappa-opioid receptor antagonists, and GABA agonists should not qualify as dissociatives.

We aren't talking about "true dissociatives", we're talking about drugs that cause dissociation. --Thoric 18:08, 16 July 2007 (UTC)

Not only is there a medical difference, but the subjective effects of those drugs are completely different from dissociatives. Most obvious to me is muscimol; I've had friends who've tried amanitas, and I was able to talk to them during their trip about their OEVs... obviously that kind of experience is more like classic psychedelics than dissociatives. I suggest we trash Thoric's whole classification since it's based on his disputed chart and start over with a "hallucinogen" article. Jolb 15:32, 16 July 2007 (UTC)

Sorry to disagree here, but Amanita experiences include both a dizzy inebriated awake experience which is consistently described as very different from psychedelics as well as a dissociative dream-like experience. Potential for delirium is also indicated. Please research things more carefully before making bold incorrect statements! --Thoric 18:08, 16 July 2007 (UTC)

Agreed, the experience is different from psychedelics, but dissociative experiences are normally associated with CEVs and incapacitation... Amanita experiences are marked by OEVs, awareness, alertness, and the ability to walk and talk normally--not quite dissociative. Jolb 21:00, 16 July 2007 (UTC)

This is dosage dependent. If you read enough amanita experience reports, you will see that the alert, aware portion is only that -- a portion of the experience. Another major portion is drowsiness, and depending on the person and the dosage, often involves a stage where the user falls into an unrousable sleep. I would not be opposed to placing this closer to the overlap between psychedelics and dissociatives, but from all the experience reports I have read, the most common theme is how markedly different the experience is from psilocybin mushrooms, and also reports of drowsiness, vivid dreams, dissociation and delirium. --Thoric 21:37, 16 July 2007 (UTC)

I think our new article should be called "Hallucinogens," and will be less based on this three-pronged organization (which isn't really based on the medical consensus.) Then, each section could explain a different pharmacologic pathway for hallucinations. We could have the following sections:

• 5-HT2A serotonergic hallucinogens including what's in "psychedelics" here
• NMDA receptor antagonists including the true dissociatives
• Anticholinergics including the true deliriants
• Kappa-opioid receptor agonists, salvinorin A
• GABA agonists, muscimol and ibotenic acid

etc.

Above you complain that all the drugs that are labeled as dissociatives aren't "true dissociatives" (even though they all produce dissociation), yet now you want to label all of these drugs as "hallucinogens", even though a great deal of them do not produce hallucinations whatsoever. Hallucinogen is certainly not the correct label for MDMA. --Thoric 18:08, 16 July 2007 (UTC)

They produce dissociation? Citations, please.

Here you go: [22]

...there are a number of drugs capable of producing a toxic delirium that features hallucinations. These potent dissociative agents are generally much more dangerous than the psychedelics. Atropine and scopolamine, anticholinergic dissociative agents, are found in a number of plants belonging to the Solanaceae family that grow wild in the States. These include Datura stamonium (Jimson weed), Atropa belladonna (deadly nightshade), and Mandragora officinarum (mandrake), and Hyoscyamus niger (henbane). Of these, only plants of the genus Datura are native to the United States. Mushrooms of the genus Amanita contain the dissociative agents ibotenic acid, muscimol, and muscazone.

Also, I don't think that MDMA qualifies in any of those categories listed above (nor did I mean to give that impression... it is a serotonin releaser and not a 5-HT2A agonist.) I think MDMA is rightfully classified otherwise. However, I think that MDMA could justifiably be considered a "psychedelic," but "psychedelic" is a controversial term that we shouldn't use as a classification. Jolb 20:57, 16 July 2007 (UTC)

This organization avoids classifications. Even if such classifications are referenced, they're arbitrary, and wikipedia should stick closer to universal truths as opposed to referenced opinions. Jolb 15:47, 16 July 2007 (UTC)

Jolb's citations

I say that dissociative only applies to NMDA receptor antagonists, not muscimol, anticholinergics, or salvinorin-A.

[23] Lists only PCP and ketamine as dissociatives.

[24] Look at Table 3 about halfway down. Anticholinergics are distinct from dissociatives, and dissociatives include only NMDA receptor antagonists.

[25] Not a very good citation, but this book on dissociative dependence only talks about NMDA receptor antagonists, not salvinorin, muscimol, or deliriants.

I'll list more later.Jolb 21:16, 16 July 2007 (UTC)

Just because a certain list doesn't include certain things does not mean that they are specifically excluded. Also, the anticholinergics are special enough to have their own subcategory, but they still produce dissociation, and have been described (in cited articles) as "potent dissociatives". Why do you think that you spending a few minutes with a search engine is in any way comparable to years worth of research that I have done with numerous texts? I have put a great deal of research into these classifications -- research. I didn't pull them out of my ass. I've been researching these things actively for the past ten years. You start drinking cough syrup last year, and now you are an expert? Please have a little more respect for others. --Thoric 21:43, 16 July 2007 (UTC)

Always with the ad hominem attacks...

Anyway, my citations are far more in-line with wikipedia policies than your "great deal of [original] research." You cited anticholinergics, and I'll let that go for now, but what about muscimol? I'm less concerned with salvinorin, but you should provide some more citations there.

I've also cited musimol -- re-read the citation above. My research is not "original", as it is straight from peer-reviewed publications. --Thoric 07:26, 17 July 2007 (UTC)

Thoric did not cite his sources, however. Jolb 15:28, 19 July 2007 (UTC)

WTF? What do you think [26] is??? Anyways, this is not the place for battle, this page is to list supporting references for the chart. Why is it be cluttered up with opposing arguments? --Thoric 15:38, 19 July 2007 (UTC)

The link is to a PubMed reference of an article, you have to read the article itself. I put a summary of it right afterwards... just look up a few paragraphs. Halpern specifically labeled the amanitas as "dissociatives", and the tropanes/deliriants as "powerful dissociatives". --Thoric 15:49, 19 July 2007 (UTC)

You're right, I re-read what you posted...

But that still leaves out salvinorin... Plus, one citation isn't adequate to describe a universal categorization of drugs... you should give at least one or two more, especially since I have three that contradict your one. Jolb 15:50, 19 July 2007 (UTC)

What about salvinorin? The guy who devoted his whole life to working with and researching the stuff (Daniel Siebert) considers it to be a dissociative [27]. I'll get you some more references. --Thoric 14:54, 20 July 2007 (UTC)

Alright Thoric, I'll concede this one, but I do think you should find more than one reference about muscimol and deliriants. Jolb 15:50, 21 July 2007 (UTC)

This page is not for arguing

The point of this page was to list supporting references for the diagram, not to argue against it -- hence the title "diagram references". We need to be able to put supporting references all in one nice neat place, and if you want to have opposing references, at least put them all in their own section, or on another page. I also do not feel that this is the correct place to bring the psychedelic/dissociative battle. That is another can of worms. --Thoric 15:36, 19 July 2007 (UTC)

Thoric, I believe this is the perfect place to hash out (no pun intended) any debates about the chart. You should be happy that we're trying to work this stuff out instead of outright deleting the chart. Jolb 15:40, 19 July 2007 (UTC)

I'm not trying to say that these things should not be debated, just that we need a place where all the supporting references can be put together in a readable fashion. If they are all mixed in with disagreements, then it is very difficult to read. I am only requesting that the supporting references be separated from the contrasting references so that it is not such a mess. BenB4 is particularly guilty as instead of putting a single "all the above references here are not peer-reviewed", he repeated, "this is not peer-reviewed" after every single entry in an almost graffiti-like way. --Thoric 15:45, 19 July 2007 (UTC)

Lol, Thoric, you're also guilty of inserting short snippits into other people's long paragraph-style posts. Regardless, I don't think this is the place for putting all the citations, that should be in an article namespace or even right on the Psychoactive Drug article. This page is a talk page, and it is therefore here for discussion. Jolb 15:53, 19 July 2007 (UTC)

The article should only contain standard citations, which do not include quoted text. We cannot fill the article with hundreds of lines of supporting text. Once we have a list of accepted quoted citations, we can keep it in one place for people to review if they have issues. The diagram section of the article can contain standard citations. Again, I am not against discussion, only that we need a concrete list of supporting citations organized such that people can see them clearly. --Thoric 16:21, 19 July 2007 (UTC)

Well we can discuss them here and then create the page Psychoactive drug/diagram references for all the references once the issues are resolved. We should continue to discuss here, however. Jolb 17:09, 19 July 2007 (UTC)

Works for me. --Thoric 18:12, 19 July 2007 (UTC)

Make the changes!

Thoric, there are changes here you seem to have agreed to, and there are other discussions where you haven't provided any/enough citations to defend certain drugs' placement. Therefore, until you make the changes, we have citations stating otherwise, and since you're the only one capable of changing the chart, you should make the changes! It seems like you should change "Hallucinogens" to "Psychotomimetics," and you should either change or defend "alcohol," "psychedelic," "ketamine," and "fluoxetine and other SSRIs," as you're currently losing in those citation battles. Jolb 07:22, 20 July 2007 (UTC)

While you may have the summer off, some people have to work very busy, demanding jobs. I haven't finished acquiring citations to support some of these positions, and as for the changes, I wasn't sure any consensus had been reached. Chill out. --Thoric 14:48, 20 July 2007 (UTC)

Hello all. Time permitting, I should be able to make any agreed-upon changes (to the base graphic or the text labels) if Thoric is unavailable. heqs ·:. 12:56, 21 July 2007 (UTC)

Well since Thoric basically left this conversation, I think you should make all the changes that seem supported on this talk page. Then you can start adding the references you use to Psychoactive drug/diagram references Jolb 15:45, 24 July 2007 (UTC)

Left this conversation? When did that happen? I said above (only four days ago) that consensus hasn't been reached on most of these issues. About the only thing that more than one person has agreed upon is that "psychotomimetic" may be a better term than "hallucinogen". It would, however, be a good idea to get at least one other person to agree with that idea, and if agreed, we should also make global changes to reflect that. --Thoric 16:28, 24 July 2007 (UTC)

This page should not be in mainspace

I will move and userfy this page if need be, otherwise it should be deleted as we don't have subpages like this in mainspace. Casliber (talk · contribs) 00:29, 28 August 2009 (UTC)

Yes, please move / delete. This is not an allowed use of subpages.--Fabrictramp | talk to me 19:00, 30 August 2009 (UTC)

Okay, I moved it/them (talk page included). Can someone with access please delete the resulting mainspace redirects? --Thoric (talk) 18:23, 1 September 2009 (UTC)