Mechanism of psychoactive drugs mimicking the symptoms of psychosis
A drug with psychotomimetic (also known as psychotogenic) actions mimics the symptoms of
psychosis, including
delusions and/or
delirium, as opposed to only
hallucinations. Psychotomimesis is the onset of psychotic symptoms following the administration of such a drug.
Some rarely used drugs of the
opioid class have psychotomimetic effects. Particularly, mixed
kappa receptor agonist
mu receptor antagonist opioid analgesics can cause dose-related psychotomimesis.[1] This adverse effect, incidence 1–2%, limits their use.
Pentazocine and
butorphanol fall under this opioid class.[2]
There is evidence that
cannabinoids are psychotomimetic,[3] especially
delta-9-tetrahydrocannabinol (Δ9-THC). D'Souza et al. (2004) found that intravenous THC produced effects that resemble
schizophrenia in both the positive symptoms (hallucinations, delusions, paranoia, and disorganized thinking) and negative symptoms (
avolition,
asociality,
apathy,
alogia, and
anhedonia).[4] Certain strains of cannabis may be more psychotomimetic than others, probably due to the action of cannabidiol (CBD), which inhibits P450 3A11's metabolic conversion of THC to
11-Hydroxy-THC, which is four times more psychoactive.[5]p. 39
Carl Sagan used the word "psychotomimetic" in his anonymous article "Mr.X"[6] to describe the effects of
cannabis, writing that "I smile, or sometimes even laugh out loud at the pictures on the insides of my eyelids. In this sense, I suppose cannabis is psychotomimetic, but I find none of the panic or terror that accompanies some psychoses."
^Brenneisen R. Chemistry and analysis of phytocannabinoids and other Cannabis constituents. In: ElSohly MA (ed). Marijuana and the cannabinoids. Humana Press Inc: Totowa, New Jersey, 2007.
^Sagan, Carl.
"Mr. X". Marijuana-Uses.com. Retrieved November 8, 2012.