Dissociatives, colloquiallydissos, are a subclass ofhallucinogens that distort perception of sight and sound and produce feelings of detachment – dissociation – from the environment and/or self. Although many kinds of drugs are capable of such an effect, dissociatives are unique in that they do so in such a way that they producehallucinogenic effects, which may includedissociation, a general decrease insensory experience,hallucinations,dream-like states oranesthesia.[1]
The effects of dissociatives can include sensory dissociation, hallucinations,mania,catalepsy, analgesia and amnesia.[4][5][6] According to Pender (1972), "the state has been designated as dissociative anesthesia since the patient truly seems disassociated from his environment."[7] Both Pender (1970) and Johnstone et al. (1959) reported that patients under anaesthesia due to eitherketamine orphencyclidine were prone to purposeless movements and had hallucinations (or "dreams"[8]) during and after anaesthesia. Some patients found the hallucinations euphoric while others found them disturbing.
At sub-anesthetic doses, dissociatives alter many of the same cognitive and perceptual processes affected by other hallucinogenic drugs such asmescaline,LSD, andpsilocybin; hence they are often contrasted and also consideredhallucinogenic.[9][10][11] Perhaps the most significant subjective differences between dissociatives and theclassical hallucinogens (such asLSD andmescaline) are the detaching effects, including:depersonalization, the feeling of being unreal, disconnected from one's self, or unable to control one's actions; andderealization, the feeling that the outside world is unreal or that one is dreaming.[12]
Many dissociatives such asketamine are used asanesthetics forsurgery or pain relief in medical contexts such as in hospitals. However, due to possiblepsychotomimetic reactions they are sometimes used reluctantly.[13][14] Certainmorphinan dissociatives such as dextromethorphan are also used in sub-psychoactive dosages tosuppress coughing.[15]
Some dissociative drugs are used recreationally.Ketamine andnitrous oxide areclub drugs.Phencyclidine (PCP or angel dust) is available as a street drug.Dextromethorphan-based cough syrups (often labeled DXM) are taken by some users in higher than medically recommended levels for their dissociative effects. Historically,chloroform anddiethyl ether have been used recreationally.
^Giannini, AJ; Eighan, MS; Loiselle, RH; Giannini, MC (1984). "Comparison of haloperidol and chlorpromazine in the treatment of phencyclidine psychosis".Journal of Clinical Pharmacology.24 (4):202–4.doi:10.1002/j.1552-4604.1984.tb01831.x.PMID6725621.S2CID42278510.
^Giannini, A. James; Nageotte, Catherine; Loiselle, Robert H.; Malone, Donald A.; Price, William A. (1984). "Comparison of Chlorpromazine, Haloperidol and Pimozide in the Treatment of Phencyclidine Psychosis: Da-2 Receptor Specificity".Clinical Toxicology.22 (6):573–9.doi:10.3109/15563658408992586.PMID6535849.
^Mason, Oliver J.; Morgan, Celia J.M.; Stefanovic, Ana; Curran, H Valerie (2008). "The Psychotomimetic States Inventory (PSI): Measuring psychotic-type experiences from ketamine and cannabis".Schizophrenia Research.103 (1–3):138–42.doi:10.1016/j.schres.2008.02.020.PMID18387788.S2CID807162.
^Gouzoulis-Mayfrank, E.; Heekeren, K.; Neukirch, A.; Stoll, M.; Stock, C.; Obradovic, M.; Kovar, K.-A. (2005). "Psychological Effects of (S)-Ketamine and N,N-Dimethyltryptamine (DMT): A Double-Blind, Cross-Over Study in Healthy Volunteers".Pharmacopsychiatry.38 (6):301–11.doi:10.1055/s-2005-916185.PMID16342002.S2CID260241166.
^Vollenweider, F; Geyer, MA (2001). "A systems model of altered consciousness: integrating natural and drug-induced psychoses".Brain Research Bulletin.56 (5):495–507.doi:10.1016/S0361-9230(01)00646-3.PMID11750795.S2CID230298.
^Adams HA (December 1997). "[S-(+)-ketamine. Circulatory interactions during total intravenous anesthesia and analgesia-sedation]" [S-(+)-ketamine. Circulatory interactions during total intravenous anesthesia and analgesia-sedation].Der Anaesthesist (in German).46 (12):1081–7.doi:10.1007/s001010050510.PMID9451493.S2CID36323023.
^Rossi, S, ed. (2013).Australian Medicines Handbook. Adelaide: The Australian Medicines Handbook Unit Trust.ISBN978-0-9805790-9-3.[page needed]
^Sanacora G, Frye MA, McDonald W, Mathew SJ, Turner MS, Schatzberg AF, et al. (April 2017). "A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders".JAMA Psychiatry.74 (4):399–405.doi:10.1001/jamapsychiatry.2017.0080.PMID28249076.S2CID28320520.
^Marcantoni WS, Akoumba BS, Wassef M, Mayrand J, Lai H, Richard-Devantoy S, Beauchamp S (December 2020). "A systematic review and meta-analysis of the efficacy of intravenous ketamine infusion for treatment resistant depression: January 2009 - January 2019".J Affect Disord.277:831–841.doi:10.1016/j.jad.2020.09.007.PMID33065824.S2CID223557698.
^Midega, Thais Dias; Chaves, Renato Carneiro de Freitas; Ashihara, Carolina; Alencar, Roger Monteiro; Queiroz, Verônica Neves Fialho; Zelezoglo, Giovana Roberta; Vilanova, Luiz Carlos da Silva; Olivato, Guilherme Benfatti; Cordioli, Ricardo Luiz; Bravim, Bruno de Arruda; Corrêa, Thiago Domingos (2022)."Ketamine use in critically ill patients: a narrative review".Revista Brasileira de Terapia Intensiva.34 (2).doi:10.5935/0103-507X.20220027-en.PMC9354105.
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