Phencyclidine (PCP) Use Disorder
Pp. 168-174 (7)
Subhash C. Bhatia and Aly Hassan
PCP is highly lipophilic dissociative anesthetic and a hallucinogen. This has
been available since early 1950s. Its recreational use started in 1960’s. It is smoked,
snorted or consumed orally. PCP works through NMDA receptor antagonism as well as
through direct and indirect dopaminergic effects leading to psychosis. Intoxication with
low to moderate dose produce numbness in the extremities, unsteady gait, slurred
speech, bloodshot eyes, horizontal, vertical or rotator nystagmus, tachycardia,
hypertension, elevation of body temperature, shallow breathing, dry skin, loss of
balance, muscle rigidity, agitation, aggression false sense of invulnerability and
superior strength leading to daring acts like jumping off of high building. A moderate
dose may produce analgesia and anesthesia. High dose may cause drop in blood
pressure, heart and respiratory rate, seizures, coma and death. The presence of
nystagmus may assist in differentiating PCP psychosis from other causes of psychoses..
Long-term effects of PCP may include “flash-backs”, similar to LSD, persistent speech
problems, memory impairment, chronic anxiety, depression or psychosis. There is no
specific PCP antagonist medication. Supportive care in an environment of reduced
sensory stimulation, urine acidification, and sedation with benzodiazepines is
recommended. For patients with psychosis antipsychotic medication may be warranted.
Psychosocial interventions add significant value.
Angel Dust, Dissociative Anesthetic, NMDA Receptor Antagonist,
PCP, Phencyclidine, Psychotomimetic drug.
Department of Psychiatry, Mental Health and Behavioral Sciences, Creighton University; Department VA Nebraska- Western Iowa Health Care System 4101 Woolworth Ave Omaha, NE 68105, USA.