PCP
PCP is a dissociative anesthetic of the arylcyclohexylamine class, originally introduced as a medical anesthetic roughly sixty years ago, though most of its use has since occurred outside clinical settings.1 It functions primarily as an NMDA receptor antagonist.12 PCP is commonly associated with erratic and sometimes violent behavior, though such incidents likely reflect overdose cases rather than typical use.1 Caution is warranted due to reports of mania, psychosis, and habit-forming potential.34
Contents
Dosage & Duration
Dosage
Duration
Subjective Effects
PCP produces a dissociative anesthetic state combining detachment from the body and surroundings with physical euphoria and a degree of stimulation uncommon among dissociatives. It is notably more likely than related dissociatives to produce psychotic reactions; in clinical studies of anesthetic doses, agitation or hallucinations occurred in up to half of patients, and lasting mental disturbances in roughly a sixth. High doses carry a real, though not typical, risk of dangerous psychotic and manic states, which underlie the drug's reputation for erratic and occasionally violent behavior in overdose.
Physical
The body feels numbed and anesthetized, with pronounced loss of motor coordination that can render walking difficult. Unlike most dissociatives, a stimulating physical energy is often present alongside the sedating and ataxic effects, which are strongly potentiated by depressants.
Dissociative
Cognitive
The headspace is dissociated and can be euphoric and confident, but is unusually prone to tipping into agitation, delusional thinking, mania, or outright psychosis, particularly at high doses. Caution is strongly recommended given the volume of reports of manic episodes and related psychosis.
Emotional
Psychological
PCP is more likely to produce psychotic reactions than other dissociatives, and dangerous psychotic states are possible at high doses.
Visual
Hallucinatory States
Hallucinations are considerably more common on PCP than on most other dissociatives, occurring in up to 50% of patients given anesthetic doses in clinical studies.
Tactile
Touch is progressively suppressed and anesthetized as the dissociative state deepens.
Reagent Testing
Loading reagent data
Pharmacology
Pharmacodynamics
PCP acts primarily as a noncompetitive NMDA receptor antagonist, binding to a site within the ion channel that is accessible only when the channel has been opened by a coagonist such as glycine.5 It also functions as a potent partial agonist at dopamine D2 receptors (specifically the high-affinity state) and inhibits dopamine reuptake, leading to increased extracellular dopamine levels.67 PCP additionally shows high affinity for the σ2 receptor and inhibits nicotinic acetylcholine receptors.8 Binding data indicate high selectivity for the NMDA receptor (Ki = 59 nM at the dizocilpine site) and σ2 receptor (Ki = 136 nM), with affinity exceeding 10,000 nM at most other assayed targets aside from the serotonin transporter (Ki = 2,234 nM).8
Pharmacokinetics
PCP is both water- and lipid-soluble, allowing rapid distribution throughout the body.9 It undergoes extensive first-pass hepatic metabolism, with approximately 90% metabolized via oxidative hydroxylation during the initial pass through the liver.10 The resulting metabolites are glucuronidated and excreted renally, while roughly 9% of an ingested dose is excreted unchanged in urine.9
Dangerous
Highest riskThese combinations are considered extremely harmful and should always be avoided. Reactions to these drugs taken in combination are highly unpredictable and have a potential to cause death.
Unsafe
AvoidThere is considerable risk of physical harm when taking these combinations, they should be avoided where possible.
Caution
Use cautionThese combinations are not usually physically harmful, but may produce undesirable effects, such as physical discomfort or overstimulation. Extreme use may cause physical health issues. Synergistic effects may be unpredictable. Care should be taken when choosing to use this combination.
Tolerance
Other dissociatives
Harm Potential
Addiction & Dependence
Psychological
ModeratePCP is classified as habit-forming and is known to cause addiction with excessive use. It induces ΔFosB expression in the nucleus accumbens and has rewarding and reinforcing effects mediated in part by NMDA receptor blockade in dopaminergic pathways.11
Toxicity
Neurotoxicity is a concern with PCP, particularly at high doses and with frequent use, though the clinical significance in humans remains controversial. Animal studies have shown that high doses of NMDA receptor antagonists can cause reversible vacuoles in brain tissue (Olney's lesions), but these findings are from non-human animals and may not directly apply to humans.12
Rhabdomyolysis (muscle breakdown) is described as a not-unusual manifestation of PCP toxicity and may occur during intoxication.14
Psychosis Risk
PCP is more likely to produce psychosis compared to other dissociatives. Studies found agitation or hallucinations in up to 50% of patients at anesthetic doses, with greater psychiatric issues in approximately 17%. Recreational doses occasionally induce psychotic states with emotional and cognitive impairment resembling schizophrenic episodes.14 A 2019 review found that 26% of those diagnosed with hallucinogen-induced psychosis (including PCP) later transitioned to a schizophrenia diagnosis.15 High doses have been associated with dangerous psychotic states, including paranoia, delusions, and suicidal impulses.14 Flashbacks may occur despite stopping usage.
Seizure Risk
High doses and overdoses may lead to convulsions and seizures. Benzodiazepines are the drugs of choice for controlling seizures when present during PCP intoxication.142 Certain antipsychotics such as phenothiazines may lower the seizure threshold and are not preferred for managing PCP-induced psychosis.14
History & Culture
Discovery and Medical Development
Phencyclidine was first synthesized in 1926 by German chemist Arthur Kötz and his student Paul Merkel during research involving Grignard reactions with piperidinocyclohexancarbonitrile compounds. The compound remained largely unexplored until 1956, when chemist H. Victor Maddox independently…
Legality
International
UN Convention on Psychotropic Substances 1971: scheduled
By Country
References
Source Pages
Citations
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Further Reading
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