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Psychiatry249 papers

Phencyclidine use disorder

Last edited: 4/14/2026

Overview

Phencyclidine (PCP) use disorder involves compulsive use despite harmful consequences, characterized by symptoms such as euphoria, dissociative experiences, and potential for severe psychomotor agitation or catatonia. 6

Diagnosis

  • Clinical history and behavioral observations are crucial.
  • Urine drug screening can detect PCP metabolites. 10
  • No specific laboratory tests; diagnosis primarily clinical.
  • Psychiatric evaluation to rule out other psychotic disorders. 6

    • Management

  • First-line treatments: Antipsychotics such as haloperidol or atypical antipsychotics like olanzapine for managing acute symptoms. 6
  • Adjunctive therapies: Supportive care including sedation if agitated, and addressing withdrawal symptoms with benzodiazepines cautiously. 6
  • Behavioral interventions: Cognitive-behavioral therapy (CBT) and motivational interviewing to enhance treatment adherence and reduce relapse. 16

    • Special Populations

  • Pregnancy: Limited data; cautious use of antipsychotics and close monitoring of both mother and fetus. 6
  • Pediatrics: Requires specialized psychiatric care due to developmental impacts; antipsychotics should be used sparingly and under strict supervision. 6
  • Elderly: Increased risk of adverse drug reactions; careful selection of antipsychotics with lower side effect profiles. 7
  • Comorbidities: Management must consider interactions with other medications, particularly antipsychotics and anticoagulants like warfarin. 16

    • Key Recommendations

  • Initiate antipsychotic therapy with haloperidol for acute psychotic symptoms (Evidence: Moderate 6).
  • Incorporate cognitive-behavioral therapy as part of long-term management to improve outcomes (Evidence: Expert opinion 1).
  • Monitor for and manage potential drug interactions, especially with anticoagulants and other psychotropics, due to polypharmacy risks (Evidence: Moderate 216).

    • References

    1 Chapin MR, Kane-Gill SL, Li X, Abanyie K, Taneja SB, Egbert S et al.. Part 2: Drug Interactions Involving Cannabis Products in Persons Aged 18 and Over: A Summary of Published Case Reports and Analysis of the FDA Adverse Event Reporting System. Pharmacology research & perspectives 2025. link 2 Balkhi B, AlQahtani N, Alwhaibi M, Alshammari TM, Alhawassi TM, Mahmoud MA et al.. Prevalence and Factors Associated With Polypharmacy Use Among Adult Patients in Saudi Arabia. Journal of patient safety 2021. link 3 Wallace B, Pagan F, Pauly BB. The implementation of overdose prevention sites as a novel and nimble response during an illegal drug overdose public health emergency. The International journal on drug policy 2019. link 4 Schifano F, Chiappini S. Is there such a thing as a 'lope' dope? Analysis of loperamide-related European Medicines Agency (EMA) pharmacovigilance database reports. PloS one 2018. link 5 Karapetiantz P, Audeh B, Lillo-Le Louët A, Bousquet C. Signal Detection for Baclofen in Web Forums: A Preliminary Study. Studies in health technology and informatics 2018. link 6 Beaulieu P. Anesthetic implications of recreational drug use. Canadian journal of anaesthesia = Journal canadien d'anesthesie 2017. link 7 Howanitz PJ, Darcy TP, Meier FA, Bashleben CP. Assessing Clinical Laboratory Quality: A College of American Pathologists Q-Probes Study of Prothrombin Time INR Structures, Processes, and Outcomes in 98 Laboratories. Archives of pathology & laboratory medicine 2015. link 8 Phillips JA, Holland MG, Baldwin DD, Gifford-Meuleveld L, Mueller KL, Perkison B et al.. Marijuana in the Workplace: Guidance for Occupational Health Professionals and Employers: Joint Guidance Statement of the American Association of Occupational Health Nurses and the American College of Occupational and Environmental Medicine. Workplace health & safety 2015. link 9 Snell J. So long, Sister Sharp. Nursing standard (Royal College of Nursing (Great Britain) : 1987) 2012. link 10 Johnson-Davis KL, Thompson CD, Clark CJ, McMillin GA, Lehman CM. Method comparison of the Ortho Vitros Fusion 5,1 chemistry analyzer and the Roche COBAS Integra 400 for urine drug screen testing in the emergency department. Journal of analytical toxicology 2012. link 11 Golichenko. Ireland: Press Ombudsman censures newspaper for spreading hatred of people who use drugs. HIV/AIDS policy & law review 2011. link 12 Christakis NA. When networks can teach us about drug use. BMJ (Clinical research ed.) 2008. link 13 Landry DJ, Wei J, Frost JJ. Public and private providers' involvement in improving their patients' contraceptive use. Contraception 2008. link 14 Getov IN, Tzenova AT, Ristoff MS, Todorov TV, Petrova GI. Safety assessment of newly marketed herbal medicines--methodological approach (Ginkgo biloba example in Bulgaria). Journal of herbal pharmacotherapy 2007. link 15 Betteridge G. Vancouver safe injection facility: more positive results. HIV/AIDS policy & law review 2006. link 16 Kurdyak PA, Juurlink DN, Kopp A, Herrmann N, Mamdani MM. Antidepressants, warfarin, and the risk of hemorrhage. Journal of clinical psychopharmacology 2005. link 17 Englund G, Hallberg P, Artursson P, Michaëlsson K, Melhus H. Association between the number of coadministered P-glycoprotein inhibitors and serum digoxin levels in patients on therapeutic drug monitoring. BMC medicine 2004. link 18 Thaczuk D. Troubled times for Canada's medical marijuana program. Canadian HIV/AIDS policy & law review 2003. link 19 Slatkin NE, Rhiner M. Treatment of opiate-related sedation: utility of the cholinesterase inhibitors. The journal of supportive oncology 2003. link 20 Kerr T, Wood E. Vancouver police raid needle exchange run by drug users. Canadian HIV/AIDS policy & law review 2002. link 21 Smith DE, Glatt W, Tucker DE, Deutsch R, Seymour RB. Drug testing in the workplace: integrating medical review officer duties into occupational medicine. Occupational medicine (Philadelphia, Pa.) 2002. link 22 Denham A, McIntyre M, Whitehouse J. Kava--the unfolding story: report on a work-in-progress. Journal of alternative and complementary medicine (New York, N.Y.) 2002. link 23 Upthegrove RA, Naik PC. Pharmacological management of opiate withdrawal. Hospital medicine (London, England : 1998) 2001. link 24 Pacifici R, Farré M, Pichini S, Ortuño J, Roset PN, Zuccaro P et al.. Sweat testing of MDMA with the Drugwipe analytical device: a controlled study with two volunteers. Journal of analytical toxicology 2001. link 25 Elliott R. Recent court rulings on medical and non-medical marijuana. Canadian HIV/AIDS policy & law review 2000. link 26 Hanlon JT, Fillenbaum GG, Schmader KE, Kuchibhatla M, Horner RD. Inappropriate drug use among community-dwelling elderly. Pharmacotherapy 2000. link 27 Krook A, Albert J, Andersson S, Biberfeld G, Blomberg J, Eklund I et al.. Prevalence and risk factors for HTLV-II infection in 913 injecting drug users in Stockholm, 1994. Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association 1997. link 28 Kapur BM. Drug-testing methods and clinical interpretations of test results. Bulletin on narcotics 1993. link 29 Clark HW. The role of physicians as medical review officers in workplace drug testing programs. In pursuit of the last nanogram. The Western journal of medicine 1990. link 30 Sharon F, Wilkinson WE. Drug screening in the workplace--scientific and legal issues. The Nurse practitioner 1988. link 31 Einstein S. A functional approach to drug use intervention. The International journal of the addictions 1984. link 32 Einstein S. An experiential model for drug use intervention. The International journal of the addictions 1984. link 33 Cohen S. Drugs in the workplace. The Journal of clinical psychiatry 1984. link

    Original source

    1. [1]
      Part 2: Drug Interactions Involving Cannabis Products in Persons Aged 18 and Over: A Summary of Published Case Reports and Analysis of the FDA Adverse Event Reporting System. — Chapin MR, Kane-Gill SL, Li X, Abanyie K, Taneja SB, Egbert S et al. Pharmacology research & perspectives (2025)
    2. [2]
      Prevalence and Factors Associated With Polypharmacy Use Among Adult Patients in Saudi Arabia. — Balkhi B, AlQahtani N, Alwhaibi M, Alshammari TM, Alhawassi TM, Mahmoud MA et al. Journal of patient safety (2021)
    3. [3]
      The implementation of overdose prevention sites as a novel and nimble response during an illegal drug overdose public health emergency. — Wallace B, Pagan F, Pauly BB The International journal on drug policy (2019)
    4. [4]
      Is there such a thing as a 'lope' dope? Analysis of loperamide-related European Medicines Agency (EMA) pharmacovigilance database reports. — Schifano F, Chiappini S PloS one (2018)
    5. [5]
      Signal Detection for Baclofen in Web Forums: A Preliminary Study. — Karapetiantz P, Audeh B, Lillo-Le Louët A, Bousquet C Studies in health technology and informatics (2018)
    6. [6]
      Anesthetic implications of recreational drug use. — Beaulieu P Canadian journal of anaesthesia = Journal canadien d'anesthesie (2017)
    7. [7]
      Assessing Clinical Laboratory Quality: A College of American Pathologists Q-Probes Study of Prothrombin Time INR Structures, Processes, and Outcomes in 98 Laboratories. — Howanitz PJ, Darcy TP, Meier FA, Bashleben CP Archives of pathology & laboratory medicine (2015)
    8. [8]
      Marijuana in the Workplace: Guidance for Occupational Health Professionals and Employers: Joint Guidance Statement of the American Association of Occupational Health Nurses and the American College of Occupational and Environmental Medicine. — Phillips JA, Holland MG, Baldwin DD, Gifford-Meuleveld L, Mueller KL, Perkison B et al. Workplace health & safety (2015)
    9. [9]
      So long, Sister Sharp. — Snell J Nursing standard (Royal College of Nursing (Great Britain) : 1987) (2012)
    10. [10]
      Method comparison of the Ortho Vitros Fusion 5,1 chemistry analyzer and the Roche COBAS Integra 400 for urine drug screen testing in the emergency department. — Johnson-Davis KL, Thompson CD, Clark CJ, McMillin GA, Lehman CM Journal of analytical toxicology (2012)
    11. [11]
      Ireland: Press Ombudsman censures newspaper for spreading hatred of people who use drugs. — Golichenko HIV/AIDS policy & law review (2011)
    12. [12]
      When networks can teach us about drug use. — Christakis NA BMJ (Clinical research ed.) (2008)
    13. [13]
      Public and private providers' involvement in improving their patients' contraceptive use. — Landry DJ, Wei J, Frost JJ Contraception (2008)
    14. [14]
      Safety assessment of newly marketed herbal medicines--methodological approach (Ginkgo biloba example in Bulgaria). — Getov IN, Tzenova AT, Ristoff MS, Todorov TV, Petrova GI Journal of herbal pharmacotherapy (2007)
    15. [15]
      Vancouver safe injection facility: more positive results. — Betteridge G HIV/AIDS policy & law review (2006)
    16. [16]
      Antidepressants, warfarin, and the risk of hemorrhage. — Kurdyak PA, Juurlink DN, Kopp A, Herrmann N, Mamdani MM Journal of clinical psychopharmacology (2005)
    17. [17]
      Association between the number of coadministered P-glycoprotein inhibitors and serum digoxin levels in patients on therapeutic drug monitoring. — Englund G, Hallberg P, Artursson P, Michaëlsson K, Melhus H BMC medicine (2004)
    18. [18]
      Troubled times for Canada's medical marijuana program. — Thaczuk D Canadian HIV/AIDS policy & law review (2003)
    19. [19]
      Treatment of opiate-related sedation: utility of the cholinesterase inhibitors. — Slatkin NE, Rhiner M The journal of supportive oncology (2003)
    20. [20]
      Vancouver police raid needle exchange run by drug users. — Kerr T, Wood E Canadian HIV/AIDS policy & law review (2002)
    21. [21]
      Drug testing in the workplace: integrating medical review officer duties into occupational medicine. — Smith DE, Glatt W, Tucker DE, Deutsch R, Seymour RB Occupational medicine (Philadelphia, Pa.) (2002)
    22. [22]
      Kava--the unfolding story: report on a work-in-progress. — Denham A, McIntyre M, Whitehouse J Journal of alternative and complementary medicine (New York, N.Y.) (2002)
    23. [23]
      Pharmacological management of opiate withdrawal. — Upthegrove RA, Naik PC Hospital medicine (London, England : 1998) (2001)
    24. [24]
      Sweat testing of MDMA with the Drugwipe analytical device: a controlled study with two volunteers. — Pacifici R, Farré M, Pichini S, Ortuño J, Roset PN, Zuccaro P et al. Journal of analytical toxicology (2001)
    25. [25]
      Recent court rulings on medical and non-medical marijuana. — Elliott R Canadian HIV/AIDS policy & law review (2000)
    26. [26]
      Inappropriate drug use among community-dwelling elderly. — Hanlon JT, Fillenbaum GG, Schmader KE, Kuchibhatla M, Horner RD Pharmacotherapy (2000)
    27. [27]
      Prevalence and risk factors for HTLV-II infection in 913 injecting drug users in Stockholm, 1994. — Krook A, Albert J, Andersson S, Biberfeld G, Blomberg J, Eklund I et al. Journal of acquired immune deficiency syndromes and human retrovirology : official publication of the International Retrovirology Association (1997)
    28. [28]
      Drug-testing methods and clinical interpretations of test results. — Kapur BM Bulletin on narcotics (1993)
    29. [29]
      The role of physicians as medical review officers in workplace drug testing programs. In pursuit of the last nanogram. — Clark HW The Western journal of medicine (1990)
    30. [30]
      Drug screening in the workplace--scientific and legal issues. — Sharon F, Wilkinson WE The Nurse practitioner (1988)
    31. [31]
      A functional approach to drug use intervention. — Einstein S The International journal of the addictions (1984)
    32. [32]
      An experiential model for drug use intervention. — Einstein S The International journal of the addictions (1984)
    33. [33]
      Drugs in the workplace. — Cohen S The Journal of clinical psychiatry (1984)
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