Mescaline

Background

Peyote

• Psychedelic phenethylamine , naturally occurring in peyote and other cacti
• Similar to, but chemically distinct from and less potent than LSD
• Thought to be a serotonin agonist
• Sold as dried cactus parts or "buttons"
• Used in religious ceremonies by some indigenous Central and South american peoples.

Clinical Features

• Onset 30-60 minutes, lasts 5-12 hours (though wide individual variability)
• Euphoria, energy, esoteric/spiritual experiences
• Altered sensorium, altered sense of time, extreme focus or distractibility, hallucinations
• Nausea/vomiting, abdominal pain
• Adrenergic stimulation: mydriasis, mild tachycardia, mild hypertension, hyperthermia
• Dizziness, headache

Differential Diagnosis

Hallucinogens

• LSD
• 25C-NBOMe
• Phencyclidine
• Mescaline (Peyote)
• Psilocybin/Mushroom Poisoning
• N,N-Dimethyltryptamine
• Ecstasy (MDMA)
• PCP
• Bath Salts
• Salvia toxicity
• Marijuana
• Absinthe

Dissociative drugs

• Dextromethorphan
• Ketamine
• Nitrous oxide
• Phencyclidine (PCP)
• Alcohol Withdrawal
• Anticholinergic Toxicity
• Tricyclic (TCA) Toxicity
• Ertapenem Toxicity
• Encephalitis
• Hypocalcemia/Hypercalcemia
• Schizophrenia, schizo-affective Disorder
• Dementia
• Delirium
• Migraine
• Seizure
• Parkinson's Disease

Evaluation

• Not detected on routine drug screens
• Evaluate for other organic causes of hallucinations or hyperadrenergic symptoms
• Evaluate for co-ingestions

Management

• Supportive care
• Not usually associated with significant morbidity/mortality

See Also

• Hallucinogens

References

• Tintinalli’s
• https://erowid.org/chemicals/mescaline/mescaline.shtml

Authors

Claire