Differential Diagnosis and Treatment - Hallucinogen- and MDMA-Related Disorders

Differential Diagnosis and Treatment

The differential diagnosis of posthallucinogen psychosis is that for any acute psychotic disorder. This includes protracted psychoses following the use of the dissociative anesthetics phencyclidine and ketamine, amphetamines, and cocaine; schizophrenia and af-fective disorders, migraine, deliria from CNS infections, closed head injuries, tumors, vascular events, and the toxic effects of bromine, heavy metals and anticholinergic drugs. Central to di-agnosis is a careful premorbid history, complemented by data from friends and family on the patient’s recent medical history and behavior. Neurological examination, an acute urine for toxicological screening, and computed tomography or magnetic resonance imaging of the brain are helpful in ruling out treatable nonLSD-related psychotic disorders.

Treatment for post-LSD psychoses includes neuroleptics, electroconvulsive therapy (ECT), and lithium.