Talk:Psychoactive drug

Consensus decision on the inclusion of Thoric's chart

Conversation conclusion The Venn diagram depicting the subjective and behavioral effects of certain psychoactives created by User:Thoric constitutes original research and should not be included in this article. It is still available here for reference. Main arguments: The classification depicted by the diagram is an original synthesis of various sources, none of which include a similar diagram or classification. There are conceptual issues with the chart that editors with expertise in this field strongly object to.

Steve Carlson^Talk 03:02, 3 February 2010 (UTC)

Rename to Psychoactive compound

I think that calling the article psychoactive drug skews the article in one direction, when psychoactive compounds includes all compounds affecting brain chemistry (including histamine, glutamate and other psychopharmacological compounds) not necessarily effecting a high.Apothecia (talk) 00:15, 19 January 2010 (UTC)

Could you expand on that a bit? I don't really follow your argument. Regards, Looie496 (talk) 17:14, 19 January 2010 (UTC)

A drug implies that we are referring to non-endogenous compounds that act upon receptors within the brain by mimicking endogenous brain chemicals, which is what this article is about. An article inclusive of both endogenous brain chemicals and psychoactive drugs could possibly exist as a separate article, but I'm not sure if it would make sense to replace this one. --Thoric (talk) 17:42, 19 January 2010 (UTC)

Like Thoric, I do not really think this page should be concerned with endogenous compounds. Beyond that, I would have concerns about a rename, in that most readers would look for "Psychoactive drug", whereas "Psychoactive compound" is counterintuitive. --Tryptofish (talk) 19:15, 19 January 2010 (UTC)

I agree with the OP's point - "drug" is a stigmatized word, and this article should try to be neutral. I think I have previously advocated for "psychoactive substance", which is less "chemical" than "compound", but less stigmatized than "drug". We can use redirects to catch the users who try to find the article under a different title. Steve Carlson^Talk 03:05, 3 February 2010 (UTC)

The issue of stigma is an ambiguous one, and I don't really buy the argument that it is POV as used here. Lot's of people say that "a drug saved my life", referring to an antibiotic or antihypertensive and so forth. --Tryptofish (talk) 16:05, 3 February 2010 (UTC)

While true that the word "drug" is stigmatized, it is still the most correct terminology. If the pharmaceutical industry has no issue using the word "drug", then why should we? --Thoric (talk) 17:07, 4 February 2010 (UTC)

new chart

Here is a new chart of drug dependence potential and active/lethal dose ratio based on well-referenced data.

I think it might be appropriate for inclusion on this page. Thundermaker (talk) 15:39, 2 April 2010 (UTC)

Do you mean that it would replace the image currently in the "Addiction" section? I think I would agree that it would be an improvement. However, you need to indicate the sourcing. --Tryptofish (talk) 19:28, 2 April 2010 (UTC)

Click on the image for refs to the data source. I'll leave it to other editors to decide whether there's a consensus to put it on the page and/or to remove the other one. Thundermaker (talk) 19:35, 2 April 2010 (UTC)

By click, I assume you mean the reference on the file page. Yes, that does look to me like reliable sourcing, and not synth. I would support replacing the existing image with this. --Tryptofish (talk) 19:51, 2 April 2010 (UTC)

The fact that the chart only includes recreational drugs makes it inappropriate for an article on psychoactive drugs, and (unfortunately or fortunately), I do not believe sufficient information on legal psychoactive drugs (e.g., antidepressants, anxiolytics) is available to add them to the chart. Although most of them are known to create dependence, the medical community often equates dependence with addiction, where based on the word origins, something addictive will result in some degree of craving (resulting in a potential for abuse); whereas something that creates dependence will just make you feel miserable if you stop taking it. If you look at the stories posted on line, Cymbalta withdrawal can be pure hell; but its product information doesn't even list dependence as a possible side effect, so patients think it's safe. At the same time, dosing of Cymbalta is based on anecdotal appearance of effectiveness in falsified "trials", and one of the methods of falsification would also eliminate trial participants before a lethal dose is reached. KMLion (talk) 16:25, 28 February 2012 (UTC)

Addiction section: direct and indirect action confusion possibly?

It says drugs that directly affect the dopaminergic system; like cocaine & amphetamine (which are both indirect dopamine agonists) are more likely to be addictive than certain psychedelics (I am assuming psilobin & LSD; which act as direct agonists to the serotonin system: adjuncts to dopamine release) so it seems from one perspective backwards. Does it mean as indirect agonists they increase dopamine levels and therefore directly activate the dopaminergic system? (not directly agonizing but indirect agonism by directly increasing the level?) the serotonin system I can see as peripheral to the dopamine system being considered indirectly dopaminergic but the statement as is, is still confusing to the layman as to the actual nature of the function. Nagelfar (talk) 01:20, 1 August 2010 (UTC)

I see what you are getting at. I think that the "indirect" reference means drugs that act on neurotransmitters other than dopamine, but, due to downstream synaptic connections, end up ultimately increasing dopamine activity, whereas the directly acting drugs actually act directly at dopamine synapses (but not necessarily at dopamine receptors, thus not needing to be dopamine receptor agonists). Since the wording is about directly or indirectly stimulating "the dopaminergic system", I don't think there is a problem about implying receptor agonism. But it does strike me that the sentence about "indirect" psychedelics is unsourced and potentially an OR over-generalization, so I'm going to tag it for a citation. --Tryptofish (talk) 18:29, 1 August 2010 (UTC)

I just want to point out that both cocaine and amphetamines work directly upon the dopaminergic system which is their primary site of action. The psychedelics mentioned(lysergic acid diethylamide & psilobin) both work indirectly on dopamine. Like other tryptamines and psychedelic phenethylamines they work primarily upon the serotonergic system(5-HT), in particular 5-HT_2A. Amphetamines and cocaine work as dopamine re-uptake inhibitors(DRI). Essentially this means that they inhibit(slow down) the transportation of dopamine(via the dopamine transporter) resulting in decreased re-absorption(re-uptake) of dopamine. This inhibits dopamine breakdown which, in turn, increases the extracellular concentrations of dopamine(accumulation of dopamine levels outside the cell) resulting in increased postsynaptic dopaminergic neurotransmission(dopamine binding to and activating receptors).

Amphetamines also work as releasing agents(RA) which in short means they increase the release of neurotransmitters(specifically dopamine, serotonin and norepinephrine) from the presynaptic neuron via a process known as phosphorylation. This results in increased extracellular concentrations of these neurotransmitters thus increasing neurotransmission. The end result is similar to that of re-uptake inhibitors as both increase neurotransmission. The only difference worth mentioning is that you need more re-uptake inhibition than you do neurotransmitter release to get the same result since re-uptake inhibition only increases the concentrations of degraded neurotransmitters. Sorry this isn't very concise.

Additionally I need to point out that the article itself goes into very little depth regarding why drugs are addictive. The current explanation of psychological addiction isn't a satisfactory and is only partially correct; the dopaminergic reward system isn't the only cause of psychological addiction. --Spacegiraffe 220.245.100.87 (talk) 07:34, 19 December 2011 (UTC)

Venn diagram, again

A new clone of the old Venn diagram (File:Drug_Chart_Color.jpg) has been added to a large number of psychoactive drug related articles. I have removed them for now as there is a clear and longstanding consensus against this diagrams because they are considered original research/compilation against Wikipedia policy and are factually misleading if not wrong. The several past discussions can be found on this page and in the archives of this page, e.g. above. Cacycle (talk) 07:20, 2 September 2010 (UTC)

I agree with you about this. I could see at least one dubious claim in that image. --Tryptofish (talk) 22:59, 2 September 2010 (UTC)

ambiguity regarding classification \ categorization

When I educate myself on a topic broad as 'psychoactive drugs', I find it easier to gather knowledge of the information in a whollistic way, by categorizing things; granted there will be over-lap. Psychoactive drugs are divided into 3 groups:[1]

Depressants - those that slow down the central nervous system; such as tranquillisers, alcohol, petrol, heroin and other opiates, cannabis (in low doses) Stimulants- those that excite the nervous system; such as nicotine, amphetamines, cocaine, caffeine Hallucinogens - those that alter how reality is perceived; such as LSD, mescaline, Psilocybin mushrooms, Salvia divinorum —Preceding unsigned comment added by Victamon, Ja (talk • contribs) 16:25, 10 September 2010 (UTC)

Um, what's your point? Looie496 (talk) 16:30, 10 September 2010 (UTC)

Omfg, I was just editing my post, typed it all up, tried to post it, then it wouldn't allow me because someone else was editing it?

Why didn't I copy it all...

Well I don't feel like re-typing everything, but my point was that there are several contradictions with the classifications, specifically pharmaceutical medications versus the broader psychoactive drugs.—Preceding unsigned comment added by Victamon, Ja (talk • contribs) 17:31, 10 September 2010

What happened was that you accidentally copied and pasted this entire talk page. I've restored this the best I could. --Tryptofish (talk) 17:42, 10 September 2010 (UTC)

To try to answer your question substantively, the categorization into three groups comes from a source, which is cited. If I understand you correctly, you are asking if the page could, instead, separate clinically useful drugs (used as medicines) from drugs that are abused or used recreationally. I suppose a problem with trying to do that is that there are a lot of drugs that can be used either way. --Tryptofish (talk) 17:47, 10 September 2010 (UTC)

I am fully aware of this fact, indeed aprreciative of it. It is this very fact that has caused me irritation when trying to educate myself regarding the broad topic of 'psychoactive drugs' on Wikipedia, some of which are 'psychiatric medications' or *psych meds*; "A psychiatric medication is a licensed psychoactive drug taken to exert an effect on the mental state and used to treat mental disorders." (non-surprisingly). Hokay, so this means that all psych meds are some form of a psychoactove drug[s] (but not the other way around, obviously, since plenty of common street drugs such as LSD-25 has not a *single* patient doctor-prescribed use, as of yet). So far, so good. But then you read further on the classifications. Psych meds are categorized into, apparently, =six= classes or what_have-you: 'antipsychotics', 'antidepressants', 'mood stabilizers', 'stimulants', 'anxiolytics' & 'hypnotics'; two of these categories share names with two of the three classifications of 'psychoactive drugs': 'stimulants', and 'drepressants'(the term 'hypnotics' is apparently a sub-set of 'depressants', the latter of which is used on the actual page dedicated to psychiatric medications). Is this to imply that the other four classes of psych meds, seeing as how all psych meds fall under the broader array of psychoactive drugs (granted, most drugs have side-effect[s] at least on some scale, be them physiological and\or unintended_psychological), must fall under the third general category of 'psychoactive drugs', which is hallucinogens(which gets further divided into three types: dissociatives, psychadelics, and deliriants; granted, some herbs or compounds such as salvia exhibit qualities of both psychadelich and dissociative flavor, and MDMA for example exhibits qualities even further separated, of stimulants as well as psychadelics) ? Well, perhaps, but this would require a much looser definition on the term 'hallucinogen' than is used colloquially or even as denoted on Wikipedia. But in that case, where (more specifically) under the genre of 'psychoactive drugs' do do 'psychiatric medications' not specific-to or used for treatment of stimulation\tranquilizing\sedation fall? "A psychoactive drug, psychopharmaceutical or psychotropic is a chemical substance that crosses the blood-brain barrier and acts primarily upon the central nervous system where it alters brain function, resulting in changes in perception, mood, consciousness, cognition, and behavior.[1]" Perhaps the linking word 'and' would more accurately be replaced with conjunction 'and\or'?

Doctor-prescribed drugs don't hold many differences from 'street drugs'(which indeed, do very much overlap), but one important difference I think is that medications as perscribed by doctor are usually intended to treat one specific syndrome or condition on one person(or maybe symptom{s} just a few), even though they usualy do have consequences\side-effects at least to a small degree (these 'side-effects' often being the 'high' achieved when 'abused'), and despite the fact that one drug such as many SSRIs may be used for treatment of different conditions, depending on which neuro-transmitters they bind with or inhibit or whatever.

Then also on the psychoactive drug wiki, directly under the outline of 'psychiatric medication', is another brief outline—of 'recreational use', which lists *five* 'classes', including 'stimulants' and 'hallucinogens' (again sharing the terminology with two of the three categories granted to the broad topic of 'psychoactive drugs'), as well as 'hypnotics'(like depressants), 'opioid analgesics'(apparently similar to hypnotics, probably just differ in which brain receptors they work on\with), and 'inhalants'(which this last one seems out of place, seeing as how the term implies more of the method of consumption rather than type of high or what-have_you).

Do you see where I'm coming from now? —Preceding unsigned comment added by Victamon, Ja (talk • contribs) 18:37, 10 September 2010 (UTC)

At least in part, I'm getting the idea. To some extent, I guess I have to say that this particular talk page is very specifically about making editorial changes to the article, so if part of what you are asking for is explanation of what the page means (in contrast to specific suggestions about how to change what the page says), you will get better help at the Reference Desk than here. Now beyond that, Wikipedia places a very high importance on the WP:OR policy, which means that we cannot arrange articles around what editors want, but rather, we must do so based on what published sources say. The passage you quoted at the beginning of this discussion thread is sourced to the first reference on the reference list, so it's their classification, and we are just reporting it. If you are interested in changing this page to be organized in a different way, the best fashion in which to go about it would be to search for references that would support such an organization. But I can tell you, since I've done a lot of reading about these subjects myself, that much of the complication to which you refer is just the way it is. I think you'll see those kinds of overlaps and redundancies in many, many references. This subject is just a complicated one. --Tryptofish (talk) 19:19, 10 September 2010 (UTC)

People self-medicate with non-"psych meds" all the time; that's mostly what recreational drugs use is about. The only reason all psychoactive drugs are not "psych meds" is that it hasn't occurred to medicine to formally try them. However, if they did try them, they would face the same difficulty of proving efficacy as the drug industry currently faces proving the efficacy of "psych meds": it is impossible to design a valid clinical trial for a drug intended to treat a psychological condition, if the drug, the control and the placebo do not have IDENTICAL side effects for each person taking them, and for every person in the test. The efficacy of "psych meds", is a measure of changes in perception; but changes in perception are subjective, and because the placebo effect applies to all side effects, there is no way of knowing which side effect is causing a perceived improvement.

Based on what you'll find if you look carefully at the "clinical trials" of Cymbalta, the only reason anyone tries it is that its manufacturer has gone to great lengths and expense to convince everyone that it is safe and effective (including misleading labeling, rigged trials and TV advertisements - also seen by children). If you search for postings by people who have taken Cymbalta, you will find that it is far from safe; and if you look at the "clinical trials", you will find that their evidence of efficacy is all anecdotal. "Psych meds" are drugs; their purpose is physical interferance with brain function, with the intent to alter perception in hopes of disguising, distracting from, or eliminating symptoms of subjectively defined non-physical conditions. They do not attempt to disguise, disarm or eliminate physical causes of objectively defined physical conditions the way antibiotics or antidotes do; they drug people. KMLion (talk) 17:21, 28 February 2012 (UTC)

Marijuana and the brain

We need some help over on this page [[1]] Thanks R. Shaw —Preceding unsigned comment added by Scottdahippie (talk • contribs) 17:10, 2 December 2010 (UTC)

Could you clarify? There is no such article. There once was one, but it was deleted back in February; see Wikipedia:Articles for deletion/Marijuana and the brain. Looie496 (talk) 01:18, 13 August 2011 (UTC)

Uses

There are problems with the first part of the Uses section, and not being in a medical or pharmacological field, and without knowing how much of the three bullets are quoted from the reference (13), I can't tell if psychoactive drugs really are commonly divided into three groups by pharmacological effect, and/or if the bullets should be revised or eliminated. I suspect part of problems' cause being that the reference may apply exclusively to psychoactive plants, whereas psychoactive drugs include many that exist no-where in nature.

The first bullet says "...but do not affect perception"; however, all psychoactive drugs affect perception, it's what they do (read the very first sentence of the entire article). I feel it is also misleading that the examples in this first bullet do not explicitly include "antidepressants" or examples of classes of them (e.g., "SSRI"s, "NSRI"s, etc.), because that could lead someone to conclude that antidepressants don't qualify as psychoactive drugs, and read no further (which manufacturers would probably prefer).

The second bullet says "...sometimes induce perceptual changes, such as dream images...". Does anyone have any idea what that means? Again, all psychoactive drugs affect perception; but is a dream image a perceptual change or a perception, do we perceive dreams as images, or is sleep to be considered a depressant?

The third bullet says "...encompasses all those substances that produce distinct alterations in perception, sensation of space and time, and emotional states". Depending on dose and the individual's reaction, stimulants and depressants can do the same things. Replacing the word "distinct" with "pronounced, even extreme" might be more accurate. Based on descriptions I remember from the days of LSD, possible feelings of euphoria would also apply here.

These three bullets might be rewritten with a caveat to be conditionally valid generalizations, thus:

Some attempt to divide psychoactive drugs into three groups according to their pharmacological effects:[13?]

• Stimulants ("uppers"), including antidepressants. Substances that "wake one up" or stimulate the mind.

Examples: coffee, tobacco, tea, cacao, guarana, maté, ephedra, khat, coca, amphetamine, SSRI, SNRI, and antidepressants in general.

• Depressants ("downers"), including sedatives, anxiolitics, hypnotics, and narcotics. This category includes all of the calmative, sleep-inducing, anxiety-reducing, anesthetizing substances, which depress mental activity (not to be confused with being depressed).

Examples: opioids, barbiturates, benzodiazepines, and alcohol.

• Hallucinogens, including psychedelics, dissociatives and deliriants. This category encompasses all those substances that produce very pronounced, even extreme alterations in perception, sensation of space and time, and emotional states.

Examples: psilocybin, LSD, Salvia divinorum, marijuana and nitrous oxide.

However, such generalizations are of limited value, because the effects of psychoactive drugs are highly variable, depending on the individual's physical and mental state, as well as on dose. In fact, some antidepressants and anxiolitics have worse depression and anxiety as possible side and/or withdrawal effects, respectively. Physical dependence may cause severe withdrawal effects lasting years in some people, but only brief, almost unoticeable withdrawal effects in others. Some people find effects so pleasant that they are perceived as feelings of euphoria and can even be psychologically addicting, while others may find them so unpleasant that they never want to take the drug again. Some depressants, initially or at low doses may have a stimulating effect (e.g., alcohol, if it releases psychological inhibitions). At the same time, doses of some stimulants lower than the minimum available for purchase can result in severe anxiety in some people, while higher doses can cause some people to become lethargic and unresponsive to the point of easily passing for "clinically depressed".

The caveat is based on my experience and on information readily availailable from web sites that publish drug documentation, including the FDA's. I don't know if reference 13 would still apply. KMLion (talk) 19:29, 28 February 2012 (UTC)