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Effects of hallucinogenic drugs on the human heart

Summary

Hallucinogenic drugs like LSD and psilocybin affect not only the brain but also the heart. These drugs increase heart rate and contractility mainly through specific serotonin and histamine receptors. While these effects might have therapeutic potential for psychiatric conditions, prolonged use can damage heart valves and cause dangerous arrhythmias. Understanding these cardiac effects is crucial for safe medical use and treatment of overdoses.

Background

Hallucinogenic drugs are used for their central nervous system effects, primarily through serotonin receptor stimulation. However, these tryptamine derivatives also act on the heart through multiple receptor pathways, potentially affecting cardiac contractility and rhythm.

Objective

To review the inotropic and chronotropic actions of hallucinogenic compounds including bufotenin, psilocin, psilocybin, LSD, ergotamine, ergometrine, DMT, and 5-methoxy-DMT in the human heart and discuss their cardiac effects and clinical implications.

Results

Most hallucinogenic compounds increase cardiac force and heart rate primarily via 5-HT4 serotonin receptors or H2 histamine receptors rather than 5-HT2A receptors. These drugs can cause positive inotropic and chronotropic effects, but may also induce arrhythmias and valvular dysfunction through 5-HT2B receptor stimulation, particularly with prolonged use.

Conclusion

Hallucinogenic drugs have significant cardiac effects that warrant careful consideration in clinical applications. Understanding the specific receptor mechanisms helps guide safe therapeutic use and appropriate management of overdoses using receptor antagonists such as 5-HT4 or H2 receptor blockers.
  • Published in:Frontiers in Pharmacology,
  • Study Type:Review,
  • Source: PMID: 38370480, DOI: 10.3389/fphar.2024.1334218
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