The effects of dissociatives can include sensory dissociation, hallucinations,
mania,
catalepsy, analgesia and amnesia.[4][5][6] According to Pender (1972), "the state has been designated as dissociative anesthesia since the patient truly seems disassociated from his environment."[7] Both Pender (1970) and Johnstone et al. (1959) reported that patients under anaesthesia due to either
ketamine or
phencyclidine were prone to purposeless movements and had hallucinations (or "dreams"[8]) during and after anaesthesia. Some patients found the hallucinations euphoric while others found them disturbing.
At sub-anesthetic doses, dissociatives alter many of the same cognitive and perceptual processes affected by other hallucinogenic drugs such as
mescaline,
LSD, and
psilocybin; hence they are often contrasted and also considered
hallucinogenic.[9][10][11] Perhaps the most significant subjective differences between dissociatives and the
classical hallucinogens (such as
LSD and
mescaline) are the detaching effects, including:
depersonalization, the feeling of being unreal, disconnected from one's self, or unable to control one's actions; and
derealization, the feeling that the outside world is unreal or that one is dreaming.[12]
Use
Medical use
Many dissociatives such as
ketamine are used as
anesthetics for
surgery or pain relief in medical contexts such as in hospitals. However, due to possible
psychotomimetic reactions they are sometimes used reluctantly.[13][14] Certain
morphinan dissociatives such as dextromethorphan are also used in sub-psychoactive dosages to
suppress coughing.[15]
Some dissociative drugs are used recreationally.
Ketamine and
nitrous oxide are
club drugs.
Phencyclidine (PCP or angel dust) is available as a street drug.
Dextromethorphan-based cough syrups (often labeled DXM) are taken by some users in higher than medically recommended levels for their dissociative effects. Historically,
chloroform and
diethyl ether have been used recreationally.
^Giannini, AJ; Eighan, MS; Loiselle, RH; Giannini, MC (1984). "Comparison of haloperidol and chlorpromazine in the treatment of phencyclidine psychosis". Journal of Clinical Pharmacology. 24 (4): 202–4.
doi:
10.1002/j.1552-4604.1984.tb01831.x.
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^Giannini, A. James; Nageotte, Catherine; Loiselle, Robert H.; Malone, Donald A.; Price, William A. (1984). "Comparison of Chlorpromazine, Haloperidol and Pimozide in the Treatment of Phencyclidine Psychosis: Da-2 Receptor Specificity". Clinical Toxicology. 22 (6): 573–9.
doi:
10.3109/15563658408992586.
PMID6535849.
^Vollenweider, F; Geyer, MA (2001). "A systems model of altered consciousness: integrating natural and drug-induced psychoses". Brain Research Bulletin. 56 (5): 495–507.
doi:
10.1016/S0361-9230(01)00646-3.
PMID11750795.
S2CID230298.
^Adams HA (December 1997). "[S-(+)-ketamine. Circulatory interactions during total intravenous anesthesia and analgesia-sedation]" [S-(+)-ketamine. Circulatory interactions during total intravenous anesthesia and analgesia-sedation]. Der Anaesthesist (in German). 46 (12): 1081–7.
doi:
10.1007/s001010050510.
PMID9451493.
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^Rossi, S, ed. (2013). Australian Medicines Handbook. Adelaide: The Australian Medicines Handbook Unit Trust.
ISBN978-0-9805790-9-3.[page needed]
^Sanacora G, Frye MA, McDonald W, Mathew SJ, Turner MS, Schatzberg AF, et al. (April 2017). "A Consensus Statement on the Use of Ketamine in the Treatment of Mood Disorders". JAMA Psychiatry. 74 (4): 399–405.
doi:
10.1001/jamapsychiatry.2017.0080.
PMID28249076.
S2CID28320520.
^Marcantoni WS, Akoumba BS, Wassef M, Mayrand J, Lai H, Richard-Devantoy S, Beauchamp S (December 2020). "A systematic review and meta-analysis of the efficacy of intravenous ketamine infusion for treatment resistant depression: January 2009 - January 2019". J Affect Disord. 277: 831–841.
doi:
10.1016/j.jad.2020.09.007.
PMID33065824.
S2CID223557698.