Clinical and Prognostic Findings in Psychotropic Substance Poisoning: A Cross-sectional Study

Background: Psychotropic substance poisoning is a growing public health concern. Objectives: This study aimed to investigate patients with psychedelic poisoning and evaluate the frequency of clinical, preclinical, and prognostic findings. Methods: This retrospective cross-sectional study extracted clinical findings of patients, including neurological findings, cardiovascular findings, preclinical findings, treatment measures, and prognosis of patients poisoned with psychoactive substances who were admitted to Shah Vali Hospital in Yazd Province, Iran, and Shaheed Beheshti Hospital in Taft City, Iran, from 2014 to 2023 from their medical records and the hospital information system (HIS). Results: In the present study, information was extracted from 311 patients with psychotropic intoxication, comprising 164 individuals who had used stimulants and 147 who had used hallucinogens. The highest frequency of stimulant use was related to glass, with 160 individuals (51.4%), and the highest frequency of hallucinogen use was related to hashish, with 138 individuals (44.4%). Notably, most patients survived (99.67%). The most common symptoms observed were increased blood pressure (BP) (28.2%), mydriasis (73.31%), tachycardia (77.9%), shock (1.9%), seizures (5.5%), and agitation (68.16%). Elevated creatine phosphokinase (CPK) levels were observed in 3.53% of patients, and the severity of intoxication was statistically significant (P=0.001). The results also showed a significant difference in the frequency distribution of psychoactive substances (stimulants and hallucinogens) according to the route of consumption (oral vs inhalation). Specifically, most psychoactive substances (both stimulants and hallucinogens) were inhaled rather than ingested (P<0.01). Also, a significant difference was observed in the frequency distribution of individuals poisoned with psychedelics (stimulants and hallucinogens) according to the reason for consumption (suicide vs abuse) (P>0.01). In this regard, the most common reason for consumption was abuse (70.1%). The frequency distribution of treatment types among patients poisoned with psychotropic drugs (stimulants and hallucinogens) showed that benzodiazepines were the most frequently used treatment (73%). Conclusion: This study of 311 patients with psychedelic poisoning reveals a significant prevalence of substance abuse, particularly among younger males, with stimulants being the most commonly used drugs. These findings underscore the urgent need for targeted prevention and intervention programs to address the critical issue of psychotropic substance misuse among at-risk populations.