Phencyclidine intoxication
292.89 Phencyclidine Intoxication
Refer, in addition, to the text and criteria for Substance Intoxication (see p. 199). The essential feature of Phencyclidine Intoxication is the presence of clinically significant maladaptive behavioral changes (e.g., belligerence, assaultiveness, impulsiveness, unpredictability, psychomotor agitation, impaired judgment, or impaired social or occupational functioning) that develop during, or shortly after, use of phencyclidine (or a related substance) (Criteria A and B). These changes are accompanied by two or more of the following signs that develop within an hour of using the substance (or less when it is smoked, "snorted," or used intravenously): vertical or horizontal nystagmus, hypertension or tachycardia, numbness or diminished responsiveness to pain, ataxia, dysarthria, muscle rigidity, seizures or coma, and hyperacusis (Criterion C). The symptoms must not be due to a general medical condition and are not better accounted for by another mental disorder (Criterion D).
Specific signs and symptoms are dose related. Lower doses of phencyclidine produce vertigo, ataxia, nystagmus, mild hypertension, abnormal involuntary movements, slurred speech, nausea, weakness, slowed reaction times, euphoria or affective dulling, and lack of concern. Disorganized thinking, changed body image and sensory perception, depersonalization, and feelings of unreality occur at intermediate doses. There is evidence that individuals with Schizophrenia may experience an exacerbation of psychotic symptoms. Higher doses produce amnesia and coma, with analgesia sufficient for surgery, and seizures with respiratory depression occur at the highest doses. Effects begin almost immediately after intravenous use or smoking, reaching a peak within minutes. Peak effects occur about 2 hours after oral doses. In milder intoxications, the effects resolve after 8-20 hours, whereas signs and symptoms of severe intoxications may persist for several days. Phencyclidine-Induced Psychotic Disorder (p. 338) may persist for weeks.
Specifier
The following specifier may be applied to a diagnosis of Phencyclidine Intoxication:
With Perceptual Disturbances. This specifier may be noted when hallucinations with intact reality testing or auditory, visual, or tactile illusions occur in the absence of a delirium. Intact reality testing means that the person knows that the hallucinations are induced by the substance and do not represent external reality. When hallucinations occur in the absence of intact reality testing, a diagnosis of Substance-Induced Psychotic Disorder, With Hallucinations, should be considered.
Diagnostic criteria for 292.89 Phencyclidine Intoxication
- Recent use of phencyclidine (or a related substance).
- Clinically significant maladaptive behavioral changes (e.g., belligerence, assaultiveness, impulsiveness, unpredictability, psychomotor agitation, impaired judgment, or impaired social or occupational functioning) that developed during, or shortly after, phencyclidine use.
- Within an hour (less when smoked, "snorted," or used intravenously), two (or more) of the following signs:
- vertical or horizontal nystagmus
- hypertension or tachycardia
- numbness or diminished responsiveness to pain
- ataxia
- dysarthria
- muscle rigidity
- seizures or coma
- hyperacusis
- The symptoms are not due to a general medical condition and are not better accounted for by another mental disorder.
Specify if:
With Perceptual Disturbances