解離劑
解離劑(英語:Dissociative)是致幻劑的亞類之一,能扭曲視覺和聽覺感知,並能產生脫離環境與自我的解離效果。雖然許多種類藥物都能產生解離,但解離劑的獨特之處,在於其產生解離效果的方式,而其中可能包括解離、感官體驗淡漠、幻覺、夢境與麻醉。[1]
雖說大多數解離劑的主要作用機制與NMDA受體的拮抗作用有關,但解離劑中的一些物質,也會非選擇性的作用影響於多巴胺[2] 或阿片[3]系統,因而可能會產生更直接與可重複的興奮感與症狀,此類典型的「硬性毒品」,或常見濫用藥物的效果更為相似。這或許為解離性藥物被認為有一定成癮性之因,並且使其與迷幻藥形成區別。儘管某些解離性藥物,如苯環己哌啶具有刺激性,但多數解離藥,具有抑制作用,可產生鎮靜、呼吸抑制、噁心、迷失方向、鎮痛、麻醉、共濟失調、認知和記憶障礙以及失憶等的症狀。
效果
解離劑的作用包括感覺解離、幻覺、躁狂、催眠、鎮痛與失憶。[4][5][6]據彭德(Pender,1972)所說「因為病人似乎真的與周遭環境分離了,因而這種(解離的)狀態被稱為解離性麻醉。」[7]彭德(Pender,1970)和約翰斯頓(Johnstone,1959)等人都曾報告,使用氯胺酮或苯環己哌啶麻醉的患者,在麻醉期間與麻醉後容易出現無目的的運動和幻覺(或「夢」),一些患者認為幻覺令人興奮,而另一些患者對幻覺表示不安。[8]在亞麻醉劑量下,解離劑與其他致幻劑(如麥司卡林、LSD和賽洛西賓)類似,會改變許多相同的認知和感知過程,因此,這兩類經常被用作對比,前者亦被認為具有致幻性。[9][10][11]解離劑與傳統迷幻藥物(如LSD與麥司卡林),在主觀體驗上最大區別或許在於解離效應,包括:人格解體,即感到自我一部分或全部不真實、與自我脫節或無法控制自己的行為;去人格化,即感覺外部世界不真實或認為自我處於夢境。[12]
用途
醫用
在醫院等醫療環境中,氯胺酮等許多解離劑,被用作手術或止痛的麻醉劑。不過,由於可能產生致幻作用,因此僅有迫不得已時使用。[13][14]某些嗎啡喃解離劑,如右美沙芬,也被以亞精神活性劑量用於抑制咳嗽。[15]
作為一種可能的速效抗抑鬱劑的氯胺酮,目前也正在接受研究,並顯示出良好的效果。[16][17]它還可作為C-PTSD和慢性疼痛的可能的緩和治療方法之一。[18][19]
娛樂用途
一些解離藥物被用於娛樂。如,氯胺酮和氧化亞氮是俱樂部毒品。苯環己哌啶(俗稱天使塵)是街頭毒品的一種。右美沙芬止咳糖漿也具有解離作用,一些使用者過量使用,以用於娛樂。[20]氯仿和二乙醚歷來也都被用於娛樂。
擴展閱讀
參考文獻
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