Halüsinojen ile İlişkili Bozukluklar
Özet
Halüsinojenler, gerçek bir uyaran olmamasına rağmen tüm duyusal modalitelerde algı yanılsamasına, düşünce ve duygudurum değişikliklerine yol açan heterojen bir psikoaktif madde grubudur. Tarihsel süreçte mistik ve dinsel ayinlerde kullanılan bu maddeler, kimyasal yapılarına ve birincil etki mekanizmalarına göre indolaminler, fentalaminler ve disosiyatifler gibi sınıflara ayrılmaktadır. DSM-5'te ise "PCP ve ilişkili arilsikloheksaminler" ile "başka varsandıranlar" olarak iki grupta ele alınırlar. Bu maddeler etkilerini temelde serotonerjik sistem üzerinden, özellikle de pre- ve post-sinaptik 5-HT2 reseptörlerine parsiyel agonist olarak bağlanarak gösterirken dopaminerjik ve glutamaterjik sistemleri de etkilerler. Klinik olarak bilinç durumu, algı, duygu ve kendilik algısında derin değişikliklere yol açarlar ve intoksikasyon durumunda otonomik, psikolojik bozukluklar ile "varsandırana bağlı kalıcı algı bozukluğu" (HPPD) gibi kalıcı psikiyatrik tablolara neden olabilirler. 1960'lı yıllardan sonra yasal kısıtlamalar nedeniyle azalan bilimsel araştırmalar, son yıllarda bu maddelerin nikotin ve alkol bağımlılığı, terminal dönem kanser hastalarındaki anksiyete, depresyon ve travma sonrası stres bozukluğu gibi alanlardaki tedavi edici potansiyeline yönelik olarak yeniden hız kazanmıştır.
Halucinogens are a heterogeneous group of psychoactive substances that cause perceptual illusions in all sensory modalities, along with alterations in thought and mood, despite the absence of a real stimulus. Used in mystical and religious rituals throughout history, these substances are classified into groups such as indolamines, phenethylamines, and dissociatives based on their chemical structures and primary mechanisms of action. In DSM-5, they are categorized into two groups as "PCP and related arylcyclohexamines" and "other hallucinogens". These substances primarily exert their effects via the serotonergic system, specifically by binding as partial agonists to pre- and post-synaptic 5-HT2 receptors, while also influencing dopaminergic and glutamatergic systems. Clinically, they induce profound changes in consciousness, perception, emotion, and self-awareness, and in cases of intoxication, they can lead to autonomic and psychological disturbances, as well as persistent psychiatric conditions such as "hallucinogen persisting perception disorder" (HPPD). Scientific research, which declined after the 1960s due to legal restrictions, has recently gained renewed momentum regarding the therapeutic potential of these substances in areas such as nicotine and alcohol substance use disorders, anxiety and depression in terminal cancer patients, and post-traumatic stress disorder.
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