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Phencyclidine (PCP) intoxication in adults

Kennon Heard, MD
Jason Hoppe, DO
Section Editor
Stephen J Traub, MD
Deputy Editor
Jonathan Grayzel, MD, FAAEM


Despite a fall in popularity since the 1970s, phencyclidine (PCP) remains a commonly abused drug that accounts for a significant number of poison center calls and hospitalizations. Early identification and prompt symptomatic treatment are vital to avoid possible sequelae, including rhabdomyolysis and seizures.

PCP is a synthetic arylcycloalkylamine discovered in 1926 and subsequently developed as Sernyl in the 1950s for use as a nonnarcotic anesthetic [1,2]. Sernyl exerted a calming effect at low anesthetic doses and induced cataplexy at higher doses, but it did not markedly suppress blood pressure or respiration. The use of Sernyl as a dissociative anesthetic was discontinued due to postoperative dysphoria and hallucinations, and by 1967 was limited to veterinary use [1]. In April of 1979, all legal manufacturing of PCP in the United States was terminated [3].

In the early 1970s a laboratory investigation of PCP derivatives led to the discovery of ketamine. Ketamine is 5 to 10 percent as potent as Sernyl and is now used clinically to induce dissociative anesthesia. Ketamine is also abused as a recreational drug.

PCP's popularity as a drug of abuse peaked in the 1970s. During the late 1970s, one urban psychiatric hospital in the US found that 63 of 145 consecutive patients sampled over a 48-hour period tested positive for PCP [4]. Since that time, hospital visits and poison center calls related to PCP use have declined, although it remains an important drug of abuse [5].

The basic pharmacology, clinical manifestations, and management of PCP intoxication in adults will be reviewed here. The management of PCP poisoning in children, ketamine poisoning, and other issues related to the management of the poisoned patient are discussed elsewhere. (See "Phencyclidine (PCP) intoxication in children and adolescents" and "Ketamine poisoning" and "General approach to drug poisoning in adults".)

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Literature review current through: Nov 2017. | This topic last updated: Sep 19, 2016.
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