====== Hallucinations ======

There are a very large number of toxins that can lead to hallucinations and/or delirium.

  * Withdrawal states
  * [[:wikitox:3.2.1.3_toxidromes|Anticholinergic syndrome]]
  * [[:wikitox:3.2.1.3_toxidromes|Serotonergic syndrome]]
  * Dopaminergic drugs
  * Illicit drugs
  * Differentiating features

A psychotomimetic reaction, with apparent visual or auditory hallucinations, delirium and heightened or only slightly decreased level of consciousness, is most commonly due to:

==== Withdrawal states ====

  * [[:wikitox:2.1.11.5.2_alcohol_withdrawal|Alcohol withdrawal]]
  * [[:wikitox:3.5.3_sedative_hypnotic|Sedative drug withdrawal]]

==== The anticholinergic syndrome ====

  * [[:wikitox:2.1.11.4.1_anticholinergics|Anticholinergic]] drugs
  * [[:wikitox:2.1.11.4.2_antihistamines|Antihistamines]]
  * [[:wikitox:2.1.11.9.2.1_tricyclic_antidepressants|Tricyclic antidepressants]] (TCAs)
  * [[:wikitox:2.1.11.9.3_antipsychotics|Low potency neuroleptics]]

==== The serotonergic syndrome ====

  * [[:wikitox:2.1.11.9.2.3_serotonin_reuptake_inhibitors|Selective serotonin reuptake inhibitors (]][[:wikitox:2.1.11.9.2.3_serotonin_reuptake_inhibitors|SSRI]]s)
  * [[:wikitox:2.1.11.9.2.2_monoamine_oxidase_inhibitors|Monoamine oxidase inhibitors (MAO inhibitors]])
  * Tricyclic antidepressants (TCAs)

==== Dopaminergic drugs ====

  * Bromocriptine
  * L-dopa

==== Illicit drugs ====

  * Amphetamines
  * [[:wikitox:2.1.11.4.8.1_cocaine|Cocaine]]
  * MDMA(ecstasy)
  * Illicit hallucinogens (LSD, mescaline)
  * Hallucinogenic mushrooms
  * [[:wikitox:2.3.4_plants|Hallucinogenic plants]] (mostly anticholinergic)
  * Marijuana
  * [[:wikitox:2.1.11.5.1_acute_management_of_alcohol_problems|Alcohol intoxication]]

In addition, a large number of drugs that impair consciousness may lead to delirium usually without significant hallucinosis. These drugs are discussed under drugs leading to coma.

==== Differentiating features ====

Features that help to differentiate between these drugs are:

  * [[:wikitox:response_to_painful_stimuli|Response to Painful Stimuli]]
  * [[:wikitox:type_of_hallucinations|Type of Hallucinations]]
  * [[:wikitox:hyperthermia|Hyperthermia]]
  * [[:wikitox:response_to_antagonists|Response to Antagonists]]
  * [[:wikitox:pupil_size_and_reaction|Pupil Size and Reaction]]
  * [[:wikitox:myoclonic_jerking_or_hyperreflexia|Myoclonic Jerking or Hyperreflexia]]
  * [[:wikitox:nystagmus|Nystagmus]]
  * [[:wikitox:heart_rates|Heart Rate]]
  * [[:wikitox:bowel_sounds|Bowel Sounds]]
  * [[:wikitox:ecg_changes|ECG Changes]]
  * [[:wikitox:response_to_antagonists|Response To Antagonists]]
  * [[:wikitox:electrolytes_and_blood_glucose|Electrolytes and Blood Glucose]]
  * [[:wikitox:blood_concentrations|Blood Concentrations]]

See also [[:wikitox:delirium_and_its_treatment|delirium treatment]].