Phencyclidine is an illegal hallucinogenic drug sometimes called PCP or angel dust. It can cause a person to feel dissociated from their senses and environment, and can lead to severe and lasting side effects.

Phencyclidine blocks N-methyl-D-aspartate (NMDA) receptors in the brain, which are responsible for various functions such as learning, emotions, and pain sensations.

Scientists initially developed phencyclidine as an anesthetic. Today, the Drug Enforcement Administration (DEA) considers phencyclidine as a Schedule II controlled substance due to its high potential for dependence and misuse. This means it is illegal in the United States.

This article looks at the presentation of phencyclidine intoxication, potential complications of using the substance, and signs of an overdose.

It also looks at what a person can expect in the emergency room with phencyclidine treatment, the outlook for phencyclidine intoxication, and seeking help for phencyclidine use disorder.

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Phencyclidine can be in crystal, powder, liquid, or tablet form. The substance may both depress and stimulate the central nervous system (CNS).

It binds to NMDA receptors, which decreases mood inhibitors called GABA receptors. It also blocks the uptake of the neurotransmitters serotonin, norepinephrine, and dopamine.

The effects of phencyclidine can vary between people. Effects can depend on various factors, such as the dose, frequency of use, and the form of phencyclidine.

Scientists estimate the half-life of phencyclidine is 21 hours. The half-life of a drug is how long it takes for the body to reduce the amount of the drug by half in the bloodstream. The half-life can be shorter or longer based on how a person takes phencyclidine.

Symptoms of phencyclidine intoxication may include:

The duration of phencyclidine intoxication can vary based on the dose and the method of use.

For example, phencyclidine can begin to cause symptoms of intoxication within 2–5 minutes after inhalation or intravenous administration. If a person ingests phencyclidine, symptoms may begin within 30–60 minutes.

Symptoms of phencyclidine intoxication may last from several hours to as long as 48 hours.

There are various potential physical and psychological complications of phencyclidine intoxication. These include:

  • Injury, trauma, and self-mutilation: Phencyclidine can alter a person’s perceptions, give them delusions of increased physical ability, and cause a sense of detachment from their sensations and surroundings. This can lead to people acting in ways that may result in injury or death, such as jumping from high structures or engaging in physical fights.
  • Substance use disorder: Phencyclidine may cause a person to develop substance use disorder. They may find it challenging to stop using phencyclidine despite the harmful effects of the substance.
  • Hallucinogen persisting perception disorder (HPPD): A person who experiences HPPD may have involuntary flashbacks of experiences they had while they were intoxicated with phencyclidine, which can be distressing.

High doses of phencyclidine can result in complications that may be severe and life threatening. These include:

Chronic phencyclidine use may result in complications such as:

Call 911 or local emergency medical services immediately for any symptoms of phencyclidine overdose.

Phencyclidine toxicity can lead to severe, long-term complications and death.

Symptoms can include:

  • nausea and vomiting
  • fast or irregular heart rate
  • agitation, aggression, and violent behavior
  • confusion and disorientation
  • loss of coordination and balance
  • respiratory depression, which is a shallow, slow breathing rate
  • convulsions
  • seizures
  • coma
  • signs of shock, such as sweating, loss of consciousness, and clammy, pale skin

Most people who receive medical treatment for phencyclidine intoxication survive.

If a person has used high doses of phencyclidine, doctors may help calm and sedate them. They ensure their airway is protected and perform a psychiatric evaluation.

How do doctors diagnose phencyclidine overdose?

To diagnose a phencyclidine overdose and rule out other causes of symptoms, doctors may perform tests that can include:

If a person experiences a potential phencyclidine overdose, doctors may use several treatment methods. These include:

  • Gastrointestinal decontamination: Doctors may administer activated charcoal in cases where someone has ingested high amounts of phencyclidine or has ingested another dangerous substance with phencyclidine.
  • Sedation: To help calm violent symptoms in someone with phencyclidine toxicity, doctors may place them in a quiet, dimly lit environment. They may use physical restraints and sedative medications, such as benzodiazepines, to control violence, agitation, and episodes of psychosis.
  • Respiratory protection: Doctors carefully monitor a person’s breathing. They may intubate them and put them on ventilation support to help them breathe.
  • Monitoring: Doctors monitor a person’s blood pressure, heart rate, circulation, breathing, and airway for signs of complications. They treat other issues or complications from phencyclidine toxicity, such as kidney failure or shock, and try to prevent further, more severe complications.
  • Hospital admittance: If someone has complications or severe symptoms of phencyclidine toxicity, doctors may admit them to a monitored hospital bed for longer-term treatment. If someone has no symptoms, doctors may observe them for at least 6 hours before discharge.
  • Psychiatric evaluation: If someone’s physical symptoms and complications have resolved with treatment but behavioral symptoms persist, doctors may suggest psychiatric evaluation.

The outlook for a person with phencyclidine intoxication and toxicity can depend on a variety of factors. These include whether the phencyclidine use is chronic, the dosage, methods of use, and whether a person uses phencyclidine with other substances.

A person’s outcome is more likely to be positive if they seek treatment from a team of healthcare professionals. Most people who experience phencyclidine intoxication survive when they receive supportive care.

In severe cases, a person may require admission to the intensive care unit (ICU). In cases of mild phencyclidine toxicity, a person may recover within 6–12 hours.

Phencyclidine may cause dependence, which can lead to withdrawal symptoms if a person stops using the drug. Seeking help from healthcare professionals and substance use treatment providers may help a person safely withdraw from phencyclidine and other substances.

If someone is worried they or someone else may have a phencyclidine or other substance use disorder, local hospitals and primary care doctors can provide resources and support.

Options for getting help and support for phencyclidine use disorder include:

Mental health resources

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Phencyclidine intoxication can cause various symptoms. These include physical symptoms, such as fast heart rate, nausea, and vomiting, and psychological symptoms, such as hallucinations, agitation, and dissociation.

Chronic use and higher doses of phencyclidine may increase the risk of severe symptoms and life threatening complications. These include violent behavior, overdose, seizures, coma, and sudden death.

If someone believes they or someone else is experiencing a phencyclidine overdose, they should call 911 or local emergency services immediately. Doctors can often treat symptoms of toxicity and help prevent severe complications.

Help and support are available for phencyclidine use disorder. A person can speak with a doctor or another healthcare professional or reach out to a substance use disorder treatment facility.