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Research material (131) · Classic Psychedelic (69) · Stimulant (43) · Opioid (29) · Sedative-Hypnotic (29) · Tryptamine (26) · Phenethylamine (25) · Botanical (23) · Benzodiazepine (22) · Anticonvulsant (19) · Dissociative (19) · Antidepressant (17) · Plant Medicine (17) · Antiparkinsonian (16) · Antipsychotic (16) · Empathogen (16) · Analgesic (15) · Neuroleptic (15) · Cathinone (14) · Nootropic (13)

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5-HT2A agonist (27) · GABAA positive allosteric modulator (22) · None (12) · Monoamine releasing agent (11) · CB1/CB2 agonist (7) · Potent mu-opioid receptor agonist (6) · Sodium channel blocker (6) · Dopamine/norepinephrine reuptake inhibitor (5) · GABAA potentiator; NMDA antagonist (5) · Phenothiazine D2 antagonist (5) · Potent 5-HT2A agonist (5) · 5-HT1B/1D agonist (4) · LSD analogue; 5-HT2A agonist (4) · Mu-opioid receptor agonist (4) · Muscarinic receptor antagonist (4) · Prodrug of LSD; 5-HT2A agonist (4) · Selective norepinephrine reuptake inhibitor (4)

None (408) · 0.5–1 oz (10–30 g) ground for psychoactive effect; far smaller for culinary use (1) · 12.5 mg PO once or twice daily. Titrate gradually: 25-50 mg/day increments every 1-2 days as tolerated. Target dose 300-450 mg/day in divided doses (BID or TID). Most patients stabilize between 200-600 mg/day. Therapeutic plasma level guide: target trough clozapine ≥350 ng/mL. (1) · 5 mg PO (1) · A ''marduuf'' bundle (~50 g fresh leaves) chewed over a couple of hours (1) · A measured pour of absinthe diluted 5:1 with cold water over sugar (the louche ritual) (1) · IV: 1 mEq/kg bolus in arrest indication, then titrated to ABG and clinical status; PO: 325-2000 mg up to QID as antacid (1) · Narcolepsy/OSA: 200 mg PO once daily in the morning. Shift work disorder: 200 mg PO approximately 1 hour before the start of the work shift. Lower starting dose (100 mg) can be considered in elderly patients or those with hepatic impairment. (1)

None (391) · 4.2%, 7.5%, 8.4% IV (1 mEq/mL at 8.4%); 325, 650 mg oral tablets; bulk powder (1) · A ''betel quid'': areca nut slice + betel leaf + slaked lime (calcium hydroxide) ± tobacco ± spices, chewed (1) · Acid/base extraction of fresh young grass for tryptamines; combined with an MAOI (1) · Bark/woody stem decocted with a DMT-source plant (''Psychotria viridis'', ''Diplopterys cabrerana'') to make ayahuasca (1) · Bright red seeds, traditionally ingested or smoked. Highly toxic, narrow margin between active and lethal (1) · Clozaril 25 mg and 100 mg tablets; FazaClo orally disintegrating tablets (12.5/25/100/150/200 mg); Versacloz oral suspension 50 mg/mL. All brands subject to identical REMS ANC monitoring requirements. Generic tablets widely available. (1) · Desoxyn 5 mg tabs (1) · Dried leaves and twigs, infused in a gourd (''mate'') and drunk through a metal straw (''bombilla'') (1) · Dried leaves; absinthe liqueur (120–160 proof, with hyssop, lemon balm, fennel, anise, sometimes Acorus calamus) (1) · Fermented and roasted seeds, ground. Mexican tradition: drunk with chili, cornmeal, achiote. European tradition: with sugar and milk (1) · Flowers or leaves infused or smoked. Highly variable potency; narrow toxic margin (1) · Fresh leaves and tender twigs chewed; degrades on drying (1) · Fresh nuts chewed; also dried and powdered (1) · Ground dried seed (nutmeg) or fruit aril (mace); occasionally infused (1) · Leaves and seeds, traditionally smoked or infused. Possibly the original Pythia oracle plant (1) · Leaves chewed with a pinch of slaked lime (the lime converts cocaine HCl to freebase for buccal absorption); also drunk as tea (''mate de coca'') (1) · Leaves, berries, root. Historically: belladonna cigarettes ("Asthmador") OTC in US until the 1970s (1) · Oral tablets 100 mg and 200 mg (Provigil and generics). No IV or extended-release formulations available; compare armodafinil (Nuvigil) 50/150/250 mg tablets as the R-enantiomer alternative. (1) · Parotid-gland venom expressed onto a glass plate, dried into a shellac-like resin, vaporized and inhaled (1) · Roasted seeds ground to powder, mixed with water; commercial syrups and energy drinks (1) · Root bark acid/base-extracted for DMT; or as the resurrected ''jurema preta'' brew (decocted with an MAOI such as ''Peganum harmala'') (1) · Root, traditionally carved into ''mannikens'' or infused into wine (1) · Tablets 5, 10, 40 mg (40 mg dispersible restricted to OTPs); oral concentrate 10 mg/mL; oral solution 1, 2, 10 mg/mL; injection 10 mg/mL (1) · Toasted leaves and twigs decocted to a near-black concentrate (1)

None (410) · 25 mg/day (ADHD per Desoxyn label); 15 mg/day (obesity, short-term, per Desoxyn label) (1) · 400 mg/day (though clinical trials and FDA label note that doses above 200 mg/day have not demonstrated additional benefit in controlled studies for the approved indications; 200 mg is the standard therapeutic dose).'"`UNIQ--ref-0000004B-QINU`"' (1) · 900 mg/day (split into BID or TID dosing). Clinical practice rarely exceeds 600 mg/day; seizure risk increases substantially above 600 mg/day and requires consideration of prophylactic anticonvulsant.'"`UNIQ--ref-0000004A-QINU`"' (1) · No fixed maximum; titrated to pH and bicarbonate level; chronic high oral doses cause metabolic alkalosis and volume overload (1) · No formal hard ceiling; in MOUD maintenance, doses typically remain at or below 120 mg/day with higher doses reserved for documented under-treatment after careful clinical assessment (1)

None (408) · 15–30 min (1) · Immediate (IV); within minutes (oral antacid) (1) · Oral analgesic effect 30-60 minutes; opioid-withdrawal suppression 30 minutes (oral); IV ~10 minutes (1) · Oral peak plasma 2.5 hours. Clinical antipsychotic response typically emerges over weeks with continued titration; full response assessment requires 3-6 months at adequate therapeutic levels. (1) · Peak plasma concentrations 2-4 hours after oral dose. Wakefulness-promoting effect onset correlates with peak plasma; subjective alertness typically reported within 1-2 hours of dosing. (1) · Seconds (1) · Slow, 2–6 h (1)

None (408) · 12–24 h or longer (1) · 2–4 h (1) · Analgesic effect 4-8 hours (much shorter than half-life would suggest, due to receptor kinetics); MOUD effect (opioid withdrawal suppression) 24-36 hours per single daily dose (1) · Due to the half-life of 12 hours (wide range), dosing is BID or TID. Once-daily dosing produces higher peak/trough fluctuations and is generally not used except for a single end-of-day dose in stable patients. (1) · Effective wakefulness promotion through approximately 12-15 hours reflecting the half-life of the predominant R-enantiomer. For shift-work use, 200 mg taken 1 hour before shift provides coverage through most 8-12 hour shifts. (1) · IV: hours, dependent on ongoing acid load; oral antacid: ~30 minutes (1) · ~15 min (1)

None (411) · 100% (IV); rapidly neutralized by gastric acid (oral) (1) · Approximately 50-60% (oral; subject to first-pass metabolism); food does not significantly affect absorption.'"`UNIQ--ref-0000004C-QINU`"' (1) · Approximately 80% (well-absorbed orally; not significantly affected by food, though food may delay Tmax by ~1 hour).'"`UNIQ--ref-0000004D-QINU`"' (1) · ~70-85% (oral, high relative to other opioids) (1)

None (413) · Category C (per Desoxyn label) (1) · Routine antacid and acidosis correction acceptable (1)

None (408) · 5-MeO-DMT is Schedule I in US (since 2011); the toad itself is protected in several southwestern states (1) · Currently legal in most jurisdictions with thujone limits (1) · Leaves legal in Bolivia, Peru, Colombia; cocaine internationally controlled (1) · Plant unrestricted; pharmaceutical atropine Rx-only (1) · Schedule I in US since 1993 (despite traditional use elsewhere); legal in Ethiopia, Kenya, Yemen, Somalia, Djibouti (1) · Schedule II (1) · [[USLegal:Prescription only|Rx-only]] for IV formulations; OTC for oral (1)

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