From PCP to Ketamine and DXM: How Medical Anaesthetics Evolved

At MycoMind, we're always curious about how the substances that shape our world—especially those linked to the mind and body—impact human consciousness. When we first stumbled upon the history of Ketamine and its predecessor PCP, we realized this was a subject not often discussed in everyday conversations but rich with fascinating stories. How did a drug like PCP, with such dangerous side effects, evolve into something as transformative as Ketamine, now used not only in surgeries but also to treat severe depression and PTSD? And what about DXM, the common ingredient in cold medicine, that holds a place in the same pharmacological family?

This concept was new to us, and we wanted to dive deeper into the story. So, we embarked on a journey to understand how these substances came to be, why they shifted roles in the medical field, and how their uses have transformed over time. Our hope is that everyone reading this finds it as intriguing as we did. We believe that by understanding the history and science behind these drugs, we can approach life a little more informed, aware, and awakened to the complex interplay between medicine, the mind, and consciousness.

Disclaimer: MycoMind is not a licensed medical practitioner, nor do we make any medical claims. We encourage everyone to do their own due diligence and consult with a healthcare professional before considering any substance for medical or therapeutic use.

The Origins of PCP: A Promising Start, A Troubling Outcome

Phencyclidine (PCP) was first synthesized in 1926, though it didn’t catch the attention of the medical world until the 1950s. It was developed by Parke-Davis under the trade name Sernyl and was initially hailed as a groundbreaking anesthetic. Its dissociative properties allowed patients to remain conscious while disconnecting from their pain and environment, without the usual risks of respiratory depression common to other anesthetics.

However, what began as a promising medical tool soon unraveled. Patients often experienced severe psychological side effects, such as hallucinations, delirium, and dysphoria. The post-anesthetic confusion and psychotic-like episodes made PCP impractical for use in humans, leading to its withdrawal from the medical market by the 1960s. What had seemed like a safer option quickly revealed its darker side, earning it a reputation that would later surface on the streets as the notorious drug “angel dust.”

Enter Ketamine: A Safer Alternative

The search for a less problematic anesthetic led to the development of Ketamine in the early 1960s, again by Parke-Davis. Structurally similar to PCP, Ketamine offered the same dissociative effects but with a key difference: a much shorter duration of action and fewer severe psychological effects. By 1970, Ketamine was approved for use in humans and quickly became a go-to anesthetic, particularly in high-stakes environments like battlefield surgeries during the Vietnam War.

The reasons for Ketamine's success over PCP are clear:

• Fewer psychological side effects: While still dissociative, Ketamine produced fewer hallucinations and psychotic episodes, making it a more manageable anesthetic.

• Shorter action: Patients recovered more quickly, reducing the chances of prolonged delirium or confusion.

• Versatility: Ketamine’s applications extended to both human and veterinary medicine, making it a popular choice for a wide variety of surgeries and pain management procedures.

Though PCP found an unfortunate place in the illegal drug market, Ketamine has continued to evolve in its medical applications, now serving as a treatment for chronic pain and severe mood disorders in psychiatric settings.

DXM: The Cough Suppressant with Dissociative Potential

Meanwhile, another drug with a similar mechanism of action emerged in a very different market. Dextromethorphan (DXM), developed in the 1950s, became a key ingredient in over-the-counter cough suppressants. Unlike codeine, which posed risks of dependence, DXM provided a safer, non-addictive alternative for suppressing coughs.

Like PCP and Ketamine, DXM acts as an NMDA receptor antagonist, inhibiting a receptor involved in pain perception, memory, and mood regulation. However, while low doses of DXM are effective for its intended purpose, higher doses can produce dissociative and hallucinogenic effects. This led to a rise in recreational use, particularly among teenagers seeking its psychoactive properties. Known as "robotripping," DXM abuse emerged as a public health concern in the 1990s and 2000s.

Ketamine’s Modern Role in Medicine and Psychiatry

Fast forward to today, and Ketamine has expanded beyond its role as an anesthetic. In recent years, it has gained attention for its use in treating conditions like treatment-resistant depression and PTSD. Administered in sub-anesthetic doses, Ketamine’s effects on mood and perception have sparked interest in its therapeutic potential, leading to the rise of Ketamine clinics offering treatment for severe mental health conditions.

As a derivative, Esketamine, in nasal spray form, has also become an FDA-approved treatment for depression. This resurgence of Ketamine in modern medicine underscores its versatility and potential to provide relief in ways far beyond its original purpose.

Conclusion: The Evolution of Anesthetics and the Role of NMDA Antagonists

The journey from PCP to Ketamine and DXM highlights the importance of understanding not just the pharmacological effects of these substances but their impact on both medical practice and public health. While PCP’s dangerous psychological side effects pushed it out of medical use, Ketamine emerged as a safer, more predictable alternative. DXM, though widely used in cough medicines, has shown the same dissociative potential at higher doses, leading to its own complications in recreational misuse.

These substances, linked by their NMDA receptor antagonism, continue to shape our understanding of anesthesia, pain management, and even psychiatric treatment, each bringing with it lessons about the fine line between therapeutic use and the risk of abuse.

Works Cited

• American Society of Anesthesiologists. “The Use of Ketamine in Modern Medicine.” ASA Monitor, 2020.

• History of Drug Abuse. “The Dark Side of PCP: How a Medical Anesthetic Became a Dangerous Street Drug.” DrugRehab.com, 2019.

• Weissman, Adam M. “DXM and the Rise of Robotripping: A Historical Perspective.” Journal of Substance Abuse, vol. 35, no. 4, 2018, pp. 45–60.