Dissociatives produce analgesia, amnesia and catalepsy at anesthetic doses. They also produce a sense of detachment from the surrounding environment, hence "the state has been designated as dissociative anesthesia since the patient truly seems disassociated from his environment." Dissociative symptoms include the disruption or compartmentalization of "...the usually integrated functions of consciousness, memory, identity or perception."p. 523 Dissociation of sensory input can cause derealization, the perception of the outside world as being dream-like or unreal. Other dissociative experiences include depersonalization, which includes feeling detached from one's body; feeling unreal; feeling able to observe one's actions but not actively take control; being unable to recognize one's self in the mirror while maintaining rational awareness that the image in the mirror is the same person. Simeon (2004) offered "...common descriptions of depersonalisation experiences: watching oneself from a distance (similar to watching a movie); candid out-of-body experiences; a sense of just going through the motions; one part of the self acting/participating while the other part is observing;...."
The primary dissociatives achieve their effect through blocking the signals received by the NMDA receptor set (NMDA receptor antagonism) and include ketamine, phencyclidine (PCP), dextromethorphan (DXM), and nitrous oxide. However, dissociation is also remarkably administered by salvinorin A's (the active constituent in Salvia divinorum shown to the left) potent κ-opioid receptor agonism and is notably the most potent psychoactive chemical harnessed directly from the plant kingdom.
Some dissociatives can have CNS depressant effects, thereby carrying similar risks as opioids, which can slow breathing or heart rate to levels resulting in death (when using very high doses). DXM in higher doses can increase heart rate and blood pressure and still depress respiration. Inversely, PCP can have more unpredictable effects and has often been classified as a stimulant and a depressant in some texts along with being as a dissociative. While many have reported that they "feel no pain" while under the effects of PCP, DXM and Ketamine, this does not fall under the usual classification of anesthetics in recreational doses (anesthetic doses of DXM may be dangerous). Rather, true to their name, they process pain as a kind of "far away" sensation; pain, although present, becomes a disembodied experience and there is much less emotion associated with it. As for probably the most common dissociative, nitrous oxide, the principal risk seems to be due to oxygen deprivation. Injury from falling is also a danger, as nitrous oxide may cause sudden loss of consciousness, an effect of oxygen deprivation. Because of the high level of physical activity and relative imperviousness to pain induced by PCP, some deaths have been reported due to the release of myoglobin from ruptured muscle cells. High amounts of myoglobin can induce renal shutdown. Along with most, if not all of the chemicals in this article, none of the dissociatives have any physically addictive properties, though psychological addiction has been observed.
Many users of dissociatives have been concerned about the possibility of NMDA antagonist neurotoxicity (NAN). This concern is partly due to William E. White, the author of the DXM FAQ, who claimed that dissociatives definitely cause brain damage. The argument was criticized on the basis of lack of evidence and White retracted his claim. White's claims and the ensuing criticism surrounded original research by John Olney.
In 1989, John Olney discovered that neuronal vacuolation and other cytotoxic changes ("lesions") occurred in brains of rats administered NMDA antagonists, including PCP and ketamine. Repeated doses of NMDA antagonists led to cellular tolerance and hence continuous exposure to NMDA antagonists did not lead to cumulative neurotoxic effects. Antihistamines such as diphenhydramine, barbiturates and even diazepam have been found to prevent NAN. LSD and DOB have also been found to prevent NAN.
Read more about this topic: Psychedelics, Dissociatives And Deliriants