Application of a radioimmunoassay screening test for detection and management of phencyclidine intoxication.

A radioimmunoassay procedure has been developed to monitor patients suspected of phencyclidine (PCP) intoxication. Symptoms in 11 patients suspected of phencyclidine intoxication included violent, aggressive behavior with delusions, hallucinations, agitation, and other signs of toxic psychosis. In five subjects serum concentrations of PCP ranged between 0.5 and 40 ng/ml. For laboratory confirmation, ascorbic acid should be administered to the patient after collecting the initial urine specimen. The initial urine and the first and second specimen after acidification should be collected and submitted for analysis. By following this provocative mobilization procedure, phencyclidine has been identified in the first or second postacidification urine when the initial specimen gave either a negative or questionable reaction. Patients reporting to emergency rooms with hallucinations and psychosis and a history of "pot" smoking should be screened for the presence of phencyclidine in their blood and urine. For those cases that turn out to be negative for the phencyclidine group of compounds, other hallucinogenic drugs such as lysergic acid diethylamide, ketamine, mescaline, or psilocybin may be suspect.