Gastrointestinal Drugs

One of the commonest drugs used to treat intestinal cramps and diarrhea is Lomotil, a combination of a synthetic opiate called diphenoxylate and atropine, one of the constituents of nightshade plants. Both of these drugs reduce the movement of the intestines by paralyzing the nerves that control them. Diphenoxylate is a close chemical relative of meperidine (Demerol), one of the strong medical narcotics. Like its relative, diphenoxylate can cause depression of the nervous system that may be intensified by simultaneous use of other depressants. It can also cause euphoria and dependence. Many patients who take Lomotil for intestinal upset experience narcotic effects on mood but have no idea they are using an opiate.

Atropine by itself has little psychoactivity in low doses; most people find high doses unpleasant. Some combination drugs mix atropine with other nightshade derivatives, including scopolamine, the main psychoactive principle of the nightshade family. Donnatal is an example of such a mixture; it also includes some phenobarbital as a sedative. Doctors frequently maintain patients on these drugs, especially patients with ulcers, gastrointestinal spasms, and urinary disorders. Rarely do doctors or patients consider the potential of these treatments to affect mood and thought, but as noted in the section on deliriants,* nightshade drugs can influence the mind profoundly. The psychoactive effect most likely to be noticed by people who take these drugs is drowsiness, but over time, or in high dosage, they may cause more bizarre changes.

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