and expectations of the individual using the hallucinogen may contribute to the nature of
and severity of halluc inogen intoxication. Continued use of hallucinogens, particularly
MDMA, has also been linked with neurotoxic effects.
Differential Diagnosis
Other substance intoxication. Other hallucinogen intoxication  should be differentiated
from intoxication with amphetamines, cocaine,  or other stimulants; anticholinergics; in-
halants; and phencyclidine. Toxicological tests are useful in making this distinction, and
determining the route of administration may also be useful.
Other conditions. Other disorders and conditions to be considered include schizophre-
nia, depression, withdrawal from other drugs (e.g., sedatives, alcohol), certain metabolic
disorders (e.g., hypoglycemia),  seizure disorders, tumors of  the central nervous system,
and vascular insults.
Hallucinogen persisting perception disorder. Other hallucinogen intoxication is dis-
tinguished from hallucinogen persisting percep tion disorder because the symptoms in the
latter continue episodically or continuously for weeks (or long er) after the most recent in-
toxication.
Other hallucinogen-induced disorders. Other hallucinogen intoxication is distinguished
from the other hallucinogen-induced disorder s (e.g., hallucinogen- induced anxiety disor-
der, with onset during intoxication) because the symptoms in these latter disorders pre-
dominate the clinical presentation and are severe enough to warrant independent clinical
attention.