Emergency Medical Minute2 Feb 2021

Podcast 637: LSD

Contributor: Katie Sprinkel, MD

Educational Pearls:

Commonly known as "acid," LSD is seeing a resurgence in the population as a recreational hallucination
Onset is about 30 minutes with peak pharmacologic effects at 2-4 hours, the drug's half life is 3 hours resulting in some prolonged effects
While there is not an significant addictive component of LSD, tolerance for LSD does occur and prolonged usage is associated with increased incidence of schizophreniform disorders
Hallucinations and pseudo-hallucinations (sensory misperceptions) are typical of LSD intoxication, other common signs of intoxication include nausea, diaphoresis, tachycardia, mydriasis, and hypertension
More serious effects can be coma, hyperthermia, seizures, cardiac arrest, serotonin syndrome (with concomitant SSRI use) and coagulopathy, although the dose to cause these effects is very high
Treatment is decreasing sensory stimulation, benzodiazepines in some cases, and symptomatic treatment - no specific antidote exists

References

Blaho K, Merigian K, Winbery S, Geraci SA, Smartt C. Clinical pharmacology of lysergic acid diethylamide: case reports and review of the treatment of intoxication. Am J Ther. 1997 May-Jun;4(5-6):211-21. doi: 10.1097/00045391-199705000-00008. PMID: 10423613.

Klock JC, Boerner U, Becker CE. Coma, hyperthermia and bleeding associated with massive LSD overdose. A report of eight cases. West J Med. 1974;120(3):183-188.

Summarized by John Spartz, MS3 | Edited by Erik Verzemnieks, MD

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