lysergic acid diethylamide (LSD, Lysergide, Lysergamid)
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Indications
- a recreational drug (no approved medical use)
Clinical manifestations
- effects vary with both the user & the environment
- euphoria
- hallucinations
- synesthesias
Dosage
- doses as low as 20-25 ug can produce effects
- dose of 0.5-2 ug/kg can result in adverse effect[4]
Pharmacokinetics
- onset of psychological effects occurs 30-60 minutes after ingestion
- peak effects in ~5 hours
- effects last ~12 hours
1/2life = 3.5-4 hours
protein binding = 90 %
Adverse effects
- mydriasis
- tachycardia
- tremor
- weakness
- paresthesias
- labile mood
- hypothermia
- hypoglycemia[4]
- recurrent (flashback) hallucinations
- delayed occurrence of:
- hysterical behavior
- hyperactivity
- hyperthermia
- psychotic reactions
Drug interactions
- LSD in combination with serotonin precursors or serotonin agonists, serotonin-release stimulators, SSRIs, nonselective serotonin-reuptake inhibitors, or nonspecific inhibitors of 5-HT metabolism may result in serotonin syndrome
- patients taking SSRIs or lithium carbonate have greater risk for seizures & flashbacks[4]
Laboratory
- specimen:
- methods:
- labs with Loincs
Mechanism of action
- action at multiple sites within CNS via 5-HT2A receptor[3]
Management
- management of intoxication
- supportive therapy: IV fluids, benzodiazepine[6]
More general terms
Additional terms
References
- ↑ The Pharmacological Basis of Therapeutics, 8th ed. Gilman et al, eds. Permagon Press/McGraw Hill pg 941
- ↑ Clinical Guide to Laboratory Tests, NW Tietz (ed) 3rd ed, WB Saunders, Philadelpha 1995
- ↑ 3.0 3.1 Preller KH, Herdener M, Pokorny T et al The Fabric of Meaning and Subjective Effects in LSD-Induced States Depend on Serotonin 2A Receptor Activation. Current Biology Jan 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28132813 <Internet> http://www.cell.com/current-biology/fulltext/S0960-9822(16)31510-X
- ↑ 4.0 4.1 4.2 4.3 Sinert RO Fast Five Quiz: Psilocybin and Other Hallucinogenic Drugs. Medscape. September 07, 2021 https://reference.medscape.com/viewarticle/957547
- ↑ Rega PP, Thornton SL LSD Toxicity Medscape. Jan 4, 2019 https://emedicine.medscape.com/article/1011615-overview#showall
- ↑ 6.0 6.1 NEJM Knowledge+ Psychiatry