LSD is the most potent hallucinogen. This as well as other hallucinogens
have been used for religious rituals by Native Americans for centuries. LSD chemical
structure has similarity to serotonin and works through post synaptic 5-HT2A receptor
agonistic effects. LSD was first synthesized in late nineteen thirties. LSD intoxication
significantly increases central autonomic activity leading to panic states, tachycardia,
increased blood pressure and body temperature, pupillary dilatation, piloerection,
tremor and hyperreflexia. The panic states, perceptual disturbances and flashbacks are
often referred to as “trips”. Patient may experience these “trips” long after cessation of
its use. Subjective effects of LSD start with somatic symptoms followed by perceptual
disturbances, lability of mood, depersonalization, altered sense of time, visual
distortions, mixing of sensations like “seeing” smells and “hearing” colors. This mixing
of sensations is called synesthesia. LSD is not addictive but tolerance to behavioral
effects and cross tolerance to other hallucinogens drugs are reported. Acute intoxication
results in somatic, perceptual and psychic effects. Some patients also relive these
experiences through flashbacks even long after cessation of its use. No withdrawal
symptoms are reported. Long -Term effects of LSD use may include psychosis,
depression, paranoid delusions and flashbacks. The treatment therefore will consist of
targeting the specific clinical syndrome like with SSRIs for depression, antipsychotics
like chlorpromazine for psychosis and bad “trips”. As with acute effects safety of the
user must be assured and may require inpatient admission. Comorbid mental disorder
should be treated to improve outcome. Cognitive behavioral therapy, social skills
enhancement training can help to improve adaptive functions.
Keywords: DMT, Ergot derivative, Hallucinogen, LSD, LSD Trip, Lysergic
Acid, MDA, Synesthesia.
