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.