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Substance Use Disorders
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Naturally occurring hallucinogens have been used for centuries as part of religious and cultural activities. LSD, the prototypical synthetic hallucinogen, was synthesized in 1938 by the chemist Albert Hofmann who recognized its hallucinogenic capabilities when he was accidentally exposed. LSD is currently being studied as a treatment for a variety of psychiatric indications.
Hallucinogens and Phencyclidine
Published in Frank Lynn Iber, Alcohol and Drug Abuse as Encountered in Office Practice, 2020
LSD is supplied by illicit manufacturers in the U.S. and is available in highly purified form. An effective dose in a nontolerant user is as little as 20 μg, and the street dose varies from 50 to 300 <g, usually dried on a sugar cube; the drug can be taken orally, snuffed, or injected. The onset of action by all routes is most rapid as regards adrenergic effects. Perception changes and visual imagery follow in 30 to 60 min for all routes of administration. A marked euphoria is a regular feature. The effects last from a few hours with low doses to a maximum of 20 to 24 h with higher ones.
Drugs of Abuse and Addiction
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Shalini Mani, Chahat Kubba, Aarushi Singh
Continuous ingestion of LSD is almost impossible as the “good trip” or high remains for a longer time. The dependence on LSD is not due to cravings or any physical effects but only due to personal need and psychological aspects (Dolder et al., 2017).
Safety issues of psilocybin and LSD as potential rapid acting antidepressants and potential challenges
Published in Expert Opinion on Drug Safety, 2022
Giordano Novak Rossi, Jaime E. C. Hallak, José Carlos Bouso Saiz, Rafael G. Dos Santos
As reported above, psilocybin was associated with significant reductions in depressive symptoms in most trials, where it was administered (comparisons with baseline and/or between treatment groups), with preliminary and nonconfirmatory evidence of sustained therapeutic effects and remission rates from weeks to months after interventions. LSD treatment was associated with a trend to lower depressive symptoms and significantly reduced anxiety. Moreover, reductions in anxiety symptoms were also reported in most articles with psilocybin. Finally, secondary measurements such as well-being, attitudes toward life, quality of life, augmented meaning in life, death acceptance, and optimism, among others, corroborated the main results found in all articles. Although promising, the short- and long-term efficacy of psychedelics is not established, as all studies are preliminary and not confirmatory. Further trials with larger samples are needed to replicate these results.
Description of Adverse Events in a Cohort of Dance Festival Attendees with Stimulant-Induced Severe Agitation Treated with Dissociative-Dose Ketamine
Published in Prehospital Emergency Care, 2021
Matt S. Friedman, David Saloum, Astrid Haaland, Jefferson Drapkin, Antonios Likourezos, Reuben J. Strayer
Common drugs of abuse utilized at festivals tend to be entactogens–psychostimulants that produce experiences of emotional communion and openness such as 3,4-methylenedioxymethamphetamine (MDMA) as well as hallucinogens like lysergic acid diethylamide (LSD). MDMA, known colloquially as Molly or Ecstasy, causes euphoria and mental stimulation but is well known to cause serious adverse effects including hyperthermia, seizures, hyponatremia, rhabdomyolysis, and multiorgan failure (10). LSD, often referred to as acid, causes intense visual hallucinations as well as altering the user’s emotional valence and relationship to their surroundings. Dangerous effects of LSD primarily arise from distortion of reality leading to impulsive actions such as believing one can fly, but LSD may also cause hypertension, tachycardia, and hyperthermia (11).
Metabolism of lysergic acid diethylamide (LSD): an update
Published in Drug Metabolism Reviews, 2019
Rui Filipe Libânio Osório Marta
In this work, the metabolism of LSD was reviewed. LSD is extensively metabolized into inactive metabolites and only very little of unchanged LSD is excreted (Passie et al. 2008; Dolder et al. 2017; Steuer et al. 2017; Dolder et al. 2018). Urine samples from LSD users indicated that O-H-LSD seems to be the major metabolite in urine and can be detected a few days after LSD ingestion. Since blood concentrations are relatively low, LSD analysis is often performed in urine, although, recent studies have validated methods in plasma samples (Steuer et al. 2017). The identification of new metabolites can be helpful to prove consumption in a wider detection window. For the first time, LSD and its metabolite O-H-LSD were detected in vitreous humor, which can be an advantage in forensic determination of postmortem LSD levels (Favretto et al. 2007). LSD was also detected in human hair from drug abusers (Nakahara et al. 1996; Rohrich et al. 2000; Jang et al. 2015). Therefore, the analysis of new biological specimens is a step forward.