Lysergic acid diethylamide toxicity: Difference between revisions
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==Background==
==Background==
d-lysergic acid diethylamide, more commonly known as LSD, was first synthesized in 1938 by the chemist Albert Hofmann in efforts to chemically create a blood stimulant.<ref>Hofmann A. "Die Geschichte des LSD-25". Triangel Sandoz Zeitschrift fur Medizinische Wissenschaften. 1955;2(3):117-24. (as cited in Ott J. Pharmacotheon. 1993. pg 123.)</ref>In 1943, Hoffman accidently ingested LSD for the first time, discovering its hallucinagenic properties, reportedly seeing "an uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopelike play of colors."
d-lysergic acid diethylamide, more commonly known as LSD, was first synthesized in 1938 by the chemist Albert Hofmann in efforts to chemically create a blood stimulant.<ref>Hofmann A. "Die Geschichte des LSD-25". Triangel Sandoz Zeitschrift fur Medizinische Wissenschaften. 1955;2(3):117-24. (as cited in Ott J. Pharmacotheon. 1993. pg 123.)</ref>In 1943, Hoffman accidently ingested LSD for the first time, discovering its hallucinagenic properties, reportedly seeing "an uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopelike play of colors."<ref>http://www.theatlantic.com/health/archive/2014/09/the-accidental-discovery-of-lsd/379564/</ref>
LSD became very popular in the 1960's and 1970's, making it a very important part of the "counterculture" movement, encouraging participants to  "turn on, tune in, drop out."
LSD became very popular in the 1960's and 1970's, making it a very important part of the "counterculture" movement, encouraging participants to  "turn on, tune in, drop out."<ref>Leary, T. "Flashbacks." Tarcher, 1997.</ref>


===Mechanism===
===Mechanism===
Serotonin like agent
Serotonin-like agents, like LSD, have similar chemical properties of serotonin. These are 5-HT2 agonists, mediating excitatory neurotransmitter release.<ref>Ly, B. "Hallucinogens", ''Rosen's Emergency Medicine: Concepts and Clinical Practice''. 7th Ed. Pgs 2010-2012</ref>  LSD also binds to dopaminergic receptors, contributing to its psychogenic affects.<ref>Marona-Lewicka D, Thisted RA, Nichols DE (2005). "Distinct temporal phases in the behavioral pharmacology of LSD: Dopamine D2 receptor-mediated effects in the rat and implications for psychosis". Psychopharmacology 180 (3): 427–435.</ref>


===Pharmacology===
===Pharmacology===
Known as one of the most potent psychoactive drug, doses of minimum of 25μg. Doses of 1 to 1.5 μg/kg produce psychedelic effects, with the “optimum” dosage for a typical fully unfolded LSD reaction is estimated to be in the range of 100–200 μg.
Known as one of the most potent psychoactive drug, doses of minimum of 25μg. Doses of 1 to 1.5 μg/kg produce psychedelic effects, with the “optimum” dosage for a typical fully unfolded LSD reaction is estimated to be in the range of 100–200 μg.


Route of administration can be PO (most common), IM, or IV.  
Route of administration can be PO (most common), IM, or IV.<ref>Passie, T. "The Pharmacology of Lysergic Acid Diethylamide: A Review". CNS Neuroscience & Therapeutics, Volume 14, Issue 4,  pages 295–314, Winter 2008</ref>
 
PO: Usual Dose 100-250μg, Onset 30-45mins, Peak effect 1-2.5hrs, Total duration 9-12hrs
Mode of application Dose (μg) Onset of symptoms (min) Peak effect (h)* Total duration (h)*
IM: Usual Dose 100-250μg, Onset 15-20mins, Peak effect 1hr, Total duration 9-10hrs
Per os 100–250 30–45 1.0–2.5 9–12
IV: Usual Dose 40-180μg, Onset 3-5mins, Peak effect 1hr, Total duration 9-10hrs
Intramuscular 100–250 15–20 1.0 9–10
Intravenous 40–180 3–5 1.0 9–10
 
The acute psychological effects of LSD last between 6 and 10 h, depending on the dose applied.
 
Distribution


Tolerance to LSD-25 builds up over consistent use and cross-tolerance has been demonstrated between LSD, mescaline and psilocybin.
Tolerance to LSD-25 builds up over consistent use and cross-tolerance has been demonstrated between LSD, mescaline and psilocybin.

Revision as of 18:55, 1 June 2015

Background

d-lysergic acid diethylamide, more commonly known as LSD, was first synthesized in 1938 by the chemist Albert Hofmann in efforts to chemically create a blood stimulant.[1]In 1943, Hoffman accidently ingested LSD for the first time, discovering its hallucinagenic properties, reportedly seeing "an uninterrupted stream of fantastic pictures, extraordinary shapes with intense, kaleidoscopelike play of colors."[2] LSD became very popular in the 1960's and 1970's, making it a very important part of the "counterculture" movement, encouraging participants to "turn on, tune in, drop out."[3]

Mechanism

Serotonin-like agents, like LSD, have similar chemical properties of serotonin. These are 5-HT2 agonists, mediating excitatory neurotransmitter release.[4] LSD also binds to dopaminergic receptors, contributing to its psychogenic affects.[5]

Pharmacology

Known as one of the most potent psychoactive drug, doses of minimum of 25μg. Doses of 1 to 1.5 μg/kg produce psychedelic effects, with the “optimum” dosage for a typical fully unfolded LSD reaction is estimated to be in the range of 100–200 μg.

Route of administration can be PO (most common), IM, or IV.[6] PO: Usual Dose 100-250μg, Onset 30-45mins, Peak effect 1-2.5hrs, Total duration 9-12hrs IM: Usual Dose 100-250μg, Onset 15-20mins, Peak effect 1hr, Total duration 9-10hrs IV: Usual Dose 40-180μg, Onset 3-5mins, Peak effect 1hr, Total duration 9-10hrs

Tolerance to LSD-25 builds up over consistent use and cross-tolerance has been demonstrated between LSD, mescaline and psilocybin.

Clinical Features

Differential Diagnosis

Serotonin-Like Agents

  • LSD
  • Psilocybin and psilocin dimethyltryptamine (DMT) and 5-methoxy- dimethyltryptamine (5-MeO-DMT)
  • Naturally occurring plants like :Hawaiian baby woodrose (Argyreia nervosa), Hawaiian woodrose (Merremia tuberosa), morning glory (Ipomoea violacea), and olili- uqui (Rivea corymbosa)

Enactogens

Dissociative Agents

Plant-based Hallucinogenics

  • Marijuana
  • Salvia
  • Absinthe
  • Isoxazole Mushrooms

Psychiatric Illnesses

Diagnosis

Management

Disposition

See Also

External Links

References

  1. ↑ Hofmann A. "Die Geschichte des LSD-25". Triangel Sandoz Zeitschrift fur Medizinische Wissenschaften. 1955;2(3):117-24. (as cited in Ott J. Pharmacotheon. 1993. pg 123.)
  2. ↑ http://www.theatlantic.com/health/archive/2014/09/the-accidental-discovery-of-lsd/379564/
  3. ↑ Leary, T. "Flashbacks." Tarcher, 1997.
  4. ↑ Ly, B. "Hallucinogens", Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th Ed. Pgs 2010-2012
  5. ↑ Marona-Lewicka D, Thisted RA, Nichols DE (2005). "Distinct temporal phases in the behavioral pharmacology of LSD: Dopamine D2 receptor-mediated effects in the rat and implications for psychosis". Psychopharmacology 180 (3): 427–435.
  6. ↑ Passie, T. "The Pharmacology of Lysergic Acid Diethylamide: A Review". CNS Neuroscience & Therapeutics, Volume 14, Issue 4, pages 295–314, Winter 2008
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