LSD: Encyclopedia II - LSD - Effects

LSD - Effects

LSD - Physical

Physical reactions to LSD are highly variable and may include: uterine contractions, Hyperthermia (body temperature increase), elevated blood sugar levels, dry-mouth, goose bumps, heart-rate increase, jaw clenching, nausea, perspiration, pupil-dilation, salivation, mucus production, sleeplessness and tremors. Cramps and muscle tension or soreness are also fairly commonly reported, but rather than being direct effects of LSD in the bloodstream, these symptoms are believed by some to be the result of awkward positions assumed by users experiencing fluctuations in their awareness of the passage of time and their own physical discomfort.

LSD was studied in the 1960s by Eric Kast [3] as a painkiller for serious and chronic pain caused by cancer or other major trauma. Even at low (sub-psychedelic) dosages, it was found to be at least as effective as traditional opiates while being much longer lasting (pain reduction lasting as long as a week — after peak effects had subsided). Kast attributed this effect to a decrease in anxiety. This reported effect is being tested (though not using LSD) in an ongoing (as of 2006) study of the effects of the hallucinogen psilocybin on anxiety in terminal cancer patients.

Furthermore, LSD has been illicitly used as a treatment for cluster headaches, an uncommon but extremely painful disorder. One researcher describes the headaches as "worse than natural childbirth or even amputation without anesthetic." [4] Although the phenomenon has not been formally investigated, case reports indicate that LSD and psilocybin can reduce cluster pain and also interrupt the cluster-headache cycle, preventing future headaches from occurring. Currently existing treatments include various ergotamines, among other chemicals, so LSD's efficacy may not be surprising. A dose-response study, testing the effectiveness of both LSD and psilocybin, is as of 2006 being planned at McLean Hospital. Unlike attempts to use LSD or MDMA in psychotherapy, this research involves non-psychological effects and often sub-psychedelic dosages; therefore, it is plausibly a way that a respected medical use of LSD will arise. [5], [6], [7]

LSD - Pharmacological

LSD affects an enormous number of receptors, including all dopamine receptor subtypes, all adrenoreceptor subtypes as well as many others. LSD binds to most serotonin receptor subtypes except for 5-HT₃ and 5-HT₄. However, most of these receptors are affected at too low affinity to be activated by the approximate 10-20 nM of LSD which penetrates the brain.[8] So the receptors which are effected by recreational doses of LSD are 5-HT_1A, 5-HT_2A, 5-HT_2C, 5-HT_5A, 5-HT_{5 B} and 5-HT₆ The hallucinogenic effects of LSD are attributed to its strong partial agonist effects at 5-HT_2A receptors as specific 5-HT_2A receptor agonists are hallucinogenic and largely 5-HT_2A specific antagonists block the hallucinogenic activity of LSD. [9] Exactly how this produces the drug's effects is unknown, but it is likely thought that it works by increasing excitation of the cortex, specifically in layer V, which facilitate the spread of information throughout the cortex. Through this, LSD causes parts of the brain which would not normally be activated by a given stimulus to become engaged.[10]

LSD - Psychological

LSD's psychological effects ( colloquially called a "trip") vary greatly from person to person, from one trip to another, and even as time passes during a single trip. Widely different effects emerge based on set and setting — the 'set' being the general mindset of the user, and the 'setting' being the physical and social environment in which the drug's effects are experienced.

An LSD trip can have long lasting or even permanent neutral, negative, and positive psychoemotional effects. LSD experiences can range from indescribably ecstatic to extraordinarily difficult; many difficult experiences (or "bad trips") result from a panicked user feeling that he or she has been permanently severed from reality and his or her ego. If the user is in a hostile or otherwise unsettling environment, or is not mentally prepared for the powerful distortions in perception and thought that the drug causes, effects are more likely to be unpleasant.

Conversely, a pleasant, comfortable environment and a relaxed, balanced and open mindset will often result in a unique and extremely unusual experience.

Many users experience a dissolution between themselves and the "outside world" - cognitive differences between subject ("I") and object ("me, "you", "it") break down or seem absurd [11]. This unitive quality may play a role in the spiritual and religious aspects of LSD.

Generally beginning within thirty to ninety minutes after ingestion and continuing for the following six to twelve hours, the user may experience anything from subtle changes in perception to overwhelming cognitive shifts.

Changes in aural and visual perception are common, ranging from mild to profound [12][13]. These sensory changes include basic "high-level" distortions such as the appearance of moving geometrical patterns, new textures on objects, blurred vision, image trailing, shape suggestibility and color variations. Users sometimes describe experiencing new, previously-unseen colors; sights and sounds may take on greater intensity or have more of an impact. Users commonly report that the inanimate world appears to animate in an unexplained way; that is, objects that are static in three dimensions can seem to be moving relative to one or more additional spatial dimensions (e.g., [14]).

Higher doses often bring about shifts at a lower cognitive level, causing intense and fundamental distortions of sensory perception such as synaesthesia, the experience of additional spatial or temporal dimensions, and temporary dissociation.

The sensory shifts caused by the drug can lead users to sit or lie in awkward positions for extended periods of time, resulting in muscle cramps and soreness that may mistakenly be attributed to the direct physical action of the drug.

LSD is considered an entheogen because it often catalyzes intense spiritual experiences where users feel they have come into contact with a greater spiritual or cosmic order. It is common for users to believe that they have achieved insights into the way the mind works and some users experience permanent or long-lasting changes in their life perspective. Some users consider LSD a religious sacrament, or a powerful tool for access to the divine. Many books have been written comparing the LSD trip to the state of enlightenment of eastern philosophy.

Such experiences under the influence of LSD have been observed and documented by researchers such as Timothy Leary and Stanislav Grof. A brief video documentary of the Good Friday Marsh Chapel Experiment conducted by Walter Pahnke under Leary's supervision (a double blind experiment using volunteers who were students in religious graduate programs, e.g., divinity, theology, etc.) can be viewed here. That study showed that hallucinogens could reliably be used to induce mystical religious states (at least in people with a spiritual predisposition).

LSD - Acute duration

LSD's primary effects normally last from 6 to 12 hours. It is typical for users of LSD to be unable to sleep restfully (or at all, despite desperate attempts) until at least 12 hours have passed, and they do not feel completely "back to normal" until after getting one or two full nights of restful sleep, although they will exhibit no outward signs of impairment after the drug has worn off.

Contrary to early reports and common belief, LSD effects do not last longer than significant levels of the drug in the blood. Aghajanian and Bing [15] found LSD had an elimination half-life of 175 min, while, more recently, Papac and Foltz [16] reported that 1 µg/kg oral LSD given to a single male volunteer had an apparent plasma half-life of 5.1 h with a peak plasma concentration of 1.9 ng/mL at 3 h post-dose. Notably, Aghajanian and Bing found that blood concentrations of LSD matched the time course volunteers' difficulties with simple arithmetic problems.

Anecdotal reports indicate that administration of Thorazine or similar typical antipsychotic tranquilizers will not end an LSD trip, but rather will just immobilize and numb the patient. While it also may not end an LSD trip, the best chemical treatment for a "bad trip" is an anti-anxiety agent such as valium (diazepam) or other benzodiazepines. There have also been reports of Niacinamide being useful, a claim that has not been confirmed by multiple research groups using double-blind scientific methods and is therefore questionable.

LSD - Physical dangers

Although LSD is generally considered nontoxic, other dangers may arise from bad judgments made while under the influence of the drug. Like many drugs, LSD may temporarily impair the ability to make sensible judgments and understand common dangers, thus making the user susceptible to accidents and personal injury.

There is also some indication that LSD may trigger a dissociative fugue state in individuals who are taking certain classes of antidepressants such as lithium salts and tricyclics. In such a state, the user has an impulse to wander, and may not be aware of his or her actions, which can lead to physical injury. MAOIs and SSRIs are believed to interact more benignly, with a tendency to significantly reduce LSD's subjective effects.

As Albert Hofmann reports in LSD – My Problem Child, the early pharmacological testing Sandoz performed on the compound (before he ever discovered its psychoactive properties) indicated that LSD has a pronounced effect upon the mammalian uterus. Sandoz testing showed that LSD can stimulate uterine contractions with efficacy comparable to ergobasine, the active uterotonic component of the ergot fungus. (It is worth noting that Hofmann's work on ergot derivatives also produced a modified form of ergobasine which became a widely accepted medication used in obstetrics, under the trade name Methergine.) LSD use by pregnant women is therefore contraindicated. (My Problem Child, chapter 1). Claims have also been made that LSD produces fetal deformities, as opposed to increasing the risk of premature contractions; however, these claims have not been substantiated. Hofmann writes, "In animal experiments, it is indeed possible to induce fetal deformities through extremely high doses of LSD, which lie well above the doses used in human beings. But under these conditions, even harmless substances produce such damage. Examination of reported individual cases of human fetal deformities reveals, again, no connection between LSD use and such injury. If there had been any such connection, it would long since have attracted attention, for several million people by now have taken LSD" (chapter 2).

LSD - Flashbacks

There is also a commonly reported possibility of "flashbacks", a psychological phenomenon in which an individual experiences an episode of some of the subjective effects of LSD (this may be a positive or negative experience) long after the drug has been consumed and worn off — sometimes weeks, months or even years afterward.

Colloquial usage of the term 'flashbacks' refers to any experience reminiscent of LSD effects; these are commonly occasional brief experiences. However, psychiatry recognizes a disorder in which LSD-like effects are persistent and cause clinically-significant impairment or distress. This chronic flashback syndrome is called Hallucinogen Persisting Perception Disorder, a DSM-IV diagnosis. Several journal articles have described the disorder (see, for example, Adverse consequences of lysergic acid diethylamide, H.D. Abraham and A. Aldridge, Addiction 1993, 88:1327-1334; [Abstract]).

Several studies have tried to determine how likely a "normal user" (that is a user not suffering from known psychiatric conditions) of LSD is to experience flashbacks. The larger studies include (Flashback phenomena in basic trainees who enter the US Air Force, Blumenfield, Military Medicine, 136, 39-41, 1971) and (LSD Flashbacks and Ego Functioning, Naditch, M & Fenwick, Journal of Abnormal Psychology, Vol. 86, No 4, 352-359, 1977), arriving at figures of 20% and 28%, respectively. A recent review suggests that chronic flashbacks, according to the DSM-IV definition, appears to be a rare disorder, that affect a distinctly vulnerable subpopulation of users (Hallucinogen persisting perception disorder: what do we know after 50 years?, Halpern JH, Pope HG Jr, Drug Alcohol Depend., Vol. 69, No 2, 109-119, 2003); (Hallucinogens: an update, Halpern JH, Curr Psychiatry Rep., Vol. 5, 347-54, 2003.)[17] Differences in the estimated prevalence of flashbacks may partly depend on the multiple meanings of the term and the fact that hallucinogen persisting perception disorder can only be diagnosed in a person who admits to their health care practitioner that they have used hallucinogens.

Debate continues over the nature and causes of chronic flashbacks. Some say chronic flashbacks are a manifestation of post-traumatic stress disorder, not directly related to LSD's mechanism, and vary according to the susceptibility of the individual to the disorder. Many emotionally intense experiences can lead to flashbacks when a person is reminded acutely of the original experience. However, not all published case reports of chronic flashbacks appear to describe an anxious hyper-vigilant state reminiscent of post-traumatic stress disorder.

Several urban legends claim that intermittent flashbacks are the result of trace amounts of LSD or related chemicals being dislodged and released into the body after having been crystallized and stored in fat or spinal fluid cells. However, there is no evidence for this and scientific research suggests that it is not the case; LSD (which is water soluble) is metabolized in the liver, as with many other drugs, and its metabolites are excreted normally in the urine[18].

An alternative theory regarding flashbacks postulates that it is a form of perceptual learning. People having unusual experiences while on LSD may be more likely to make similar interpretations of their sensory input in the future. This theory does not appear to explain why a subset of people develop hallucinogen persisting perception disorder and are unable to 'unlearn' their distressing perceptual patterns.

LSD - Psychosis

There are some cases of LSD inducing or triggering a psychosis in people that were apparently healthy prior to taking LSD. This issue was reviewed extensively in a publication by Rick Strassman in 1984. In most cases, the psychosis-like reaction is of short duration, but in other cases it may be chronic. It is difficult to determine if LSD in itself induces these reactions or if it merely triggers latent conditions that would have manifested themselves otherwise. The similarities of time course and outcomes between putatively LSD-precipitated and other psychoses suggests that the two types of syndromes are not different and that LSD may have been a nonspecific trigger. Several studies have tried to estimate the prevalence of LSD-induced prolonged psychosis arriving at numbers of around 4 in 1000 individuals (0.8 in 1000 volunteers and 1.8 in 1000 psychotherapy patients in Cohen 1960; 9 per 1000 psychotherapy patients in Melleson 1971). But these rates far lower than the lifetime prevalence for psychotic conditions, e.g., schizophrenia (just one form of psychosis) has a lifetime prevalence of about 1% in populations that are not exposed to LSD. Therefore, available data do not support a causative link between LSD and chronic psychotic disorders.

Adapted from the Wikipedia article "Effects", under the G.N U Free Docmentation License. Please also see http://en.wikipedia.org/wiki