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Is LSD toxic?

David E Nichols, Charles S. Grob

Forensic Science International March 1, 2018 DOI: 10.1016/j.forsciint.2018.01.006 (opens in new tab)

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AI-extracted from the abstract
Characteristics Review Peer reviewed
Topics LSD
Keywords Maximal restraint Positional asphyxiation LSD Safety Physiologically non-toxic Medically safe Standard doses Inherent toxicity Drug overdose deaths Massive overdoses Different drug entirely Restraint-induced fatalities Agitated individuals Hog-tying by police Cardiovascular collapse
Citations 86
Key findings Fatalities previously attributed to LSD toxicity were actually caused by massive overdoses, excessive physical restraints, or other drugs, not by LSD itself at standard doses.

Abstract

LSD (lysergic acid diethylamide) was discovered almost 75 years ago, and has been the object of episodic controversy since then. While initially explored as an adjunctive psychiatric treatment, its recreational use by the general public has persisted and on occasion has been associated with adverse outcomes, particularly when the drug is taken under suboptimal conditions. LSD's potential to cause psychological disturbance (bad trips) has been long understood, and has rarely been associated with accidental deaths and suicide. From a physiological perspective, however, LSD is known to be non-toxic and medically safe when taken at standard dosages (50-200μg). The scientific literature, along with recent media reports, have unfortunately implicated "LSD toxicity" in five cases of sudden death. On close examination, however, two of these fatalities were associated with ingestion of massive overdoses, two were evidently in individuals with psychological agitation after taking standard doses of LSD who were then placed in maximal physical restraint positions (hogtied) by police, following which they suffered fatal cardiovascular collapse, and one case of extreme hyperthermia leading to death that was likely caused by a drug substituted for LSD with strong effects on central nervous system temperature regulation (e.g. 25i-NBOMe). Given the renewed interest in the therapeutic potential of LSD and other psychedelic drugs, it is important that an accurate understanding be established of the true causes of such fatalities that had been erroneously attributed to LSD toxicity, including massive overdoses, excessive physical restraints, and psychoactive drugs other than LSD.

Comparable studies

Other narrative reviews on LSD, most cited first.

Study Year Design Participants
Study of a New Schizophrenomimetic Drug—Sernyl 1959 Review
Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. General population 2019 Integrative review
The Pharmacology of Lysergic Acid Diethylamide: A Review 2008 Review
Serotonin research: contributions to understanding psychoses 2008 Review
ADVERSE REACTIONS TO PSYCHEDELIC DRUGS. A REVIEW OF THE LITERATURE 1984 Review

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