12 Mar Recovering From LSD Psychosis
LSD (lysergic acid diethylamide) is a powerful hallucinogenic drug that can produce extreme alterations in normal sensory perception, as well as delusional thinking and rapid swings between different emotional states. Together, these LSD-related effects can trigger temporary psychological changes that closely resemble the changes associated with schizophrenia or other forms of medically defined psychosis. In relatively rare cases, these effects last for extended periods of time and produce ongoing problems for the affected individual. Recovery from LSD-induced psychosis varies according to factors that include a person’s reactions to the drug’s short-term effects and the presence of pre-existing mental illness.
No one knows for sure exactly how LSD exerts its effects on the mind. However, the best current evidence indicates that the drug alters basic brain chemistry by altering levels of a neurotransmitter (brain chemical) called serotonin. In turn, serotonin alterations lead to changes in the parts of the brain that control mood, basic thought processes, and the interpretation of input from the five senses. The specific effects of these changes vary according to factors such as an individual’s psychological makeup and current mood, the amount of LSD consumed, and the physical and emotional environment surrounding LSD use.
LSD “trips” can last up to 12 hours, and any given user of the drug typically experiences both pleasant and unpleasant reactions during this extended period of time. However, whether pleasant or unpleasant feelings predominate, the simultaneous presence of hallucinations and delusional thinking in LSD users means that the drug technically causes a psychotic state. In some cases, this state does not provoke emotionally jarring overall reactions; in other cases, users experiencing “bad trips” have extremely unpleasant emotional responses that can include intense despair or anxiety, an intense fear of dying, or a feeling that sanity is slipping away.
Short-and Long-Term Consequences
The effects of a psychologically disturbing LSD experience usually start to fade when the general effects of the drug itself end. Depending on individual circumstances, full emotional recovery from a bad trip may occur over a period of hours, days, or weeks. However, some people experience longer-term reactions in the aftermath of LSD use. One potential reaction is the development of hallucinogen persisting perception disorder (HPPD), a condition in currently sober people characterized by “flashbacks,” unpredictable reappearances of LSD-like alterations in normal sensory perception. Another potential reaction is the appearance of a long-lasting psychotic state in which delusions and hallucinations continue for years after LSD use ends.
Links to Schizophrenia
Potential symptoms of persistent LSD psychosis include hallucinations, disordered thinking, and extreme alterations of emotion and mood. Any LSD user can develop these symptoms, even if he or she only uses the drug once and has no history of psychological disturbances or mental illness. However, according to a study review published in 2011 in “Frontiers in Behavioral Neuroscience,” the people most likely to develop psychosis after LSD use have a pre-existing genetic tendency toward the onset of schizophrenia, as well as a genetic susceptibility to substance abuse. In addition, psychosis symptoms in these individuals closely resemble the symptoms of classic schizophrenia and produce similar long-term results.
There is no standard treatment for the flashbacks associated with HPPD. In most cases, people with the condition recover over a period of several months as long as they don’t take additional doses of LSD. Options for dealing with flashbacks until recovery occurs, include psychotherapeutic counseling and temporary use of medications such as benzodiazepines (Xanax, Valium, Ativan), antidepressants known as selective serotonin reuptake inhibitors (SSRIs), a high blood pressure medication called clonidine, and a drug for alcohol and opioid dependence called naltrexone.
People with persistent LSD psychosis often benefit from the same treatments used to control the symptoms of schizophrenia. In some cases, treatment may begin with hospitalization in a psychiatric facility. Medications used both inside and outside hospital settings include classes of substances called typical antipsychotics (Haldol, Prolixin, Thorazine) and atypical antipsychotics (Abilify, Risperdal, Seroquel). Other potential treatments include a form of psychotherapy called cognitive behavior therapy (CBT); rehabilitation programs that improve a patient’s ability to function in society; self-help groups; and programs designed to give a patient more autonomy in determining the overall course of treatment. Recovery and maintenance programs also commonly involve active participation on the part of family members, who frequently must provide care for affected individuals discharged from official programs.
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