LSD Poisoning Workup

  • Author: C Crawford Mechem, MD, MS, FACEP; Chief Editor: Robert G Darling, MD, FACEP   more...
 
Updated: Aug 2, 2011
 

Laboratory Studies

  • Diagnosis is made predominantly by history and physical examination. Direct diagnostic testing at identifying complications or excluding comorbidity.
    • Routine urine or serum drug screens do not detect LSD. Specialized methods for confirmation exist but are not performed in most hospital laboratories. A radioimmunoassay is available for detecting LSD and its major metabolite, 2-oxy-LSD, in the urine. Urine remains positive for LSD up to 24-36 hours after ingesting 200-400 mg. However, given an accurate history, laboratory confirmation of LSD intoxication rarely is necessary. Levels in the urine do not correlate with severity of symptoms.
    • Coagulation studies, total creatine phosphokinase, or serum electrolytes may be indicated in patients with seizures, coma, or a neuroleptic malignant syndrome–like presentation to identify coagulopathy or rhabdomyolysis or to exclude other diagnoses. Platelet dysfunction and associated bleeding have been reported in patients with large LSD overdoses.
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Imaging Studies

  • Imaging studies such as radiographs or CT scans rarely are necessary. However, they may aid in identifying complications of LSD use or in excluding other diagnoses.
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Other Tests

  • ECG may be appropriate if co-ingestion is possible or to exclude other causes of tachycardia.
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Procedures

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Contributor Information and Disclosures
Author

C Crawford Mechem, MD, MS, FACEP  Associate Professor, Department of Emergency Medicine, University of Pennsylvania School of Medicine; Emergency Medical Services Medical Director, Philadelphia Fire Department

C Crawford Mechem, MD, MS, FACEP is a member of the following medical societies: American College of Emergency Physicians, National Association of EMS Physicians, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Alan H Hall, MD, FACEP  Assistant Professor of Emergency Medicine, Division of Toxicology, Texas Tech University Health Sciences Center at El Paso; President, Chief Medical Toxicologist, Toxicology Consulting and Medical Translating Services, Inc

Disclosure: Nothing to disclose.

Specialty Editor Board

Suzanne White, MD  Medical Director, Regional Poison Control Center at Children's Hospital, Program Director of Medical Toxicology, Associate Professor, Departments of Emergency Medicine and Pediatrics, Wayne State University School of Medicine

Suzanne White, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Clinical Toxicology, American College of Epidemiology, American College of Medical Toxicology, American Medical Association, and Michigan State Medical Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Rick Kulkarni, MD  Attending Physician, Department of Emergency Medicine, Cambridge Health Alliance, Division of Emergency Medicine, Harvard Medical School

Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: WebMD Salary Employment

John D Halamka, MD, MS  Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center

John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Robert G Darling, MD, FACEP  Adjunct Clinical Assistant Professor of Military and Emergency Medicine, Uniformed Services University of the Health Sciences, F Edward Hebert School of Medicine; Associate Director, Center for Disaster and Humanitarian Assistance Medicine

Robert G Darling, MD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, American Telemedicine Association, and Association of Military Surgeons of the US

Disclosure: Nothing to disclose.

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