“LSD Overdoses: 3 Case Reports”, Mark Haden, Birgitta Woods2020-02-12 (LSD, bipolar)⁠:

Objective: In academic settings around the world, there is a resurgence of interest in using psychedelic substances for the treatment of addictions, post-traumatic stress disorder, depression, anxiety, and other diagnoses. This case series describes the medical consequences of accidental overdoses in 3 individuals.

Method: Case series of information were gathered from interviews, health records, case notes, and collateral reports.

Results: The first case report documents substantial improvements in mood symptoms, including reductions in [bipolar disorder] mania with psychotic features, following an accidental lysergic acid diethylamide (LSD) overdose, changes that have been sustained for almost 20 years. The second case documents how an accidental overdose of LSD early in the first trimester of pregnancy did not negatively affect the course of the pregnancy or have any obvious teratogenic or other negative developmental effects on the child. The third report indicates that intranasal ingestion of 550× the normal recreational dosage of LSD was not fatal and had positive effects on pain levels [chronic foot pain] and subsequent morphine withdrawal.

Conclusion: There appear to be unpredictable, positive sequelae that ranged from improvements in mental illness symptoms to reduction in physical pain and morphine withdrawal symptoms. Also, an LSD overdose while in early pregnancy did not appear to cause harm to the fetus.

…[1] A light box (Levitt et al 1996_28ya) was introduced in November 1999 for the treatment of a seasonal (winter) depression, and shortly thereafter she started to show signs of hypomania (decreased need for sleep, elevated mood, increased chattiness, increased productivity, and “obsessive cleaning”). The light box treatment was discontinued and the sertraline was reduced…She was committed under the provincial Mental Health Act because of safety concerns. At this point, she was not sleeping and she had grandiose delusions, including that she could purchase a town in Mexico and become the mayor, that she was enlightened, and that she could speak all languages.

…The LSD overdose incident occurred during a summer solstice party (June 20, 2000, at age 15), where the supplier of the liquid LSD made a decimal place error when preparing individual dosages diluted in glasses of water. Specifically, what were intended to be 100 mcg dosages (a normal recreational dosage) were actually 1,000 mcg per glass. AV drank one glass and subsequently drank the “leftover drops” from two other glasses. Her total dosage was therefore in the range of 1,100–1,200 mcg.

…AV’s father reported that when he entered the hospital room the next morning, AV stated, “It’s over.” He believed she was referring to the LSD overdose incident, but she clarified that she meant her bipolar illness was cured…AV’s father observed that his daughter appeared to be completely recovered from her mental health concerns after the overdose incident. AV reports that she was free from all mental illness symptoms (bipolar or other) for the subsequent 13 years until she gave birth and experienced postpartum depression. The birth of her second child in 2017 was also associated with a turbulent emotional period. AV reports that after the LSD overdose incident she experienced life with a “normal” brain, whereas her brain felt chemically unbalanced before the incident.

…3. LSD overdose event—September 2015 In September 2015, CB (age 46) took 55 mg intranasally of what she believed was cocaine but was actually pure LSD in powder form. This was the equivalent of 550× the normal recreational dosage of 100 mcg. She realized she had a problem within 15 minutes and called her roommate for help. He noticed that the bottle of LSD had been moved, and weighed the remaining powder to determine ~how much she ingested. She started vomiting within an hour and vomited frequently for the next 12 hours. Her recollection was that she sat up for this experience and mostly “blacked out” for the first 12 hours, after which she was able o communicate. She felt “pleasantly high” for the next 12 hours (with infrequent vomiting). The collateral report from the roommate revealed that she sat mostly still in a chair with her eyes either open, closed, or rolled back, frothing at the mouth, occasionally vocalizing random words and vomiting frequently. 10 hours later she was able to converse, went to the bathroom, and seemed coherent. Her roommate fed her and stayed with her for another 12 hours, after which she appeared to be “normal.”

CB reported that her foot pain was gone the next day. Therefore, she discontinued her morphine, did not use it for 5 days, and did not experience any withdrawal symptoms. Subsequently her pain returned, so she restarted her morphine but at a lower dose (one to two pills a day), and started microdosing LSD (25 mcg every 3 days). She continued microdosing LSD with daily morphine until January 2018, when she stopped the morphine and all other pain medications, as she believed that her pain was substantially reduced enough that pain medications were unnecessary. After discontinuing the morphine, CB reported no typical withdrawal symptoms. However, she did experience an increase in anxiety, depression, and social withdrawal as well as a sense of being “overly sensitive” to the experiences of others.