Some people experience visual disturbances (halos, trailing images, visual snow) days to weeks after use
Most cases resolve on their own within one year
See a doctor if visual disturbances are persistent or distressing
Return to the emergency department immediately for
Severe anxiety, panic, or psychotic symptoms returning after leaving
Suicidal thoughts or urges to harm yourself or others
Visual disturbances that persist or worsen after drug effects should have resolved
Fever, dark-colored urine, or severe muscle pain
These symptoms may indicate a serious muscle breakdown condition
Chest pain, palpitations, or difficulty breathing
Seizure (shaking or loss of consciousness)
Safety information
Do not drive or operate machinery for at least 24 hours
Do not use alcohol or other drugs, especially in the next 24–48 hours
Stay with a trusted person who can monitor you
Lock away all medications and substances in your home environment
Follow-up appointments
See your primary care doctor within 1 week
Discuss substance use and available support
Counseling or addiction services referral offered — please follow up
Psychiatric follow-up if anxiety, depression, or mood concerns were identified
References
Guidelines and key sources
Simon MW, Olsen HA, Hoyte CO, et al. Clinical Effects of Psychedelic Substances Reported to United States Poison Centers: 2012 to 2022. Annals of Emergency Medicine. 2024
PMID 39093248
US Poison Center data 2012–2022; epidemiology and clinical outcomes
Leonard JB, Anderson B, Klein-Schwartz W. Does Getting High Hurt? Characterization of Cases of LSD and Psilocybin-Containing Mushroom Exposures to National Poison Centers Between 2000 and 2016. Journal of Psychopharmacology. 2018
PMID 30182795
National Poison Center 2000–2016 LSD and psilocybin case series
Kopra EI, Ferris JA, Rucker JJ, et al. Adverse Experiences Resulting in Emergency Medical Treatment Seeking Following the Use of LSD. Journal of Psychopharmacology. 2022
PMID 35672900
Adverse events leading to emergency care after LSD use
Hinkle JT, Graziosi M, Nayak SM, Yaden DB. Adverse Events in Studies of Classic Psychedelics: A Systematic Review and Meta-Analysis. JAMA Psychiatry. 2024
Systematic review of adverse events in controlled psychedelic studies
Holze F, Vizeli P, Ley L, et al. Acute Dose-Dependent Effects of LSD in a Double-Blind Placebo-Controlled Study in Healthy Subjects. Neuropsychopharmacology. 2021
PMID 33059356
Controlled human dose-response study; pharmacodynamics
Dolder PC, Schmid Y, Steuer AE, et al. Pharmacokinetics and Pharmacodynamics of LSD in Healthy Subjects. Clinical Pharmacokinetics. 2017
Holze F, Erne L, Duthaler U, Liechti ME. Pharmacokinetics, Pharmacodynamics and Urinary Recovery of Oral LSD in Healthy Participants. British Journal of Clinical Pharmacology. 2024
PMID 37596682
Urinary metabolite and pharmacokinetic characterization
Lavonas EJ, et al. 2023 AHA Focused Update: Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning. Circulation. 2023
AHA toxicology-specific ACLS guideline update
Cao D, Arens AM, Chow SL, et al. Part 10: Adult and Pediatric Special Circumstances of Resuscitation: 2025 AHA Guidelines. Circulation. 2025
2025 AHA guidance on toxicologic cardiac arrest and resuscitation
Nazarian DJ, Broder JS, Thiessen MEW, et al. ACEP Clinical Policy: Critical Issues in the Diagnosis and Management of the Adult Psychiatric Patient in the ED. Annals of Emergency Medicine. 2017
ACEP evidence-based policy for agitation management; chemical sedation over restraints
Boyer EW, Shannon M. The Serotonin Syndrome. New England Journal of Medicine. 2005
Landmark review of serotonin syndrome pathophysiology and management
Kim HK, Leonard JB, Corwell BN, Connors NJ. Safety and Efficacy of Pharmacologic Agents Used for Rapid Tranquilization of ED Patients. Expert Opinion on Drug Safety. 2021
PMID 33327811
Comparative pharmacology for agitation management in toxicology
Walsh CA, Gorfinkel L, Shmulewitz D, Stohl M, Hasin DS. Use of LSD by Major Depression Status. JAMA Psychiatry. 2024
Epidemiologic data on contemporary LSD use patterns
Müller F, Kraus E, Holze F, et al. Flashback Phenomena After Administration of LSD and Psilocybin in Controlled Studies. Psychopharmacology. 2022
PMID 35076721
Controlled study data on flashbacks and HPPD after LSD
Liechti ME. Modern Clinical Research on LSD. Neuropsychopharmacology. 2017
PMID 28447622
Comprehensive review of contemporary LSD clinical research
Reiff CM, Richman EE, Nemeroff CB, et al. Psychedelics and Psychedelic-Assisted Psychotherapy. American Journal of Psychiatry. 2020
Receptor pharmacology and clinical effects of classic psychedelics
Roberts DM, Premachandra KH, Chan BS, et al. A Cluster of LSD Poisonings Following Insufflation of a White Powder Sold as Cocaine. Clinical Toxicology. 2021
PMID 33849370
Case series: non-oral route and cluster exposure
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.