Lysergic acid diethylamide (LSD)

Lysergic acid diethylamide (LSD) is a semisynthetic derivative of the alkaloids of the ergot fungus or ergot (Claviceps purpurea). Although it was initially used for therapeutic purposes and there is still medical interest in it as a possible treatment for addictions and other psychiatric disorders ^{(Haden 2020, Schmid 2015)}, it is considered a drug of abuse due to its strong hallucinogenic and psychedelic ^{(NIH 2023)} properties. Oral administration and, more rarely, by nasal inhalation or venous injection.

At the date of the last update, there was no available published data on its excretion in breast milk.

The published pharmacokinetic data (low molecular weight and basic pKa) make it probable that it will pass into breast milk in an amount that could be significant.

Its effects occur with extremely low doses, on the order of micrograms ^{(Holze 2019, Dolder 2017)} and it has excellent intestinal absorption ^{(Dolder 2016)}, so the risk of side effects in the infant is maximum.

Taking LSD produces hallucinations and variable sensory and mood alterations: euphoria, depression, anxiety, panic, distortion of body image, spatial-temporal disorientation and acute psychosis: 20% of cases ^{(Vallersnes 2016)}. They are accompanied by various somatic symptoms: fever, tremors, muscle weakness, instability, nausea, vomiting, mydriasis, tachycardia, and high blood pressure. Overdose can lead to respiratory arrest, seizures, and coma. ^{(MedlinePlus 2020, Smart 1967)}

There is an increase in plasma cortisol, prolactin, oxytocin, and epinephrine. ^{(Schmid 2015)}

The effects last between 5 and 13 hours ^{(Holze 2019)}, but there may be hallucinations for up to 2 days and psychosis for up to 4 days. They may recur months later, spontaneously or induced by alcohol, drugs, stress, or fatigue. ^{(Smart 1967)}

Although the half-life of LSD is relatively short, that of its metabolite 2-oxo-3-hydroxy-LSD (OH-LSD) can be up to 7 times longer. ^{(Holze 2019, Dolder 2017 and 2016)}

It is known from Pharmacokinetics that after 5 elimination half-lives (T½), 96.9% of an ingested substance is eliminated from the body and after 7 T½ the plasma concentrations of the substance are negligible and would constitute the safe waiting period to return to breastfeeding after having taken LSD.

Taking as reference the longest published T½ (21 h) of the LSD metabolite ^{(Holze 2019)}, these 7 T½ would correspond to one week. Meanwhile, you have to express and discard your breast milk regularly if you want to breastfeed again.

Psychotropic drugs of abuse disable the mother to care for her child, endangering the lives and health of both.

It is not recommended to share a bed with the baby if you are taking this drug. ^{(UNICEF UK 2018, 2014, 2013 2006, Sachs 2013, Landa 2012, ABM 2008)}

There is no scientific evidence on the benefits and risks of psychedelic drug microdosing. ^{(NIH 2023, Kaypak 2022, de Wit 2022, Szigeti 2021, Lea 2020, Kuypers 2019)}