Last update Aug. 23, 2021

Lysergic acid diethylamide (LSD)

Very High Risk

Very unsafe. Contraindicated. Use of an alternative or cessation of breastfeeding.

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 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).

Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.

Other names

Lysergic acid diethylamide (LSD) is also known as


Lysergic acid diethylamide (LSD) in other languages or writings:

Group

Lysergic acid diethylamide (LSD) belongs to this group or family:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 71 %
Molecular weight 323 daltons
pKa 17,02 -
Tmax LSD: 1,7(1-3); OH-LSD: 5 (3-8) hours
T1/2 LSD: 3,6(2-7); OH-LSD: 5(3-21) hours

References

  1. Haden M, Woods B. LSD Overdoses: Three Case Reports. J Stud Alcohol Drugs. 2020 Jan;81(1):115-118. Abstract
  2. MedlinePlus. LSD. Trusted Health information for you. 2020 Full text (link to original source) Full text (in our servers)
  3. MedlinePlus. LSD. Información de salud para usted. 2020 Full text (link to original source) Full text (in our servers)
  4. Holze F, Duthaler U, Vizeli P, Müller F, Borgwardt S, Liechti ME. Pharmacokinetics and subjective effects of a novel oral LSD formulation in healthy subjects. Br J Clin Pharmacol. 2019 Jul;85(7):1474-1483. Abstract Full text (link to original source)
  5. UNICEF UK. Caring for your baby at night. A guide for parents. 2018 Full text (link to original source) Full text (in our servers)
  6. Ball H, Blair PS. (For UNICEF UK). Caring for your baby at night. Health professional´s guide. 2017 Full text (link to original source) Full text (in our servers)
  7. Dolder PC, Schmid Y, Steuer AE, Kraemer T, Rentsch KM, Hammann F, Liechti ME. Pharmacokinetics and Pharmacodynamics of Lysergic Acid Diethylamide in Healthy Subjects. Clin Pharmacokinet. 2017 Oct;56(10):1219-1230. Abstract Full text (link to original source)
  8. Vallersnes OM, Dines AM, Wood DM, Yates C, Heyerdahl F, Hovda KE, Giraudon I; Euro-DEN Research Group., Dargan PI. Psychosis associated with acute recreational drug toxicity: a European case series. BMC Psychiatry. 2016 Aug 18;16:293. Abstract Full text (link to original source)
  9. Schmid Y, Enzler F, Gasser P, Grouzmann E, Preller KH, Vollenweider FX, Brenneisen R, Müller F, Borgwardt S, Liechti ME. Acute Effects of Lysergic Acid Diethylamide in Healthy Subjects. Biol Psychiatry. 2015 Oct 15;78(8):544-53. Abstract
  10. Dolder PC, Schmid Y, Haschke M, Rentsch KM, Liechti ME. Pharmacokinetics and Concentration-Effect Relationship of Oral LSD in Humans. Int J Neuropsychopharmacol. 2015 Jun 24;19(1). pii: pyv072. Abstract Full text (link to original source)
  11. UNICEF UK. Statement on co-sleeping following publication of new NICE postnatal guidance. Infosheet. 2014 Full text (link to original source) Full text (in our servers)
  12. Sachs HC; Committee On Drugs. The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics. 2013 Sep;132(3):e796-809. Abstract Full text (link to original source) Full text (in our servers)
  13. UNICEF UK Baby Friendly Initiative statement on Bed-sharing when parents do not smoke: is there a risk of SIDS? An individual level analysis of five major case-control studies. 2013 Full text (link to original source) Full text (in our servers)
  14. L.Landa Rivera, M.Díaz-Gómez, A.Gómez Papi, J.M.Paricio Talayero, C.Pallás Alonso, M.T.Hernández Aguilar, J.Aguayo Maldonado, J.M.Arena Ansotegui, S.Ares Segura, A.Jiménez Moya, J.J.Lasarte Velillas, J.Martín Calama, M.D.Romero Escós. El colecho favorece la práctica de la lactancia materna y no aumenta el riesgo de muerte súbita del lactante. Dormir con los padres. Rev Pediatr Aten Primaria. 14:53-60 2012 Full text (link to original source) Full text (in our servers)
  15. ABM - Comité de protocolos de la Academia médica de lactancia materna (Academy of Breastfeeding Medicine). Protocolo Clínico de la ABM #6: Lineamientos sobre la práctica de dormir al bebé junto con la madre y la lactancia materna Revisión, marzo de 2008. Breastfeeding Medicine 2008 Full text (link to original source) Full text (in our servers)
  16. ABM - The Academy of Breastfeeding Medicine Protocol Committee. ABM Clinical Protocol #6: Guideline on Co-Sleeping and Breastfeeding. Breastfeeding Medicine 2008 Abstract Full text (link to original source) Full text (in our servers)
  17. UNICEF UK. Compartiendo la cama con tu bebé. Guía para madres que amamantan. Folleto 2006 Full text (in our servers)
  18. Smart RG, Bateman K. Unfavourable reactions to LSD: a review and analysis of the available case reports. Can Med Assoc J. 1967 Nov 11;97(20):1214-21. Review. No abstract available. Abstract Full text (link to original source)

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