LSD Detox

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KEY TAKEAWAYS

LSD (lysergic acid diethylamide) detox works by: 

  • Medically managing LSD withdrawal symptoms (e.g. panic attacks triggered by flashbacks of ‘bad trips’) with symptomatic treatment (e.g. 40mg propranolol daily)  
  • Regulating sleep cycles and mood by stabilising serotonin (5-HT) levels after being reduced by 36% in the prefrontal cortex [1] 
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How Is LSD Detox Done?

There is no medical detox for LSD, and withdrawal symptoms are treated symptomatically for up to 28 days using:

  • SSRIs (e.g. 50mg sertraline daily) if needed to manage depression and dysphoria by restoring serotonin imbalances in the brain (e.g. a 36% reduction in 5-HT2A receptor signalling in the prefrontal cortex) after daily LSD use [1]
  • Beta blockers (e.g. 40mg propranolol daily) to manage ‘intense panic attacks’ with sweating and palpitations developing within 24 hours of cessation and lasting up to 4 hours at a time by blocking beta-1 and beta-2 adrenergic stimulation in the heart [2]
  • Anti-epileptic and antipsychotic medications (e.g. 200mg lamotrigine + 16mg Risperdone daily) to manage persistent visual disturbances (e.g. micropsia, hallucinations) by inhibiting glutamate-mediated excitatory neurotransmission in the brain [3] 
  • NSAIDs (e.g. 600mg ibuprofen daily) or Triptans (e.g. 100mg sumatriptan daily) to mitigate 15 – 180 minute cluster headache and migraine ‘attacks’ by controlling neurogenic inflammation and blocking the transmission of pain signals to the CNS [4]
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Physical Symptoms Of LSD Detox

Sleep Disturbances

Sleep disturbances are a physical symptom of LSD detox because the downregulation of 5-HT2A receptors (e.g. -7% in the striatum) after daily LSD use disrupts the body's natural sleep-wake cycle and causes nocturnal awakenings due to [1]:

  • Nightmares in up to 35%, typically developing within 24 hours of cessation, as some users claim to be repeatedly awoken by "terrible nightmares" and refer to the experience as “72 hours of insanity” [2][6]
  • 30 seconds of intense panic around 4 days after the onset of withdrawal, as some users claim to wake during the night after feeling “exceedingly uneasy” and “cast adrift” [6]

Headaches

Headaches are a physical symptom of LSD detox caused by a sudden drop in serotonin (e.g. -36% in the prefrontal cortex) after being 2 times higher during active use, resulting in the reactivation of trigeminal nerve signals and the dilation of cerebral blood vessels [1][7]. 

Headaches typically peak during days 3 – 5 of LSD withdrawal because 5-HT is elevated by 61% for up to 4 days after drug-taking, although 11% of daily users experience headaches for over 4 weeks whilst the brain attempts to rebalance serotonergic activity [7][8].

Some LSD users develop chronic cluster headache and migraine disorders and experience daily 'attacks' that last up to 3 hours at a time, exacerbating headaches during LSD withdrawal caused by 5-HT imbalances in the brain [4].

Lysergic acid diethylamide detox programmes manage persistent headaches with medication (e.g. 4g paracetamol daily) and rehydration (e.g. 2-3L of water daily) as needed for up to 28 days [9].

Appetite Fluctuations

Appetite fluctuations are physical symptoms of LSD detox due to an 18% decrease in 5-HT2A signalling in brain regions that modulate appetite and food intake (e.g. medial prefrontal cortex) via emotional regulation, impulse control, and reward processing [1].

Hunger signals (e.g. Neuropeptide Y, Orexin) become dysregulated during LSD withdrawal after being inhibited during active use due to continuous serotonin elevations in the brain (e.g. increased by 2-fold for up to 96 hours), resulting in [7]:

  • A ‘voracious’ or ‘ravenous’ appetite, as some users state, “I’ve never enjoyed food more” within 24 hours of LSD discontinuation 
  • Food aversions for up to 1 week after cessation, as some patients claim to have "lost an appetite for sugar" or be "too sensitive" towards the flavour of coffee [6]

Appetite fluctuations are exacerbated by 2-3-hour episodes of vomiting/nausea in up to 18% of LSD detox patients, arising within 24 hours of cessation and lasting up to 4 weeks, although symptoms are managed with medication (e.g. 50mg Cyclizine) as needed [2][8].

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Fatigue

Fatigue is a physical symptom of LSD detox because the brain takes up to 96 hours to rebalance serotonin levels after being elevated by 61% whilst intoxicated, as some users claim, “I was never sleepy” and “I wanted to sleep, but found I couldn’t” whilst high [6][7].

In a study by Modak, et al. (2019), a 20-year-old was fatigued for 15 days after detoxing from LSD as the brain attempted to recover from a lack of sleep and overstimulation caused by using ‘high-strength blotting paper’ (able to produce a 16-hour trip) 3 times a day for around 2 years [2].

Fatigue is exacerbated by sleep disturbances (e.g. nightmares) in up to 35% of LSD detox patients, as well as nighttime awakenings and hallucinations after “staying up for 3 days after dosing” [5][10].

Psychological Symptoms Of LSD Detox

Depression

Depression is a psychological withdrawal symptom of LSD cessation caused by a 26 – 36% decrease in 5-HT2A receptor signalling in cortical regions responsible for emotional regulation (e.g. prefrontal cortex, anterior cingulate cortex), leading to [1]:

  • Depression and suicidality in up to 61%, as some patients claim, “I collapsed into a severe, almost catatonic depression, and I was having suicidal ideation. I fell further into the abyss of hopelessness and despair. This lasted over 2 months” [5][10]
  • Low mood and thoughts of self-harm in around 20% of previous daily users, as some patients claim to feel “really down afterwards, disempowered, unsure and uncertain of myself” for up to 4 weeks after previously using 1 – 2 doses per session [8][10]

Patients typically experience dysphoria for around 2 weeks after LSD cessation, although some heavy users (e.g. 3 ‘blots’ daily) experience depression and diminished self-esteem for 12 – 18 months post-detox [2][5].

Patients with persisting depressive symptoms (e.g. low mood, suicidal ideation) at the end of a 28-day LSD detox programme will be referred to a GP to discuss long-term treatment options (e.g. weekly therapy, antidepressants).

Panic Attacks 

Panic attacks are psychological withdrawal symptoms of LSD cessation, often triggered by emotional flashbacks of ‘bad trip’ experiences involving sensations of choking to death and forgetting how to eat or urinate for up to 18 hours at a time [12][13]:

  • “For about 18 months, I awoke with the sun every morning full of absolute terror. Sometimes my anxiety would be so high in the morning that I would physically shake from the energy.” 
  • "It was absolutely traumatic. I have PTSD from it and experience flashes of the trip. I believe the experience contributed to my general anxiety for a time."
  • “After my trip was over, I felt shaken up for days/weeks and wondered if I had gone crazy. Afterwards, I am struggling with making meaning, continue to have trauma flashbacks and feel so terrible about myself” [10]

Some LSD users experience panic attacks that last up to 4 hours at a time after having recurrent ‘frightening flashbacks’ during the day and occasionally whilst asleep for up to 4 weeks after a ‘bad trip’ experience [2][13].

Panic attacks typically arise within 24 hours of LSD abstinence and last up to 18 months in some cases, although beta blockers are administered during a medically managed detox to treat panic attacks and related physical symptoms (e.g. sweating, palpitations) [2][5].

Depersonalisation/Derealisation

Depersonalisation/Derealisation occurs in up to 55% as a psychological symptom of LSD detox due to sensory-perceptual dysregulation as the brain struggles to reintegrate the Default Mode Network after being suppressed during ‘trips’ that led to “ego death” and enhanced connectedness with others and nature [5]:

  • “I felt like the person I was before had been entirely wiped from all sense memory, and I felt completely dissociated from the body, I was inhabiting. I was completely disintegrating. My life has and never will be the same.” 
  • “I began to feel like something was wrong. All of a sudden, the bathroom was not real. It just looked wrong. The street outside was not real either. The whole world was simply not real, and I felt like I had to vomit.” [10] 

Some abstinent LSD users still experience depersonalisation 7 – 12 months after cessation and claim that the symptoms (e.g. feeling disconnected from the former self or body) cause minor disruption to daily life after practising breathing techniques and journaling [5].

In a study by Sylvain, et al. (2024), a 29-year-old man's scores on the Cambridge Depersonalisation Scale decreased by 23% within 1 week of LSD withdrawal, and full remission of persistent dissociation was achieved within 2 years of receiving rTMS after 6 years of drug-taking [17].

Positive Markers Of LSD Detox

Reduction In Hallucinogen Persisting Perception Disorder

An 88% reduction in Hallucinogen Persisting Perception Disorder (HPPD) is a positive marker of LSD recovery because visual disturbances (e.g. faces changing shape) are no longer present after 3 months of taking 4mg Clonazepam daily during treatment [14].

In a study by Ayyub, et al. (2023), a 28-year-old with HPPD and a 14-year history of LSD use had complete resolution of visual disturbances within 8 days of taking 50mg lamotrigine daily during an inpatient detox, after initially claiming to see green flashes and faces of dead philosophers [16].

In a study by Hermle, et al. (2012), a 33-year-old with HPPD was relieved of visual disturbances after 1 year treatment with 200mg lamotrigine daily, after previously experiencing halo effects, flickering when looking at patterned objects, and micropsia after consuming 30 LSD ‘tabs’ within 1 year [3]. 

Regulated Sleep Cycles

The normalisation of sleep cycles (e.g. NREM/REM sleep every 90 mins) is a positive marker of LSD recovery because patient’s are no longer overstimulated for up to 18 hours at a time, after claiming “I was never sleepy, I wanted to sleep, but couldn't” whilst high [6][13].

LSD detox recalibrates circadian rhythms by stabilising serotonergic activity after being disrupted during active use (e.g. increased by 2-fold for up to 96 hours), enabling the modulation of wakefulness and sleep onset in the dorsal raphe nucleus within 4-7 days [7].

LSD rehab helps patients to recover from “staying up for 3 days after dosing” and “72 hours of repeated awakenings and terrible nightmares”, by providing a safe environment with low stimulation and medication if necessary (e.g. 10mg zolpidem daily) [6][10].

How Does LSD Combined With Other Drugs Change Detox? 

Combined With Benzodiazepines

LSD combined with benzodiazepines (BZD) changes a lysergic acid diethylamide detox because: 

  • A tapering schedule (e.g. 40mg diazepam is reduced by 5 - 10% every 1 – 2 weeks) may be required and can take up to 5 months, whereas an LSD-only detox lasts 7 – 14 days [18]
  • Additional monitoring (e.g. every 15 mins rather than 30 mins) and anticonvulsants (e.g. 200mg carbamazepine) are needed because BZD patients are 13 times more likely to have a seizure during the first week of detox compared to non-BZD patients [19]
  • Higher doses of anti-anxiety medications (e.g. 40 vs 80mg propranolol) may be required to manage rebound anxiety developing within 4 days of BZD cessation, exacerbating panic attacks and restlessness already present within 24 hours of LSD cessation [2][20]
  • BZD + LSD use depletes GABA receptors in the dentate gyrus by 15% and 5-HT2A receptor signalling by 36% in the prefrontal cortex, requiring vitamin B6 supplements or foods such as bananas and salmon to support GABA and 5-HT synthesis [1][21] 

46% of patients who have abused LSD and benzodiazepines simultaneously to ‘lessen the intensity’ of a bad trip and may require hospital care during detox as 5.9% receive emergency medical treatment due to chest pain, fits/seizures, or difficulty breathing after using both drugs [8][22]. 

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Combined With MDMA

LSD combined with MDMA changes a detox from LSD alone because higher doses of SSRIs (e.g. 10mg vs 40mg citalopram), additional symptomatic treatment (e.g. 20mg baclofen), and nutritional supplements (e.g. 1000mg omega-3) are required because: 

  • 5-HT2A signalling is reduced by up to 36% in brain regions responsible for emotional regulation (e.g. prefrontal cortex) after LSD abuse, and MDMA causes a further 19 – 46% decrease in 5-HT transporter binding throughout all cerebral cortices [1][23]
  • SSRIs and omega-3 (with a minimum of 250 – 500mg EPA + DHA) reduce suicidal ideation and low mood by up to 60% within 8 weeks in LSD+MDMA patients with exacerbated depression by stimulating the release of 5-HT from presynaptic neurons [24]
  • Headaches are intensified by the addition of MDMA due to bruxism lasting 24 – 48 hours after drug-taking in up to 89% of users, requiring muscle relaxants and regular oral checks to manage jaw pain/tension, occlusal tooth wear, and hypersensitive teeth [25]

ECGs take place during admission and nurses regularly observe (e.g. every 30 mins during days 1 – 7) LSD + MDMA patients for signs of chest discomfort, although 12% require hospital treatment due to extreme sweating, palpitations, and chest pain after simultaneous drug-taking [8].

Combined With Alcohol

LSD combined with alcohol changes LSD addiction treatment because:

  • A medical detoxification is needed alongside symptomatic treatment (e.g. paracetamol), typically using a gradual tapering regimen (e.g. day 1 = 400mg chlordiazepoxide, day 2 = 300mg, day 3 = 200mg) for a maximum of 10 days [9] 
  • Withdrawal symptoms begin within 6 hours of last drinking compared to 24 hours for LSD alone, and the CIWA-Ar is administered to establish withdrawal severity (e.g. score >20 = severe, i.e. delirium) and adjust medication/monitoring frequency as needed [9]
  • Mood swings are prolonged (e.g. up to 5 weeks) due to a 30% reduction in the availability of 5-HT transporters in the raphe nuclei after abusing alcohol, as well as a 36% reduction in 5-HT2A receptor signalling in the prefrontal cortex after LSD misuse [26][1] 
  • 7 - 14 days of thiamine supplementation (e.g. 300mg daily) is required to prevent Wernicke’s encephalopathy, and 10mg of metoclopramide is needed every 6 hours to manage intensified nausea and vomiting during withdrawal from both substances [9]

The glutamate-mediated CNS excitation following the downregulation of GABA receptors during alcohol + LSD detox leads to delirium tremens in 5% of cases, and if suspected within the first 96 hours, hospital care will be arranged for 24-hour monitoring [27].

LSD Detox At Abbeycare

LSD addiction treatment at Abbeycare involves a 7-day detox that medically manages withdrawal symptoms (e.g. insomnia, headaches, panic attacks) on a case-by-case basis (as decided by our medical team) during a full 28-day rehab programme by:

  • Client-specific observations during the first week of treatment to determine the type(s) of symptomatic medication required, e.g. 300mg ibuprofen up to 3 times a day to mitigate cluster headaches with intense periorbital pain and watery eyes
  • Administering SSRIs and nutritional supplements (e.g. 10mg citalopram, 1000mg omega-3 daily) if required to regulate mood by stabilising serotonergic activity in the brain after being disrupted during active use
  • Providing anti-epileptic medication (e.g. 100mg lamotrigine daily) for patients with Hallucinogen Persisting Perception Disorder to manage recurrent visual disturbances (e.g. hallucinations, macropsia) by inhibiting the release of glutamate in the brain
  • All as determined appropriate by our medical team

Abbeycare’s detox from LSD may include liaising with GPs to establish long-term treatment plans for patients with chronic headaches (i.e. daily ‘attacks’), persisting depression (>4 weeks), and panic attacks triggered by emotional flashbacks of ‘bad trips’, after misusing LSD.

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About the author

Mischa Ezekpo

Mischa Ezekpo has a Bachelors degree in Psychology from Northumbria
University, and a Masters degree in Childhood Development and
Wellbeing, from Manchester Metropolitan University. Since 2018, Mischa
has written and published work on Addiction, Mental Health, Depression, and Eating Disorders. Content reviewed by Laura Morris (Clinical Lead).

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Last Updated: October 9, 2025