Abstract
To the Editor.— Friedman and Hirsch's article, Extreme Hyperthermia after LSD Ingestion, (217:1549-1550, 1971) should be interpreted with caution. The case report of a hyperactive, verbally unresponsive patient with mildly elevated blood pressure, increased heart rate, and slightly dilated and reactive pupils is consistent with amphetamine as well as LSD overdose. The amnesia for the episode experienced by the patient is not particularly characteristic of either an amphetamine or LSD overdose but is very characteristic of abuse of illicitly available potent centrally acting anticholinergics (such as piperidyl benzilate) and high doses of over-the-counter anticholinergics (eg, atropine and scopolamine). The only clinical feature in the patient described that would argue against an anticholinergic having been abused is the fact that the patient's pupils were not widely dilated with minimal response to light. A reading of the article might lead a physician to treat an unresponsive hyperthermic patient suspected of drug
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