Bad Trips Research Articles

Management of "Bad Trips" in an Evolving Drug Scene

"Bad trips" arise out of an increasingly complex drug scene. Rational therapy must consider completely, social, psychological and physiological factors. Complexity results from the development of new drugs, indiscriminate ingestion, contamination, and adulteration. Drug-induced psychological changes occasionally lead to fatal behavior. Bad trips from anticholinergic compounds may be seriously worsened by phenothiazine treatment. Protection of the patient from dangerous behavior is fundamental to treatment. A clear history is invaluable but should be augmented by physical and mental examinations. Treatment begins with establishment of verbal contact without the use of tranquilizers, if possible. Reassurance and reality defining are often sufficient. With severe ego disruption, medication in combination with verbal interaction may be required. Administration of phenothiazines or sedatives helps to reestablish the observing ego with rapid dissolution of perceptual distortion and reestablishment of the premorbid ego functioning in most cases. Optimal treatment includes a follow-up visit.

Management of "bad trips" in an evolving drug scene

"Bad trips" arise out of an increasingly complex drug scene. Rational therapy must consider completely, social, psychological and physiological factors. Complexity results from the development of new drugs, indiscriminate ingestion, contamination, and adulteration. Drug-induced psychological changes occasionally lead to fatal behavior. Bad trips from anticholinergic compounds may be seriously worsened by phenothiazine treatment. Protection of the patient from dangerous behavior is fundamental to treatment. A clear history is invaluable but should be augmented by physical and mental examinations. Treatment begins with establishment of verbal contact without the use of tranquilizers, if possible. Reassurance and reality defining are often sufficient. With severe ego disruption, medication in combination with verbal interaction may be required. Administration of phenothiazines or sedatives helps to reestablish the observing ego with rapid dissolution of perceptual distortion and reestablishment of the premorbid ego functioning in most cases. Optimal treatment includes a follow-up visit.

The "bad trip"--the etiology of the adverse LSD reaction.

In an attempt to identify the factors responsible for adverse reactions to LSD and to elucidate the rising incidence of hospital admissions associated with use of the drug, the authors compared 25 psychiatric inpatients hospitalized following LSD ingestion with 25 members of a group who took LSD together regularly without reported difficulty. Although some differences were found between the groups, there were no outstanding historical or current clinical features which could be used to predict an individual's response to LSD with accuracy. These findings support the hypothesis that LSD interacts with schizoid trends, unsteady reality testing, and related factors in a complex way that makes accurate prediction of response virtually impossible.

Further observations on untoward reactions to LSD.

Back to table of contents Previous article Next article ArticleNo AccessFurther Observations on Untoward Reactions to LSDEDWIN ROBBINS, WILLIAM A. FROSCH, and MARVIN STERNEDWIN ROBBINSSearch for more papers by this author, WILLIAM A. FROSCHSearch for more papers by this author, and MARVIN STERNSearch for more papers by this authorPublished Online:1 Apr 2006https://doi.org/10.1176/ajp.124.3.393AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail PDFThis content is only available as a PDF. Access content To read the fulltext, please use one of the options below to sign in or purchase access. Personal login Institutional Login Sign in via OpenAthens Purchase Save for later Item saved, go to cart PPV Articles - American Journal of Psychiatry $35.00 Add to cart PPV Articles - American Journal of Psychiatry Checkout Please login/register if you wish to pair your device and check access availability. Not a subscriber? Subscribe Now / Learn More PsychiatryOnline subscription options offer access to the DSM-5 library, books, journals, CME, and patient resources. This all-in-one virtual library provides psychiatrists and mental health professionals with key resources for diagnosis, treatment, research, and professional development. Need more help? PsychiatryOnline Customer Service may be reached by emailing [email protected] or by calling 800-368-5777 (in the U.S.) or 703-907-7322 (outside the U.S.). FiguresReferencesCited byDetailsCited ByInside bad trips: Exploring extra-pharmacological factorsJournal of Psychedelic Studies, Vol. 2, No. 1Frontiers in Psychiatry, Vol. 8Substance Abuse: Hallucinogen‐ and MDMA‐Related Disorders20 February 2015Neuropsychologia, Vol. 59Drug and Alcohol Dependence, Vol. 114, No. 1‘Drug-induced’ depersonalization disorderPsychiatry Research: Neuroimaging, Vol. 107, No. 3Psychiatry Research: Neuroimaging, Vol. 67, No. 3Journal of Clinical Psychopharmacology, Vol. 16, No. 3International Journal of Clinical and Experimental Hypnosis, Vol. 42, No. 4Addiction, Vol. 88, No. 10Psychedelic drug flashbacks: Subjective reports and biographical dataAddictive Behaviors, Vol. 3, No. 3-4Archiv f�r Psychiatrie und Nervenkrankheiten, Vol. 222, No. 4Observations On The Phenomenology Of Consciousness Change17 January 2012 | Journal of Psychedelic Drugs, Vol. 8, No. 1International Journal of the Addictions, Vol. 11, No. 1Clinical Toxicology, Vol. 9, No. 4, Vol. 21FLASHBACKSPsychiatric Annals, Vol. 3, No. 5The Psychological Record, Vol. 23, No. 2Focal Suicide: Self-Enucleation by Two Young Psychotic IndividualsDAVID H. ROSEN, and ARTHUR M. HOFFMAN1 April 2006 | American Journal of Psychiatry, Vol. 128, No. 8Archiv f�r Psychiatrie und Nervenkrankheiten, Vol. 214, No. 4The Abuse of Psychotomimetic Drugs3 July 2009 | International Journal of the Addictions, Vol. 6, No. 2Flashbacks: Recurrent Intrusive Images After the Use of LSDMARDI J. HOROWITZ1 April 2006 | American Journal of Psychiatry, Vol. 126, No. 4International Journal of the Addictions, Vol. 4, No. 1Psykotiske reaktioner ved LSD-misbrug12 July 2009 | Nordisk Psykiatrisk Tidsskrift, Vol. 22, No. 1L.S.D. PSYCHOSIS1 January 1968 | Medical Journal of Australia, Vol. 1, No. 4 Volume 124Issue 3 September 1967Pages 393-395 Metrics PDF download History Published online 1 April 2006 Published in print 1 September 1967