Two methods for detecting LSD and its main metabolite O-H-LSD in blood were validated using LC-MS/MS. Method #1 upgraded an existing multi-compound screening procedure, while Method #2 was tailored specifically for these substances. Both methods showed good linearity and sensitivity, with limits of quantification as low as 0.025 ng/mL for LSD and 0.0125 ng/mL for O-H-LSD. Bias and precision met acceptance criteria; recoveries exceeded 83% except for O-H-LSD with Method #1. Applied successfully to two real cases, Method #1 is suitable for screening, and Method #2 provides a sensitive, reliable tool for confirmation.
Two young men, aged 19 and 21, were admitted to a hospital in a comatose state with respiratory acidosis, dilated pupils, and hypothermia after consuming 3-MeO-PCP, a dissociative anesthetic similar to phencyclidine, along with alcohol. Blood alcohol levels were 2.0 g/L and 1.7 g/L. They required intubation for 7-8 hours and remained delirious for nearly 24 hours. Toxicological analysis of blood and urine using GC-MS and LC-MS/MS detected 3-MeO-PCP at concentrations of 350.0 and 180.1 ng/mL in blood and 6109.2 and 3003.6 ng/mL in urine. The symptoms likely resulted from the combined effects of 3-MeO-PCP and alcohol. This is one of the few documented intoxication cases and the first reported in Italy, highlighting the need for broad analytical methods to detect new psychoactive substances.