A case report of extreme hyperthermia after LSD ingestion should be interpreted cautiously, as the symptoms—hyperactivity, unresponsiveness, mildly elevated blood pressure, increased heart rate, and slightly dilated reactive pupils—are also consistent with amphetamine overdose or abuse of potent anticholinergics like piperidyl benzilate or high doses of atropine and scopolamine. The patient's amnesia for the episode is not typical of LSD or amphetamine but is characteristic of anticholinergic abuse. The only feature arguing against an anticholinergic was that pupils were not widely dilated with minimal light response. Physicians should consider these alternative causes when treating unresponsive hyperthermic patients suspected of drug ingestion.
A 20-year-old woman experienced prolonged psychotic behavior after ingesting an illicit powder likely containing phencyclidine. The psychiatric effects of phencyclidine intoxication are reviewed. Treating the toxic phase with psychotropic drugs may not be beneficial. Hospitalization, supportive care, and urine acidification are recommended treatments for phencyclidine-induced toxic psychosis.