LSD Flashbacks

A patient with no history of LSD ingestion reported 14 of 16 visual symptoms characteristic of LSD flashbacks, including persistent visual distortions that began during a near-psychotic episode at age 17 and continued for 20 years with decreased frequency. Short trials of two neuroleptics (thiothixene and trifluoperazine hydrochloride) increased her symptoms. This case suggests that the visual phenomenology associated with LSD flashbacks can occur without prior hallucinogen exposure, arising instead from a psychotic episode.

Study at a glance

Abstract

To the Editor.— I read with interest Abraham's article on "Visual Phenomenology of the LSD Flashback."1The description of visual flashbacks and the apparent reduction in symptoms with the administration of a benzodiazepine called to mind the case of a woman I treated whose major difference from the patients in Abraham's group was the absence of a history of LSD ingestion. This patient had experienced the onset of visual symptoms at the age of 17 years during a near-psychotic upheaval, without any known exposure to hallucinogens. Of the 16 visual symptoms described by Abraham, my patient reported 14. Of the remaining two, she did not spontaneously endorse color confusion or positive afterimages but did not deny them. These visual distortions had persisted during the 20 years since their onset, although with decreased frequency. During short trials of two neuroleptics (thiothixene and trifluoperazine hydrochloride), she reported an increase in