LSD is quite safe by itself. What makes you think it's not?
Long term risks are HPPD in people who either abuse it or are predisposed/sensitive, mental issues - but again: pretty much only in people who are sensitive/predisposed. With a lot of schizophrenia in your family you may want to reconsider, or if you have a history with things like psychosis. That's about all I can think of.
If you merely have mental difficulties like a history of some depression etc, or just not feeling so strong in their shoes.. I'd be extra careful about starting low with the dose. Nothing about this is to panic about unless - again - you have reason to believe your mental state is fragile, or you'd have genetics that could likely make you a latent schizophrenic.. but other than that it mostly requires some good consideration, and keeping an eye on worrisome signals. You can't know whether you are sensitive to get HPPD for instance, I guess you would just unexpectedly get persisting visuals like snow etc with only a few trips under your belt. That would be an anomaly and you should probably not continue tripping frequently like others might.
Confusion is somewhat to be expected, but it may mostly be from being unexperienced and the dose being a bit high. Also preparing well with a good set and setting can help a lot, it magnifies your current state of mind so if there is not much going on focussing on your voice etc may warp those things. If instead you are in a beautiful park, that beauty is instead more likely the thing to get focus and magnification.
LSD does not fry you, it can just be a bit exhausting but it's not unhealthy.
Piracetam does potentiate trips I can tell you that, but it won't help with safety since LSD is already physically safe and combinations that are not well researched mostly add unpredictability - so LSD being rather ideal by itself you'd stand to lose more than you could win. A guess that racetams may have undiscovered benefits isnt much to go on - no offense
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I've tried it (the combo), and it made me feel more lucid and the trip a bit more extra powered (which does not sound like it's really of use to you if you still have to find a proper dosage level to learn how to deal with confusing stuff and your own mind!). It wasn't bad, but it can be more unstable. Potentiation of mushrooms with MAOIs felt much more 'unbound' which I definitely didn't appreciate very much.
Neither of these additions would I recommend until you have plenty of experience and confident in your basic tripping, and curious about changing things up.
Just learn how to use LSD. Choose a different setting, see if you need a lower dose or at some point a higher one to explore.
Separate of that, feel free to explore piracetam on its own. I thought it was nice and could be a little helpful although some other racetams were more significantly effective for me. Take a choline source with it.