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Stroke/TIA and LSD use

leungkachong

Bluelighter
Joined
Aug 26, 2003
Messages
335
Location
Toronto, Canada
I believe this thread is more suited for here than the health forum as I am interested in mechanism more than anything, the following is simply context.

Over the last bit, a 17 year old male suffered from what was most likely a transient ischemic attack (TIA). He has had what was beleived previously to be heart problems, yet no direct causation could be found. Ectopic atrial tachycardia had been recorded during previous episodes, however getting to an ECG in the middle of an attack was always of course an issue. No direct cause could be found by the top cardiologists in Canada.

The most recent (and most severe) attack occured whilst on LSD. As for context, this occured after a couple day period of sleep deprivation, being placed in a unaccustomed hot environment, with little food for around 2 days, and most likely dehydration (very low water replacement, and alcohol consumption).

Public information on strokes/TIAs list LSD as a risk factor, along with strong CNS stimulants. However no direct information concerning LSD and TIAs could be located. Although I am aware of the complicated and multi-causative nature of what is described, any input into the risk associated and the role played by LSD in this would be very helpful!
 
Shit, well I hope this male is allright.

God, I'm trying to remember the etiology of TIAs... they're classically thrombotic right. Serotonin has a pro-clotting action through 5-HT2 receptors... and a vasoconstrictive action via the same...

Increased clotting plus increased vasoconstriction.. seems like a recipe for disaster in someone prone to it allready. Dehydration wouldn't help.
 
Thanks for your reply Bilzy :P. Hmm.... Even if all TIAs aren't thrombotic, that seems a reasonable assumption in this case. Searching for information relating to this case previously, I'd searched mainly for information regarding the "serotonin-mediated heart" (as the heart was considered primary cause, rather than secondary effect previously). I know that the effect is receptor dependant, and 5-HT2 is vasoconstrictive, and has (short-term?) positive feedback loops, releasing more and amplifying the action of other vasoconstrictors in the area (angiotensin, norep). This review was pretty helpful: http://www.ncbi.nlm.nih.gov/entrez/...ve&db=pubmed&dopt=Abstract&list_uids=10821327

The vasoconstrictive risk seemed pretty clear, but I was not aware before of the pro-clotting action of serotonin. I should try to track down this paper: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=1966729 (if you can find that paper easily, please assist anyone). It seems like a lot of (poorly written?) reviews do not make too much distinction between central and peripheral effects, though many papers seem to show differences :S!
 
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yeah, the old 5-HT2A receptor mediated platlet aggregation and shape change is one of the oldest bioassays... It's not an area that's really received much pre-clinical research interest, 5-HT2A receptor agonists as anti-hemophiliac drugs probably aren't gonna be a big sucsess!
 
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