[dkmar]

note: i’m not a doctor or anything related.

Wikipedia says “5-HT2A antagonists block the psychedelic activity of LSD”[0], so wouldn’t 5-ht2a antagonists like mirtazapine work well enough here?

No idea as to how quickly the trip would be tempered, though

[0]: https://en.m.wikipedia.org/wiki/Lysergic_acid_diethylamide

[QUFB]

Yes, or at least it blocks effects if you take it pre-exposure. Risperidone, an atypical antispychotic, is also known for this. Some idiotic big pharma startup will try and milk this, rather than examining cheap existing medications. Plenty of medications block 5-HT2A, I think the important requirement here would be rapid absorption and high receptor occupancy.

[c22]

Anecdotally, I've used risperidone specifically to abort LSD trips on two occasions and found it quite successful both times. Now when I introduce people to LSD I give them a Risperdal to keep in their pocket "just in case", though to my knowledge none of them have had to use it.

[penagwin]

Simply knowing you have a backup strategy if you panic can go a long way to preventing panic attacks. Psychiatrists sometimes do something similar where they write a script for a benzo, just one or two for your bag.

Knowing you can control panic if it occurs goes such a ways in preventing panic at all.

[indenturedsmile]

Anecdotally, one of the best treatments for social anxiety I've found is to always know where the exits are. At a concert, identify the exit signs. In a conversation, have someone who can take over for you.

Knowing there's a way out of the situation can completely nullify the scariness of that situation.

[Stevvo]

Probably not; if the LSD is already bound to a 5-HT2A receptor, then how is an antagonist going to bind with that receptor?

[higginsc]

[source: PhD in drug design specializing in G-protein coupled receptor pharmacology]

Drugs like LSD form non-covalent bonds with receptors. In a macro-world analogy, think of your hand sticking to a syrup-covered fork vs. a covalent bond being your hand stuck to a super-glue covered fork. Different drugs have different levels of "stickiness" (called affinity) for a particular receptor, and LSD has pretty high affinity for its target receptor, 5-HT2a, but it isn't permanently attached. In fact, affinity is defined by relative association vs. dissociation rates of drug-receptor complex.

On a microscopic level, each molecule of LSD is falling in and out of the receptor binding site stochastically. This leaves open the possibility of another drug binding to the same site (called competitive inhibition) when LSD isn't occupying the site. If another drug has a higher affinity, it will occupy the receptor more of the time. When you zoom out and consider the entire set of receptors and drugs, the sum of these individual stochastic events these effects follow characteristic patterns described by the law of mass action.

https://derangedphysiology.com/main/cicm-primary-exam/requir... is a pretty good description

*I'm simplifying parts of this somewhat.