LSD-Linked “Alice in Wonderland Syndrome” Continues After Use

A peculiar side effect linked to LSD, a powerful hallucinogenic drug, has surfaced in a recent case report. The phenomenon, known as “Alice in Wonderland Syndrome” (AIWS), emerged in a patient even after they stopped using LSD.

The case, documented by Arturo G Lerner and Shaul Lev-Ran, sheds light on a rare condition called Hallucinogen Persisting Perception Disorder (HPPD). The patient had a history of sporadic use of cannabis, alcohol, and LSD.

AIWS is marked by distinct visual distortions, including seeing objects as larger (macropsia) or smaller (micropsia) than they are, as well as altered perceptions of distance (pelopsia) and size (teleopsia). These illusions typically arise during LSD intoxication but can persist after drug use ends.

In this instance, the patient experienced AIWS solely during LSD consumption, but the effects lingered even after discontinuing the drug. Although the condition didn’t significantly impact their daily functioning, it caused considerable distress.

Despite refusing medical treatment, the patient continued to receive psychiatric support. Remarkably, after a year, the patient reported complete remission of symptoms.

This case stands out as the first documented instance of AIWS persisting after LSD cessation in professional literature. Researchers are intrigued by this benign, reversible, yet puzzling side effect and are exploring potential explanations.

Understanding the persistence of AIWS post-LSD use could offer insights into the brain’s mechanisms and aid in developing targeted treatments for similar conditions.

This case highlights the complex and enduring effects of LSD on perception, urging further research into the mechanisms behind such phenomena for improved patient care and management.


G Lerner A, Lev-Ran S. LSD-associated “Alice in Wonderland Syndrome”(AIWS): A Hallucinogen Persisting Perception Disorder (HPPD) Case Report. Isr J Psychiatry Relat Sci. 2015;52(1):67-8. PMID: 25841113.