At ComicCon 2013, while speaking about this episode, Joss Whedon mentioned that, during his time writing Astonishing X-Men, he envisioned Cyclops, whose real name is Scott Summers, making a reference to a female cousin of his who had been sent to a mental institution for believing she was a demon hunter. However, he could not find an appropriate place in the storyline to fit it in, and therefore it was never featured.
Sarah Michelle Gellar would later appear on one of the last shows of All My Children (1970) as an unnamed character. She played a well dressed, coiffured and otherwise coherent young woman brought in from the town for medication because she claimed she "saw vampires before they were in". Gellar originally played the daughter of Susan Lucci on the show.
In his DVD commentary, director Rick Rosenthal says that he was a little intimidated working with Sarah Michelle Gellar at first because she has the habit of jokingly saying to directors, "You're not the boss of me!" or "Don't tell me what to do!"
Buffy's pre-Sunnydale experience in an asylum was later told in the comic book "Slayer, Interrupted", a title reference to Girl, Interrupted (1999) which co-starred Clea DuVall who appeared in Out of Mind, Out of Sight (1997).
This marks the fifth and final appearance of Hank Summers (albeit as a hallucination).