With the recent re-emergence of psychedelics within the field of psychiatry, researchers, patients and physicians are still left wondering how efficacious psychedelics are as a potential adjunct treatment, or replacement for current front-line treatments, such as anti-depressants.
Presently, most of the research is primarily focused on determining the efficacy of psilocybin in treating mood disorders, substance and drug abuse disorders, eating disorders and neurodegenerative disorders. However, despite the growing consensus pertaining to the therapeutic benefits of psilocybin, further research is needed in order to establish it as an evidence-based treatment. This has lead researchers to investigate the potential effectiveness of other psychedelics, specifically, Lysergic acid diethylamide or ‘LSD’.
- Lysergic acid diethylamide (LSD) was studied from the 1950s to the 1970s to evaluate behavioral and personality changes, as well as remission of psychiatric symptoms in various disorders. LSD was used in the treatment of anxiety, depression, psychosomatic diseases and addiction
Today, we intend to provide our readers a synopsis of the history and what the current literature within psychiatry has to say about the efficacy of LSD in treating psychiatric symptomology.
A Brief History on D-Lysergic Acid Diethylamide (LSD)
Psychedelics are any of the so-called mind-expanding drugs that are able to induce states of altered perception and thoughts, frequently with a heightened awareness of sensory input but with diminished control over what is being experienced.
D-Lysergic Acid Diethylamide or ‘LSD’ is part of the pharmacological group known as “classical hallucinogens” or “psychedelics”, which share its chemical structure with psilocybin and dimethyltryptamine (DMT) as a variant of indolamine (chemical structure similar to the neurotransmitter serotonin).
- LSD is the most potent and notorious of the hallucinogens, and the one that brought this class of drugs into the public eye in the 1960’s. LSD was originally synthesized from ergot alkaloids extracted from the ergot fungus Claviceps purpurea.
- LSD acts primarily as a serotonergic agonist as well influencing other neurotransmitter systems via dopaminergic and adrenergic receptors. LSD triggers an increase in cortisol, oxytocin, and adrenaline levels. The predominant effects induced by LSD included visual hallucinations, audiovisual synesthesia, and positively experienced derealization and depersonalization phenomena
LSD Discovery and Early Research
In the Sandoz Laboratories in Basel, Switzerland, in 1983, Dr. Albert Hofmann synthesized Lysergic Acid Diethylamide. Hofmann was working on as series of compounds derived from ergot alkaloids that had as their basic structure lysergic acid in an effort to develop ergot derivatives with the goal of reducing post-partum hemorrhage. However, since it’s discovery in 1983, LSD has maintained an unstable relationship with psychiatry.
It wasn’t until 1943 that LSD would enter the world of biochemical psychiatry. The major thrust of LSD research has to with its alleged ability to access the “sub-conscious mind”. This notion was probably derived from the dreamlike quality of the reports of LSD experiences and the long-held psychoanalytic view that dreams represent subconscious thoughts trying to express themselves. Therefore, LSD was widely used as an adjunct to psychotherapy – when a psychiatrist felt that a patients had reached a mental ‘roadblock’ and was unable to dredge up repressed memories and motives, LSD was theorized to have ‘mind revealing’ qualities.
- By the mid-1960s there were >1000 clinical papers on psychedelic drug therapy with >40,000 patients.
Two other potentially therapeutic uses for LSD were investigated as well. For various theoretical reasons, it was believed that LSD might be a good treatment for alcohol dependence, and initial reports of it’s efficacy were quite positive. Additionally, it was later hoped that LSD would allows people with terminal cancer to achieve a greater understanding of their own mortality. This, manus ich patients were allows to explore their feelings while under the influence of this fantasy-producing agent.
However, in the 1960s and 1970s, political parties in the USA blamed anti-war attitudes and the countercultural revolution as a consequence of drug use. Therefore, the 1970 the Controlled Substances Act was passed, which classified LSD and other psychedelics as Schedule 1 drugs thus effectively restricting all medical research into these drugs.
- In 1971 the UN Convention on Psychotropic Substances placed global restrictions on psychedelic drugs across 183 countries
Subsequently, the scientific study of the hallucinogens declined in the 1970’s. A 1974 report by the U.S. National Institute of Mental Health (NIMH) research task force on hallucinogenic research stated the following:
“…every psychological test has been used to study persons under the influence of LSD… but the research has contributed little to our understanding of the bizarre and potent effects of this drug”
As a result, the NIMH stooped all of it’s in-house LSD research on humans in 1968, and stopped funding university research. The U.S. National Cancer Centre and National Institute on Alcohol Abuse and Alcoholism also followed suit.
Psychedelics and Psychiatry Today
Most research since that time has been conducted on animals in an effort to better understand the mechanism of action at a neutral level. Today, roughly 40 years later, a new wave of studies on hallucinogens, primarily psilocybin and now LSD, is creating renewed interests in the clinical potential of psychedelics. It’s too early to tell which way the story will turn, but the next few years are going to be interesting.
Proposed clinical benefits of hallucinogenic compounds include:
- Reducing anxiety in people with cancer
- Supporting withdrawal from other psychoactive substances
- Improving the lives of those diagnosed with mood disorders
A Review of Recent Randomized-Controlled Clinical Trials
Among the clinical trials reviewed in this article, most of the trials observed positive results, revealing the therapeutic potential of LSD in the remission of psychiatric symptomology. The majority of authors described significant short-term positive.
- Other studies in our review also found promising results regarding LSD use for the treatment of heroin use disorder, anxiety, depression, psychosomatic illnesses, and anxiety in relation to life-threatening diseases.
- LSD has repeatedly been shown to be an effective therapy for the treatment of alcoholism, even after a single dose. A meta-analysis of six double-blind placebo-controlled trials showed that alcohol misuse was significantly reduced in 59% of patients after a single LSD dose of <50 µg (micrograms).
- LSD has also been successfully used in conjunction with psychotherapy to treat anxiety linked to a life-threatening disease such as cancer. A 12-month follow-up of this investigation showed that the effects of LSD were sustainable with 66.7% of patients reporting an increase in quality of life and 77.8% reporting reduced anxiety.
- Researchers evaluated LSD as a treatment of neurotic symptom. A follow-up found that participants in who received LSD showed better results in terms of their general health at 6 and 12 months.
- LSD was shown to be an effective therapy for heroin use disorder. Significant differences were observed in total abstinence rates in favour of the LSD treatment group at 12 months.
The evidence to date is strongest for the use of LSD in the treatment of alcoholism. New studies performed under modern standards are necessary in order to strengthen our knowledge, help erase the stigma that still prevails around these substances and open new doors within the field of psychiatry..
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