The History of LSD and Managing Mental Health
Since the discovery of Lysergic acid diethylamide’s (LSD) in 1938 by Swiss chemist Albert Hoffman, using the terms LSD and managing mental health in the same sentence has been met with a combination of skepticism, enthusiasm and outrage. The lack of consistency in research limits studies’ ability to find a definite effect of LSD.
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The History of LSD
Not originally thought of as a psychiatric treatment, LSD was synthesized from ergot derivatives as a medication to reduce postpartum hemorrhage, with Hoffman first experiencing its hallucinogenic effects after accidentally dosing himself. Marketed by Sandoz, Hoffman’s employer at the time, under the brand name “Delysid” in the 1950s, interest among psychiatrist evolved in the potential use of LSD as a therapeutic agent and the substance was used in several psychiatric departments in Europe and America. In the late 1950s, even prominent US celebrities like Cary Grant and Esther Williams took LSD under the guidance of Dr. Mortimer Hartman at the Psychiatric Institute of Beverly Hills in order to manage their states of mind.
Studied from the 50s to 70s, even after its federal prohibition in the US, to evaluate LSD induced behavioral and personality changes. LSD was used in the treatment of:
- Psychosomatic diseases
The study of LSD as a treatment for mental health problems came to a grounding halt due to:
- Increasing recreational use.
- Safety concerns
- Scheduling restrictions.
- US Army and CIA MK-Ultra experiments with LSD
As a result of these factors, most studies were not performed with proper research protocols and standards, further tainting the reputation of the drug. This caused studies to be viewed with skepticism by mainstream medicine, and it has taken several decades for research in LSD’s therapeutic potential to recover. After US prohibition in 1967, and as result of its popularity in counter-cultural movements, it has finally seen a resurgence of interest in its therapeutic potential for psychiatry.
Research into LSD and Managing Mental Health
How LSD May Help Understand Mental Disorders
Certain mental disorders, like schizophrenia and depression, are characterized for impairing an individual’s sense of self, making it difficult for people to distinguish themselves from others, impairing everyday mental tasks and social interactions. With regards to a dysfunctional sense of self:
- Schizophrenics lose track of themselves.
- Depressed people ruminate on themselves, stuck in an obsessive, self-oriented patterns of thought.
Understanding LSD’s ability to breaks down one’s sense of self may help researches experience symptoms of the disorders first and and find targets for future experimental drugs. Animal studies suggested that 5-HT2 plays a role in LSD’s ability to alter one’s sense of self that blocking the receptor in humans might somewhat reduce the effect of LSD. Research that used ketanserin (a 5-HT2 antagonist) to block the effect of LSD showed no difference between the performance of subjects who took LSD and ketanserin and a placebo group on measures of sense of self, indicating that 5-HT2 plays an important role in regulating sense of self in the brain. Researchers indicate that the next step involve on drugs that target the 5-HT2 receptor to determine if they alleviate the symptomatology of psychiatric illnesses affecting the sense of self.
Therapeutic Effects of LSD
Even in the earliest studies, LSD’s potential to reduce anxiety and depression were becoming clear, and it was being used in concert with therapy for cancer patients.
The reality was these studies, although held up by some as clear indication of the utility of LSD, suffered from both poor documentation and methodologies. Additionally, different and mostly non-evidence-based therapies have been used in psychedelic-assisted therapy trials making comparisons between studies difficult.
Recent scientific literature reviews of randomized controlled trials (RCTs) testing the efficacy of LSD as a psychiatric treatment have been challenging. One author screened 43 studies, published between 1966 and 2014 and found that only 11 were methodologically rigorous enough to be included in a scientific review; Many studies were excluded because:
- They did not have a control group
- Did not randomize participants.
There were many shortcomings in the studies that were considered, including:
- Variation in drug dosing and control: there was huge variation in the amount of LSD given (it ranged anywhere from 20 – 800 mcg)
- Variation in set and setting: some studies asked patients to be better prepared then others; some married the treatments to active psychotherapy, some didn’t; some included post-treatment integration, some didn’t.
Controlled LSD delivering within a therapeutic setting appears to be safe with the potential to be an effective treatment for some mental illness.
Efficacy of LSD
In the last 10 years, research in to LSD and managing mental health resurgences; first in healthy volunteers, but then in mental health patients. A meta-analysis of studies found LSD to be effective in managing substance abuse while another literature review concluded that LSD deserved further investigation as a treatment for mood disorders.
LSD and the Management of Mood Disorders
A more recent trial looked at psychotherapy and LSD, and the effect of the combination on anxiety. The findings showed that anxiety was significantly reduced and for a long time. While the depression group did not see much relief, everyone reported an increased quality of life. And perhaps most importantly, there were no adverse effects of any kind – no drug seeking behaviour, no bad trips inducing panic, no psychological complications, nothing.
LSD and the Management of Substance Abuse
- LSD appeared, in three studies, to have a pretty significant impact on alcohol-abuse sufferers. This was consistent for heroin users as well. While not consistent between the studies, there were strong indications that abstinence increased, and was sustained for quite a long time after treatment.
LSD and Cluster Headaches
Single or few doses of LSD also reportedly lessened cluster headache and induced remission more effectively than conventional medications and researchers in Switzerland are in the beginning stages of a 3o patient study o investigate the effects of an oral LSD pulse regimen (3 x 100 µg LSD in three weeks) in cluster headache patients.
The Importance of Set and Setting in LSD Treatment
While many of the LSD trials pay attention to patient preparation and aftercare, there was no consistent approach amongst, However given the the low rate of adverse events, regardless of the amount of preparation or dose size, suggests that it is worth researching the mount of preparation and psychotherapy is essential.
More so than with other psychiatric drugs, the context in which psychedelic drugs are administered, also referred to as ‘set’ and ‘setting’, is important.
- ‘Set’ refers to a participant’s thoughts and expectations. In clinical use, this may involve psychotherapy to prepare the participant.
- ‘Setting’ refers to the physical environment where people receive the drug; a comfortable room, music, the presence of supporters during the session. Other considerations are about including post-drug integration sessions.
As pointed out by numerous researchers, is not clear as to the amount of psychological support is sufficient to proved patients with the right “set” and in fact, new research into LSD is costly and time-consuming, in part due to the drug scheduling restrictions and the psychological support element.
As can be gleaned from the above, it is clear that the path forward for LSD as a tool for managing mental health relies on conducting more high quality research studies, but the initial work indicates that LSD is a low risk modality worth exploring.