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LSD-Assisted Psychotherapy: Reopening the Doors of Perception

After a nearly 40-year moratorium, a controlled study of the therapeutic use of LSD in humans has been published in The Journal of Neural and Mental Disease after the pioneering work of Swiss psychiatrist Peter Gasser. Sponsored by the Multidisciplinary Association for Psychedelic Studies (MAPS) and approved by the BAG (the Swiss Drug Enforcement Agency), the study has completed treatment of all subjects after having enrolled its first patient in April of 2008. Many hallucinogens, such as psilocybin and MDMA, are being investigated today for their clinical benefits as a result of a gradual effort to reexamine the pharmacologic and psychiatric interests in hallucinogens.

LSD is a semi-synthetic compound that was developed from ergot alkaloids, a natural substance from the parasitic rye fungus Claviceps purpurea, in 1938 by the Swiss chemist Albert Hofmann in Basel, Switzerland. LSD’s highly specific actions on the brain and human consciousness were soon discovered and the therapeutic potential of the substance was vastly appreciated. The first paper to discuss psychiatric use of LSD was published in 1947 and within the next decade Time magazine called LSD “an invaluable weapon to psychiatrists.” The drug was customarily administered and widely researched for its use in alcoholism, neurotic disorders and anxiety arising from terminal illness.

The unethical experimentation of LSD on prisoners, employees and government agents in a project titled MKULTRA in 1953 caused Congress to restrict the use of hallucinogens to scientific research. Despite studies on the effectiveness of LSD therapy in alcoholism and of psilocybin therapy on prisoner recidivism, research on hallucinogens declined until the 1990s, when the Heffter Research Center was established to do rigorous scientific research on psychedelics. Scrutiny remained pervasive under the reintroduction of what was perceived ambivalently as a medically relevant tool. A slow shift in attitude, rather than an abrupt change in regulations, and a turnover in leadership in this era allowed for the successful lobbying for legitimate human research. Studies on psilocybin use in terminal cancer patients demonstrating long-term reduction in anxiety (and administering controlled dosing to avoid adverse events) paved the way for further research at Johns Hopkins and NYU, where research is currently being done. Nevertheless, lack of funding is affected by the fact that psychedelics are off-patent, can’t be monopolized, and compete with other psychiatric medications that people take daily.

Lysergic acid diethylamide is known to affect a large number of G protein-coupled receptors, including all dopamine, all adrenoreceptor and most serotonin receptor subtypes. Agonism of D2 receptors, glutamate release in the cerebral cortex and selectivity at the 5-HT(2A) and 5-HT(2C) with enhancement of dopamine and serotonin signaling are thought to contribute to the psychoactive effects of LSD.

It has been shown that under controlled conditions, the LSD experience may have lasting positive effects on attitude and personality. Impaired psychomotor functioning, impaired visual memory, sympathomimetic (pupillary dilation, tachycardia) and parasympathomimetic (diaphoresis, salivation, nausea) effects are present to varying degrees. Typical sensory and psychological effects under the influence of a medium dose (100 to 200 micrograms by mouth) comparable to that used in the study include: illusion and pseudo-hallucination, intensification of color perception, metamorphosis of objects and faces, alteration of affect and bodily perception, imaginative thought and “mystical experiences,” hypermnesia, age-regression and re-experiencing of biographical memories, among other effects.

The subject population of a recent study done in Solothurn, Switzerland consisted of patients with advanced-stage cancer who have neither responded well to nor have received substantial relief from currently available treatments. The aim of the study was to improve the quality of life and reduce psychological distress in these individuals who suffered from anxiety, depression and chronic pain associated with their terminal illness. Patients who were administered a therapeutic dose (200mg) of LSD showed significant reduction in both state anxiety (their daily experience) and trait anxiety (an inherent feature of their personality) without experiencing any adverse events such as prolonged anxiety (“bad trip”) or lasting psychotic or perceptual disorders (flashbacks).

Though more research must be done on the neurochemical basis of psychedelic treatment and its effect in various settings, its potential has been rightly acknowledged. What Aldous Huxley called “the urge to escape from selfhood” is a facet of the therapy, which helps to disengage patients from the fear response incited by their coping with imminent passing. Combined with the spiritual proclivity of the terminally ill, psychedelic therapy has allowed many to both explore and revisit life by introspection into a mind antagonized by mortality. With the help of psychedelic therapy, anxious patients are better able to delve into “is-ness”, pure being and beatific awareness that has been squandered. Rather than an “animal obsessed with survival: apprehended, directly and unconditionally, by Mind at Large,” patients can free themselves from disease to peer infinitely inward and outward: to let go of their ailment for a few fleeting hours and healthily dissociate from “what is biologically or socially useful,” casting language, organized thought and ingrained notions aside to experience themselves and space-time in its endless mystery.

Steven Lange Steven Lange (13 Posts)

Medical Student Editor and in-Training Staff Member

Albany Medical College

Steven attends Albany Medical College as a student of the Class of 2017. Raised in Queens, New York, he earned a BA in English with a minor in Biology from Binghamton University in May 2013. Some of his interests include poetry, martial arts, traveling, and continental philosophy. He is currently aspiring to become a radiologist.