The use of L.S.D. 25 in psychiatry.

Abstract

MUCH PUBLICITY in the national press, most of it adverse in the past two years, has been attached to lyseric acid diethylamide (L.S.D.25) and, therefore, it seems essential to review cases and publish the findings about the results of treatment with this drug. It would appear that in the British Isles only about 25 psychiatrists, including the author, have been enquiring into the uses and dangers of the drug. L.S.D. 25 was first prepared in 1938 by Stoll & Hofmann, and was for a few years of interest to research workers only because of its hallucinogenic properties, and its abilities to distort the sense of perception and of orientation in time, place and person. Only later was its therapeutic potential explored in the treatment of psychiatric disorders. Sandison, Spencer & Whitelaw (1954) reported its use in a wide variety of psychiatric patients, and reports appeared more frequently until tranquillisers and anti-depressant drugs became popular. Its use by the present author has been at dosage level of 25 ug-lOO/,g per sessions and generally at weekly intervals, and varying in number from 1 to 8. This dosage is about one-tenth of that used in illicit psychedelic sessions. Three-quarters of the subjects were out-patients, a practice carried out successfully for a number of years at, for example, day hospitals (Martin 1957), (Long & Buckman 1960). Where insightful psychotherapy has been indicated the author for some years has followed the general pattern elaborated by Finesinger (1948), but even this shortcut to analytical procedure is too time-consuming for National Health Service practice. L.S.D. 25 was used in the hope of accelerating the treatment of those patients in whom a poor prognosis was predicted as regards recovery with other methods of treatment. In practically all other reported studies where the drug has been shown to be useful, the patients selected were those who would have responded equally well to other forms of treatment. The patients, in single rooms throughout each session, were given the drug orally at 9 a.m. A nurse was immediately available. The author visited the patients at intervals and also if they complained of anxiety or any peculiar sensations. At the end of 4 hours each patient received Chlorpromazine 100 mgm. orally to terminate the session. They were instructed to record any memories, ideas or "insights" which occurred to them during sessions and in the days between sessions. It was hoped that this would enhance their desire for improvement.