Changing your mind – back in (research) style.

Scientific American Magazine –  September 24, 2009

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LSD makes a comeback as a possible clinical treatment

By Gary Stix

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Albert Hofmann, the discoverer of LSD, lambasted the counter-cultural movement for marginalizing a chemical that he asserted had potential benefits as an invaluable supplement to psychotherapy and spiritual practices such as meditation. “This joy at having fathered LSD was tarnished after more than ten years of uninterrupted scientific research and medicinal use when LSD was swept up in the huge wave of an inebriant mania that began to spread over the Western world, above all the United States, at the end of the 1950s,” Hofmann groused in his 1979 memoir   LSD: My Problem Child.

For just that reason, Hofmann was jubilant in the months before his death last year, at the age of 102, when he learned that the first scientific research on LSD in decades was just beginning in his native Switzerland. “He was very happy that, as he said, ”˜a long wish finally became true,’ ” remarks Peter Gasser, the physician leading the clinical trial. “He said that the substance must be in the hands of medical doctors again.”

The preliminary study picks up where investigators left off. It explores the possible therapeutic effects of the drug on the intense anxiety experienced by patients with life-threatening disease, such as cancer. A number of the hundreds of studies conducted on lysergic acid diethylamide-25 from the 1940s into the 1970s (many of poor quality by contemporary standards) delved into the personal insights the drug supplied that enabled patients to reconcile themselves with their own mortality. In recent years some researchers have studied psilocybin (the active ingredient in “magic mushrooms”) and MDMA (Ecstasy), among others, as possible treatments for this “existential anxiety,” but not LSD.

Gasser, head of the Swiss Medical Society for Psycholytic Therapy, which he joined after his own therapist-administered LSD experience, has only recently begun to discuss his research, revealing the challenges of studying psychedelics. The $190,000 study approved by Swiss medical authorities, was almost entirely funded by the Multidisciplinary Association for Psychedelic Studies, a U.S. nonprofit that sponsors research toward the goal of making psychedelics and marijuana into prescription drugs. Begun in 2008, the study intends to treat 12 patients (eight who will receive LSD and four a placebo). Finding eligible candidates has been difficult””after 18 months only five patients had been recruited, and just four had gone through the trial’s regimen of a pair of all-day sessions. “Because LSD is not a usual treatment, an oncologist will not recommend it to a patient,” Gasser laments.

The patients who received the drug found the experience aided them emotionally, and none experienced panic reactions or other untoward events. One patient, Udo Schulz, told the German weekly Der Spiegel that the therapy with LSD helped him overcome anxious feelings after being diagnosed with stomach cancer, and the experience with the drug aided his reentry into the workplace.

The trials follow a strict protocol””“all LSD treatment sessions will begin at 11 a.m.”””and the researchers are scrupulous about avoiding mistakes that, at times, occurred during older psychedelic trials, when investigators would leave subjects alone during a drug session. Both Gasser and a female co-therapist are present throughout the eight-hour sessions that take place in quiet, darkened rooms, with emergency medical equipment close at hand. Before receiving LSD, subjects have to undergo psychological testing and preliminary psychotherapy sessions.

Another group is also pursuing LSD research. The British-based Beckley Foundation is funding and collaborating on a 12-person pilot study at the University of California, Berkeley, that is assessing how the drug may foster creativity and what changes in neural activity go along with altered conscious experience induced by the chemical. Whether LSD will one day become the drug of choice for psychedelic psychotherapy remains in question because there may be better solutions. “We chose psilocybin over LSD because it is gentler and generally less intense,” says Charles S. Grob, a professor of psychiatry at the University of California, Los Angeles, who conducted a trial to test psilocybin’s effects on anxiety in terminal cancer patients. Moreover, “it is associated with fewer panic reactions and less chance of paranoia and, most important, over the past half a century psilocybin has attracted far less negative publicity and carries far less cultural baggage than LSD.”

Others assert the importance of comparative pharmacology””how does LSD differ from psilocybin?””because of the extended period of research quiescence. Just because many types of so-called SSRI antidepressants exist, “it doesn’t mean that they are all identical,” observes Roland Griffiths, a Johns Hopkins University researcher who conducts trials with psilocybin. In any case, on the 40th anniversary of the Woodstock music festival, psychoactive substances that represented the apotheosis of the counterculture lifestyle are no longer just hippie elixirs.

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Note: This article was originally printed with the title, “Return of a Problem Child.”

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