Depressive DisordersHealthy VolunteersPTSDOlder AdultsMajor Depressive Disorder (MDD)Anxiety DisordersObsessive-Compulsive Disorder (OCD)Substance Use Disorders (SUD)Palliative & End-of-Life DistressSet & SettingInterpersonal Functioning & Social ConnectednessLSDMDMAPsilocybin

Acute subjective effects in LSD- and MDMA-assisted psychotherapy

In a Swiss compassionate-use programme of 18 patients (mainly with PTSD and major depression), LSD (100–200 µg) and MDMA (100–175 mg) administered in group psychotherapy produced pronounced alterations of consciousness and increases across mystical-experience scales on the 5D-ASC and MEQ. Acute subjective responses were largely comparable to those seen in healthy volunteers and clinical-trial patients, supporting further controlled studies of substance-assisted psychotherapy.

Authors

  • Yasmin Schmid
  • Matthias Liechti
  • Peter Gasser

Published

Journal of Psychopharmacology
individual Study

Abstract

Background

Lysergic acid diethylamide (LSD) and 3,4-methylenedioxymethamphetamine (MDMA) were used in psychotherapy in the 1960s–1980s, and are currently being re-investigated as treatments for several psychiatric disorders. In Switzerland, limited medical use of these substances is possible in patients not responding to other treatments (compassionate use).

Methods

This study aimed to describe patient characteristics, treatment indications and acute alterations of mind in patients receiving LSD (100–200 µg) and/or MDMA (100–175 mg) within the Swiss compassionate use programme from 2014–2018. Acute effects were assessed using the 5 Dimensions of Altered States of Consciousness scale and the Mystical Experience Questionnaire, and compared with those in healthy volunteers administered with LSD or MDMA and patients treated alone with LSD in clinical trials.

Results

Eighteen patients (including 12 women and six men, aged 29–77 years) were treated in group settings. Indications mostly included posttraumatic stress disorder and major depression. Generally, a drug-assisted session was conducted every 3.5 months after 3–10 psychotherapy sessions. LSD induced pronounced alterations of consciousness on the 5 Dimensions of Altered States of Consciousness scale, and mystical-type experiences with increases in all scales on the Mystical Experience Questionnaire. Effects were largely comparable between patients in the compassionate use programme and patients or healthy subjects treated alone in a research setting.

Conclusion

LSD and MDMA are currently used medically in Switzerland mainly in patients with posttraumatic stress disorder and depression in group settings, producing similar acute responses as in research subjects. The data may serve as a basis for further controlled studies of substance-assisted psychotherapy.

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Research Summary of 'Acute subjective effects in LSD- and MDMA-assisted psychotherapy'

Introduction

Schmid and colleagues situate this study within the renewed clinical interest in serotonergic hallucinogens and entactogens, noting that LSD and MDMA were used as adjuncts to psychotherapy from the 1950s to the 1980s and are again being investigated for disorders such as depression, anxiety associated with life‑threatening illness, OCD, substance use disorders and PTSD. Previous clinical and experimental work has identified acute prosocial and empathogenic effects of both LSD and MDMA, and hallucinogen‑induced mystical‑type experiences have been associated with persistent positive changes; however, most experimental studies assessed subjects individually in controlled laboratory settings, and there are few objective data on acute subjective effects when these drugs are administered clinically in group psychotherapy outside formal trials. This prospectively designed study aimed to describe patient characteristics, treatment indications and acute subjective alterations of consciousness in patients receiving LSD (100–200 µg) and/or MDMA (100–175 mg) within the Swiss compassionate use programme from 2014–2018. In addition, the investigators compared these acute responses, measured with validated psychometric instruments, to pooled data from healthy volunteers and to patients treated alone in clinical trials, to explore whether acute effects differ between clinical group settings and laboratory or single‑patient therapeutic settings.

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Study Details

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