Attenuation and anticipation: A therapeutic use of lysergic acid diethylamide

Introduction

Theoretical reasons for the use of LSD as an analgesic agent are elaborated. Two characteristics of the LSD experience which are of possible therapeutic use in situations where anticipation is of less use than in ordinary life: (1) the loss of the ability to anticipate, through the lessening of the power of words, and (2) the expansion of the immediate sensory life.

Method

Only one-dose administrations of LSD were undertaken in this study of 128 patients. All were informed of their diagnosis and were pre-terminal, meaning that death could be foreseen withinone to two months. The following observations were conducted: (1) Pain intensity, (2) Affective changes, (3) Approach to illness and death, (4) Sleep patterns, (5) Visual disturbances and hallucinations, (6) Fear and panic reaction.

Results

(1) A precipitous drop in pain occurred about 2-3 hours after LSD administration. This pain relief lasted 12 hours, but the total pain intensity was less for a protracted period (3 weeks). (2) There was a general lift of mood, almost euphoria, which lasted for about 11-12 hours, after which time the mood fell to its original level. (3) Under LSD, patients were so strikingly unconcerned about death ,or any other anticipatory concern that this seemed important. Rather often definite evidence of depression (like somatization or nagging attitudes by patients) associated with an air of unconcernedness was encountered. The patient was able to state that death was near, that the situation was hopeless, but felt that this did not matter. (4) The first night [of sleep] after LSD administration was almost invariably a good one. After that a meaningful reduction of disturbances up to .about 10 nights was noted, which is also the time when concern about the morbid condition returned. (5) At the height of the LSD reaction less than 10% of the patients 'had actual hallucinations, while about 55% (75 patients) confessed to visual distortions. (6) Seven patients had panic, while 42 suffered mild anxiety reactions. None of the reactions was of sufficiently severe character to terminate the LSD reaction. All were amenable to psychotherapy.

Discussion

In a series of 128 patients the analgesic action of LSD is further confirmed, and the undesirable pharmacologic effects are discussed. The relative safety of the drug for that use is demonstrated, and further study is recommended.