Randomized controlled three-year investigation comparing three LSD treatment conditions (hypnodelic, psychedelic, and drug-alone) against a milieu therapy control in 176 male alcoholic inpatients at Mendota State Hospital, Wisconsin. All groups improved significantly across all follow-up periods; no LSD condition outperformed the control.
A three-year randomized controlled investigation designed to determine whether any of three LSD treatment conditions would outperform a milieu-only control for male alcoholic inpatients, and whether adding post-discharge disulfiram could enhance any treatment's effect.
176 male alcoholic patients at the Alcoholic Treatment Center (ATC), Mendota State Hospital, Madison, Wisconsin were randomly assigned to one of four conditions: (1) Hypnodelic Therapy (LSD + hypnosis + psychotherapy), (2) Psychedelic Therapy (LSD + psychotherapy), (3) Drug Alone (LSD only), or (4) Milieu Therapy / No Therapy (control). 44 patients per arm. Half of each group (n=22) were additionally assigned disulfiram (0.5g/day orally) for up to 12 months post-discharge, creating a 2×4 factorial design.
All LSD conditions used a single oral dose of 3 µg/kg body weight in a ~3-hour morning session. A standardized ~2-hour preparatory session preceded treatment for all participants. Thirteen psychiatrists served as therapists, each trained in hypnosis and LSD administration and balanced across conditions. Following each session, patients were observed overnight in a dedicated observation room with nursing supervision, vital sign monitoring, and sedation as needed.
Outcome was assessed at inpatient (pre-treatment and ~2 weeks post-treatment) and at 3, 6, 9, and 12 months post-discharge using the Psychiatric Evaluation Profile (PEP), California Psychological Inventory (CPI), Breathalyzer, Drinking Follow-up Form (DFF), and Behavior Rating Scale (BRS, also rated by relatives). Follow-up rates exceeded 87% at all time points.
All four groups showed statistically significant improvement from baseline across most measures at both inpatient and follow-up evaluations. However, no treatment condition was superior to any other. Approximately 65% of patients had returned to drinking by 3 months and 80–90% by 12 months. Disulfiram assignment made no significant difference in any outcome measure. The authors concluded that LSD treatment procedures offered no therapeutic advantage over the standard milieu program.
Note: This trial predates clinical trial registration systems and has no registry entry. Details derived from Ludwig et al. (1969), American Journal of Psychiatry, 126(1):59–69.
LSD (3 µg/kg body weight, oral) administered at session start, followed by a 30–45 min hypnotic induction aimed at deep trance, then active dynamically oriented psychotherapy targeting the patient's major problem areas for the remainder of the ~3-hour session. Hypnotic control was periodically reinforced throughout. Post-session: observation room for the rest of the day and overnight, with nursing supervision, vital signs, and sedation as needed.
LSD (3 µg/kg body weight, oral) administered at session start; patients instructed to talk about their problems while therapist engaged in active dynamically oriented psychotherapy throughout the ~3-hour session — identical therapeutic style to the hypnodelic arm but without hypnosis. Post-session: same observation room protocol.
LSD (3 µg/kg body weight, oral) administered at session start; patients instructed to relax and independently work through their problems. Therapist remained present in the room throughout the ~3-hour session but was not to initiate dialogue — only brief support if the patient became anxious or panicky. Post-session: same observation room protocol.
No drug or active psychotherapy administered. Patients spent an equivalent amount of time in the treatment room in 'contemplation and meditation,' asked to conduct an honest personal inventory, write down the reasons for their problems, and make constructive plans for the future. Represents the standard milieu treatment program of the ATC (therapeutic community meetings, small group therapy, AA, work assignments, recreational and occupational therapy, individual counseling).