Therapeutic Use of LSD in Psychiatry: A Systematic Review of Randomized-Controlled Clinical Trials

The vast majority of authors describe significant and positive short-term changes in patients, despite the fact that in some studies an important homogenization was observed between the LSD treatment group and control group at long-term follow-up. Multiple variables regarding LSD treatment therapeutic approach and quality of experience were revealed and related to therapeutic outcomes. LSD is revealed as a potential therapeutic agent in psychiatry; the evidence to date is strongest for the use of LSD in the treatment of alcoholism. Despite the difficulty of designing proper double blind clinical trials with this substance, new studies that conform to modern standards are necessary in order to strengthen our knowledge on its use and open new doors in the future. Despite design heterogeneity among the clinical trials in this review, some positive results were observed, revealing the therapeutic potential of LSD in the reduction of psychiatric symptomatology. The vast majority of authors described important positive short-term changes in patients, although in some studies (59, 65, 69) an important homogenization was observed between the LSD treatment group and the control group at long-term follow-up.

Furthermore, to date, this study is the largest psychedelic-assisted trial investigating long-term outcomes in a psychiatric population. The present analysis included no control group for long-term effects of LSD. Additionally, no objective, interview-based data were collected, the herein-reported data are based on self-report questionnaires and no measure of expectancy was collected.

Lysergic acid diethylamide (LSD) was studied from the 1950s to the 1970s to evaluate behavioral and personality changes, as well as remission of psychiatric symptoms in various disorders. LSD was used in the treatment of anxiety, depression, psychosomatic diseases and addiction. However, most of the studies were not performed under contemporary standards, and it has taken several decades for a resurgence of interest in LSD research and buy lsd vial liquid its therapeutic potential for psychiatry. The aim of this review is to identify controlled and randomized clinical trials that assess the potential use of LSD in psychiatry.

Recently LSD has been used in microdoses as low as 10 mcg to enhance performance (27). The most common adverse events on dosing day included illusion, hallucinations, euphoric mood, anxiety, abnormal thinking, headache, paresthesia, dizziness, tremor, nausea, vomiting, feeling abnormal, mydriasis, and hyperhidrosis. The company previously announced statistically significant improvements on the HAM-A compared with placebo at 4 weeks, which was the trial’s primary endpoint. Of these records, 169 records were excluded, and 20 full-text articles were sought for retrieval to determine eligibility. One full-text article could not be retrieved, and 11 articles were further excluded. One additional article was identified via manual searching of reference lists in cited articles.

Each potentially relevant publication found during the search was retrieved and assessed for its use in this review after inclusion and exclusion criteria were specified. Other receptors which may contribute to the effects of these agents are the serotonin 2C and 1A receptors, as well as other effects in the dopaminergic and noradrenergic system (16). Likewise, these are potent regulators of transcription factors, which could mediate a potential mechanism of action in the synaptic structure with greater persistence of their effects over time (23, 24). Classical hallucinogens are psychoactive substances that are believed to mediate their effects mainly through an agonist activity in the serotonin 2A receptor (5-HT2A) (16). Experimental studies have previously shown that the use of 5-HT2A antagonists attenuate the main effects of these substances, both in rats (17, 18) and human subjects (19–22).

Symptom improvement was measured by comparing baseline scores to scores at various follow-up periods. The safety and tolerability of the psychedelics were investigated by noting the incidence and types of adverse effects. Sara Reed is a Licensed Marriage and Family Therapist and CEO of Mind’s iHealth Solutions, a digital health company that provides evidence based and culturally responsible mental health services for underserved groups. As a mental health futurist and clinical researcher, Sara examines the ways culture informs the way we diagnose and treat mental illness.

Despite heterogeneity, there was a trend among most modern trials within our review to emphasize the importance of the “set” of the subjects to be studied, devoting more time and providing them with a structure. In the earliest study meeting these characteristics (72), patients were previously informed of the nature of the drug, stating whether they would receive a small or a large dose. Within the LSD group of treatment (full-dose or active placebo), approximately half of the patients performed the session during the first 3 weeks, with the remaining subjects receiving LSD treatment during the last 3 weeks. There was a non-significant trend towards better results among those who received treatment during the last 3 weeks, which was highlighted by the authors as a positive association between “set” and therapeutic outcomes. However, LSD remains one of the most stigmatized and legally restricted agents among psychoactive substances. It is still included in Schedule I of the United Nations classification of drugs, restricting its use in research and making it difficult to potentially use it as a therapeutic tool in medicine.

They may give you a test or screening to learn more about the severity of your symptoms. A single dose of MM120 (lysergide d-tartrate) led to a 48% rate of remission from generalized anxiety disorder at 12 weeks following the drug’s administration, according to MindMed. He founded the Integrative Psychiatric Healing Center in in 2001 in Boulder, CO, where he currently practices.

However, this effect was related to quality of life and general health in some of the studies, with no clear improvements in alcohol abstinence. All trials were judged to have low or an unclear risk of bias due to independent and blind assessment. In one trial (72) the outcome assessor was not explicitly described as allocation-blind and in another one (59) the assessment was collected by self-report questionnaire, confirmed by telephone interview with a close relative or friend.

The FDA’s breakthrough therapy designation speeds up the development and review of drugs intended to treat a serious condition where early evidence indicates the drug may be better than available therapies. The acceleration of this process may well lead to FDA approval of LSD for treating generalized anxiety disorder within the next few years. The FDA recently designated a form of LSD as a breakthrough therapy to treat generalized anxiety disorder. This decision was based partly on a rigorously designed drug trial in which about half of the patients on the drug got significant relief from the condition.