DPT as an adjunct in psychotherapy of alcoholics

This early study (1973; n=51) investigated the use of DPT (tryptamine psychedelics) in combination with therapy for the treatment of alcoholism (AUD). At the six-month follow-up, 38% of participants stayed completely abstinent, about 50% were classified as rehabilitated.

Abstract

“The usefulness of dipropyltryptamine (DPT) as an adjunct to psychedelic therapy was explored in a pilot study carried out on 51 alcoholic patients from the Alcoholic Rehabilitation Unit at Spring Grove State Hospital. The evaluation of the results was based on the comparison of pre- and posttreatment results of a battery of psychological tests and of pretreatment and follow-up ratings of an independent team of social workers. The psychological tests involved the Minnesota multiphasic personality inventory (MMPI), Personal orientation inventory (POI), Raven progressive matrices, Psychiatric evaluation profile (PEP), and Benton visual retention test. The social history questionnaire used by the social workers for assessment of the patients’ adjustment consisted of 0-10-point scales measuring residential, occupational and interpersonal adjustment, abstinence, and global adjustment.”

Authors: Stanislav Grof, R. A. Soskin, William A. Richards, Albert A. Kurland

Summary

Several independent clinical studies indicated that LSD could be used to treat alcoholism. These studies showed that LSD is not effective when used exclusively as a psychopharmacological agent within the framework of chemotherapy.

In a controlled clinical study of 135 alcoholic patients, both the high-dose treatment group and the low-dose control group showed significant improvement from pre- to posttreatment on a variety of psychological test variables.

The therapeutic potential of LSD was appreciated, but its drawbacks and limitations were recognized. A search was made for a psychoactive drug with similar effects, but with a shorter period of action and possibly more abrupt return to normal consciousness.

Szara began studying alkylated tryptamine derivatives and the metabolism of tryptophane in 1955, after learning about the chemical analysis of cohoba, a snuff powder prepared from Piptadenia peregrina seeds, which the Haitian natives use in religious ceremonies to produce mystical states of mind and to communicate with their gods.

According to the literature, DMT and DET had unpleasant autonomic and visceral side effects, but DPT seemed to be a much more promising candidate for therapeutic utilization. A study was conducted to explore the therapeutic potential of DPT in alcoholic patients.

A group of 51 alcoholic patients were selected from the patient population in the Alcoholic Rehabilitation Unit (ARU) of the Spring Grove State Hospital on the basis of their appropriateness for psychedelic-peak therapy. They underwent a battery of pretreatment psychological tests and a social history.

There were 51 patients, 13 were married, 10 single, 11 separated, 15 divorced and 2 widowed, the average age was 38.6 years, 42 were Caucasian, 8 were Negro and 1 was half Indian and half Negro.

The treatment procedure used in the DPT study was essentially the same as the therapeutic approach used in previous studies. It consists of three mutually interrelated phases: (1) a series of drug-free interviews; (2) the DPT session; and (3) several subsequent drug-free interviews for the integration of the session.

The patient received DPT intramuscularly in the form of an aqueous solution containing 15 mg of substance per cm3. The session was carried out in a special treatment suite, furnished like a comfortable living room with sofa, easy chairs, rugs, drapes, pictures, flowers and high fidelity stereophonic music equipment.

After the DPT sessions, several additional drug-free interviews were required to work through, integrate and consolidate the events of the session(s). The patients were discharged from the hospital after completion of the course of psychedelic therapy with DPT.

Before final acceptance into the experimental treatment program, patients took a battery of psychological tests. This data served as a baseline against which posttreatment changes could be compared.

Each patient was seen by a social worker who discussed with him his past history and evaluated it with the use of a systematic social history questionnaire. This questionnaire provided quantitative ratings on the patient’s prehospital status during the 2 years pre­ ceding hospitalization.

Two samples of blood were drawn from patients before and after the DPT session. The results were analyzed at NIH.

Social workers carried out follow-up evaluations of patients after discharge from the hospital, using the same instrument as the initial evaluation.

Data analysis was performed on pre- and postpsychological test data and on social worker ratings.

We experimented with various dosages and modes of administration of DPT to become acquainted with the basic clinical effects of the drug. The threshold dose for the induction of psychological changes appeared to be in the range between 10 and 15 mg.

All 51 patients received high doses of DPT after a special psychological preparation. The effects of DPT were very similar to those of LSD, except for the necessity of parenteral administration of DPT and its rapid onset of action.

The pre- to posttreatment differences in psychological test variables indicated significant improvement in most of the measured parameters. The most dramatic changes were observed in the scales of self-regard, time competence, inner-directed, 0-1 (support) ratio, self-actualizing value, and spontaneity. The mean increment of the IQ was 4.39 points, and the difference in the PEP test was 0.01 points. The Benton visual retention test did not show significant differences.

From 51 patients, 47 could be located for follow-up assessment. All dimensions of social history questionnaire showed significant improvement.

A total of 22 patients out of 47 were classified as ‘essentially rehabilitated’ (score of 8 or more on the 0 – 10 scale of global adjustment and/or drinking behavior), and 18 patients were totally abstinent at the 6-month follow-up.

The results of this exploratory clinical study indicate that DPT can be used as an adjunct to brief intensive psychotherapy in alcoholic patients.

One of the DPT patients had a brief psychotic episode that required readmission, but subsided rather quickly after conventional treatment with a tranquillizer. The data from the chromosomal study are currently being processed.

The results of the DPT study are comparable to those of the LSD study, and the 6-month follow-up results are comparable to those of the high-dose LSD group.

The study did not have a control group, and a controlled study is now in progress to compare the results with LSD-assisted psychotherapy.