Lysergide Treatment of Schizophrenic and Nonschizophrenic Alcoholics; A Controlled Evaluation

This historic study (1970; n=75) used LSD (500μg) in the treatment of alcoholics and found that those without schizophrenia (about 2/3 of patients) responded better.

Abstract

“Of 75 alcoholics treated with lysergide, 23 were diagnosed as schizophrenics. The nonschizophrenics had better reactions to the drug and more of them were abstinent at a 1-year follow-up than the schizophrenics and than alcoholics treated by other methods.”

Authors: Milan Tomsovic & Robert V. Edwards

Summary

Lysergide was used to treat alcoholism in 75 patients. 23 of these patients were diagnosed as schizophrenics, but the nonschizophrenics had better reactions to the drug and were more abstinent at a 1-year follow-up than the schizophrenics and than alcoholics treated by other methods.

Researchers conducted a study on 29 patients with alcoholism and concluded that lysergide had beneficial effects. The study was carried out almost exclusively in the Canadian Provinces and resulted in a series of reports all of which concluded that lysergide was either beneficial or at least very promising.

Jensen and Ramsay reported statistically significant gains for the lysergide-treated group in 1962 and 1963, respectively. However, a reasonable doubt still existed as to whether the control group had a comparable treatment.

In 1966, Smart and his co-workers published a study on 30 patients who were divided into 3 groups: 10 received lysergide, 10 received ephedrine sulphate, and 10 received a comparable treatment without drugs. No differences were found between the treated and control groups.

A pilot study by Van Dusen et al. ( 12 ) and a later continuation with more cases ( 13 ) yielded negative results for lysergide treatment of chronic alcoholism.

A study of 63 lysergide-treated patients and 59 controls found that the lysergide-treated group improved more than the control group.

Researchers treated a large population of patients but did not utilize adequate controls, and the positive findings may only be a transient state that eventually fades when the alcoholic patient returns to society.

In 1965, we began evaluating lysergide. In 1968, we had follow-up information on a large number of patients who had gone through our regular 90-day rehabilitation program, providing a good comparison group.

Dosage and Physical Setting

Our method is a “single overwhelming experience” that involves a patient receiving 500 p.g. of lysergide in a specially furnished room. The room was free from the usual ward noises and had a pleasant view of the wooded hospital grounds.

Selection of Subjects and Controls

75 volunteers were selected from the population of patients in the 90-day Alcoholic Rehabilitation Program to take lysergide. They were asked to begin writing an autobiography and to include their reasons for taking the drug, personal problems, and what they expected to receive from the experience.

A second group of controls was formed from patients who had passed through the regular program but did not volunteer for the lysergide project. They will be referred to as control group I.

Composition of Lysergide and Control Groups

There were 23 schizophrenic alcoholics who received lysergide therapy, 30 in control group I, and 60 in control group II. They were diagnosed as schizophrenic based on past medical history, MMPI profile, and clinical appearance.

Table 1 shows that the nonschizophrenic patients were reasonably equated by diagnostic subtype, and Table 2 shows that the composition of the nonschizophrenic groups did not change during the study.

Conducting the Lysergide Experience

During the first 7 hours of the experience, a nursing assistant or nurse made written notes and interacted with the patient in the same manner.

The patient was not encouraged to talk extensively about his experience, but was allowed to talk with other patients and personnel the next day.

The Blewett and Chwelos Scales for the Assessment of Psychedelic Reactions were used to assess individual differences in the lysergide experience.

After the session, the patient completed a self-inventory that inquired about various perceptual, emotional, conceptual and transcendental aspects of his experience. A person who scored very high was regarded as having a very marked, desirable personality change.

A subjective classification of the experience was made based on observations of the patient during the session, his narrative account the next day, his written account, and observation of any changes in the patient during the remainder of his stay in the Program.

The patient received an interview before being discharged from the Program, during which the contents of a follow-up questionnaire were reviewed with him. The patient’s self-rating on a Drinking Adjustment Scale was obtained in six categories of drinking control.

We tried to contact the validation source by telephone in all cases where drinking was described as “total abstinence” or “much improved” and also in some cases in Category C (questionable improvement). We were able to validate 50% of the lysergide group, 37% of control group I and 54% of control group II.

Assessing Lysergide Recrudescence

We did not originally plan to study recrudescence, but after a few patients reported brief recurrences of the lysergide state, we began to make a formal inquiry by requesting this additional information.

Classification of the LSD Experience

Table 3 shows that the nonschizophrenic group achieved a higher median score on both scales, indicating a slightly more therapeutic lysergide experience.

Lysergide-treated patients had a slightly higher percentage of “good” experiences and a slightly lower percentage of “poor” experiences than lysergide-untreated patients, although the differences were not strongly home out.

Effects of Lysergide upon Postdischarge Drinking Control

We started this investigation not intending to make a specific comparative evaluation of schizophrenic and nonschizophrenic alcoholics, but preliminary inspection of the data indicated a marked negative effect of lysergide upon schizophrenic alcoholics. The study had to be retitled even though we had a relatively low number of schizophrenics in our groups. Table 7 shows that patients with complete abstinence, much improved, slight or questionable improvement, or unchanged were statistically significantly improved.

A chi square test was performed to compare the drinking control of nonschizophrenic, lysergide treated, nonschizophrenic, control group I, nonschizophrenic, control group II, schizophrenic, Jysergide treated, and schizophrenic, control group I and II.

Lysergide or the regular Alcoholic Rehabilitation Program fades in the course of a year, and the greatest gain is shown by nonschizophrenic lysergide-treated patients. The nonschizophrenic lysergide-treated alcoholics were superior to all the other groups in varying degrees, but the nonschizophrenic control group I showed the poorest drinking control of all the groups at the end of a year. This suggests that we may have introduced a strong deprivation effect.

We lost contact with many patients during the I-year period and had to remove about one-third of the cases. We could not keep patients in the study who were readmitted to the hospital or who were incarcerated for a long time. We had to make a separate judgment each time, and the loss of data did not introduce a fatal defect into the study.

Predicting Benefit from the Lysergide Experience

The assessment of the lysergide experience for each individual was compared to his drinking control at the end of 3 months and again at the end of a year.

Incidence of Lysergide Recrudescence

The 61 patients who gave information on the presence or absence of recrudescence described beneficial changes in attitudes, feelings and interpersonal relationships.

19 patients reported recrudescence during the year, and 11 patients reported altered dreams. Drinking or withdrawal was a factor in triggering recrudescence, and alterations in dreaming may be a little-recognized but real postlysergide effect.

Lysergide was added to the regular alcoholic rehabilitation program to increase what was already being achieved. Four patients had only one experience, six reported two experiences, seven reported three experiences and two had four or more experiences.

We found that the lysergide-treated nonschizophrenic alcoholics abstained from alcohol during each rating period, but the differences were not statistically significant, and we could not conclude that lysergide was beneficial. The nonschizophrenic patient who volunteered for lysergide but did not receive it showed a statistically significant negative effect.

Our data tend to corroborate studies that did not screen out schizophrenic alcoholics and observed a negative effect on these patients both in the lysergide experience itself and later benefits.

The study was limited by the progressive loss of cases, and the indeterminacy that this introduced. This reduced the percentage of patients in the “total abstinence” and “much improved” categories by 4 to 17%, depending on the particular group.

The study of recrudescence was conducted because it gave us the opportunity to grossly quantify the incidence of these effects and to contribute something to the understanding of the minor and serious aftereffects of the lysergide treatment of alcoholics.