LSD-assisted Psychotherapy

To evaluate previous findings regarding the effectiveness of lysergic acid diethylamide (LSD)-assisted psychotherapy

Participants were recruited through general information in media, flyers, cancer support groups, and hospitals. Patients were randomized to the LSD group receiving an oral dose of 200 mcg LSD or to an active placebo of 20 mcg LSD. Participants were required to taper off antidepressants and antianxiety medications and avoid alcohol and recreational drugs for 24 hours before sessions. Urine drug tests were done prior to each psychotherapy session. Two experimental sessions with LSD were completed. After each experimental session, three dug-free therapy sessions took place. A follow-up evaluation was completed two months after the second experimental session. At that time, participants in the placebo group could cross over to an identical open label treatment with LSD. The final evaluation was conducted 12 months after the last LSD-assisted session. About two-thirds of the LSD-assisted session was focused inward and one-third was brief conversation. The session ended after eight hours when acute effects subsided and was followed by a review of the day’s experience.

• N = 12  
• MALES: Not reported, FEMALES: Not reported
• KEY DISEASE CHARACTERISTICS: Not reported
• OTHER KEY SAMPLE CHARACTERISTICS: All reported a > 40 score on the State-Trait Anxiety Inventory (STAI), and half were diagnosed with generalized anxiety disorder by a structured clinical interview.  

• SITE: Single site    
• SETTING TYPE: Outpatient    
• LOCATION: Switzerland

• PHASE OF CARE: End-of-life care

Placebo-controlled, randomized, controlled trial

• Structured clinical interview 
• Speilberger State-Trait Anxiety Inventory (STAI)
• European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ)
• Hospital Anxiety and Depression Scale (HADS)
• Patient daily diary 
• Visual Analog Scale (VAS) for pain
• State of Consciousness Questionnaire (SCQ)

The visit-by-group interaction testing for differences between groups showed a significant difference between groups (p = .033) and 65.5% power. Three of eight experimental group subjects dropped lower than the threshold of 40 on the anxiety inventory while all active placebo subjects experienced increases in anxiety. The two- and 12-month follow-up results of those who received LSD in either blinded or crossover conditions showed that benefits were sustained over time. Neither the experimental nor the placebo dose of LSD produced any severe drug-related adverse events. Adverse events reported were those commonly associated with LSD, and most resolved when the drug effects diminished. There were no events of prolonged anxiety or lasting psychotic or perceptional disorders.

This study demonstrated the safety of LSD-assisted psychotherapy sessions in a small group of patients with life-threatening diseases. There were positive trends of anxiety reduction after two LSD-assisted therapy sessions.

• Small sample (< 30)
• Risk of bias (no blinding)
• Intervention expensive, impractical, or training needs

Findings from this small pilot study suggest that LSD-assisted psychotherapy may be beneficial to patients facing the end of life to reduce anxiety. Additional research studies to confirm its safety and efficacy are needed.