1952_savage_1482_1.pdf

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c
VI
LSD
No_.20
8_VAGE_
Co
(Divoof
Psychiatry
and Neurology,_ Naval MedoResearch
Insto_ Bethesda_
o
Mdo)
._ser_ic
m#
acid diethylamide _D__
a clinical- s cholo ical s ud
Amer_J,Psychiato I08_ 896 (1952)
_ _ a) Study of the effects of LSD on the affect_ cognition and expression of
normal
control subjects and of depressed patients,
- b) Treatment of depressive
reactions
with ISD.
_OD
Each
- DOSAGE - MATERIALs - Studies made on 5 normal controls and 15 depressed patients,
normal control received a single dose of 20
p@
LSD orally before breakfast°
Psy-
Chological
and physiological
observations
carried out over 8_15 hours.
Each depressed
_tient
was started on an oral dose of 20
]_g
ISD_ which was increased daily to a point
_here a definite psycho_physiological
effect could be observed_
(This varied from
20 to 1CO
}_g)o
Psychological
and physiological
studies
and after ISD treatment,
which usually lasted one month°
carried
out before_
during
RESULTS
_ - A. Normal control _"
Only 2 of the 5 subjects reported vivid
cinations and euphoria (sample protocol given)_
The other subjects manifested
"
tension and anxiety°
hallu-
extreme
(yi
Bo Characteristic effects of LSD (in order of appearance):
Effects were
-_oticed _-l_l-hours after administration°
i
They usually lasted 4 hours but sometimes
as long as 12 hours°
i) AN__S_ Rise in B_P_ and pulse rate_ occasionally followed by a rapid drop in
B_Po and pulse rate_
Mydriasis and cycloplegiao
Subjective
symptoms
- numbness_
faintness,
headache_ neckache and tension°
Pa_aesthesia
in waves_ nausea_ indifferent
appetite_
sense of urgency°
ii) Motor__
Fine tremor,_ increased, by voluntary movement_ inco-ordinationo
_ Diffic'ulty in walking_ and standing in ROMBERG_s position°
Fine movements more diffi-
cult.. Handwriting
larger_ more cumbersome and more childlike°
Tendon reflexes
increased°
iii) Moo_.:
Sense
of aggrandizeme_t,
feeling
of omnipotence_
but
euphoria
not always
present_
Instead of euphoria there was heightened ,_xiety and hypochondriacal
concern
over symptoms°
Affect may be dissociated
from experience_ so that the emotional react-
ion was inappropriate
to the situation or content of thought_
iv) Conation_ _
"
:mcreased feeling of energy°
Ambitious designs,
impairment of
vision and co-ordination,
the rapid flight of ideas_ the fail_rre of reality testing
made executive
action difficult_
v) _C_i_n_=
FT_._-s-_
of ideas_ difficulty
in concentration
and co-ordination_
No slgr_f_ocan_ difference
in WE,_HSLER.-BELi_JE
test.
Memory and _ompreh.ension not impair-
edo [os_{ of reality %estin_<o Distortion _ather than deterioration
of mental function.
_) Se2ns_9orium=_
Alterations
in the sensorj:_mnmay foIZow or coincide with the
eupho,=c state_
Heightened
sensitivity_
Ew_ggeration of defects in surroundings°
Noises becsme _bearably
loud.
Minor physic_al discomforts
became the centre of atten-
tion_
This stage was followed by a distortion of reality°
Illusions frequent and
often disturbing°
Distortions pre_en_, in all sensory mod.a!i%ieso
_ _
Most striking were
the hallucinations
that succeeded the illusions_ most prominent in the visual field_
Auditory haill_¢inations frequent and. may
occur
simultaneously
_'.th the visions°
Hallu-
cinations of to_ch_ taste and smell often present blt less vivid°
Transition of
images into hallucinations°
Hallucinations
may be induced by s_ggestion_
C_ Therapeutic _esal._s with depressed patients_
All patients treated
with
LSD were blocked and inaccessible before treatment.
Two suffering from involutional
psychoses made complete re¢overies o Four mlffering from schizophrenic
reactions with
depression showed no change or became worse°
Five schizoid patients _±th severe
depress_:¢e reaction improved so that they became free of depression;
basically they
remained
schizoid_
In _ other cases treatment was interrupted.
Of these, 2 developed pro-
found
circulatory depression_ which required termination
of treatment,
The other
2 were 6[iabeticstransferred
to the medical department,
Curiously, their insulin
requirement
was lowered temporar%ly
after taking LSD.
In 2 patients LSD fostered a better doctor-patient relationship, enabling _
them to express and recognize feelings. Only one patient was able to discuss his d_-
ficulties more freely during a pronounced euphoric reaction.
About half the patien_
developed lessening of depression, improvement of mood followed by clinical recover_
but unless this improvement was followed up by psychotherapy, the patients had dif_L
culty
inmaintaining
improvement°
Projective testing during LSD "intoxication" was less revealing than that
done during the normal waking state° All patients and all but 2 controls showed ma_
constrictionn the Form-lnterpretation
i
Test.
....
In a control series of involutional psychoses, 2 patients recovered without
specific therapy° Four schizophrenic patients with depression were unimproved.
Of 5
schizoid patients with depression_ 3 showed improvement on hospitalization alone, a_d
2 were unimproved°
Thus ISD "does not appear to have a significant therapeutic advantage in
depressed states, although it appears of value as an adjuvant in a certain _mber of
cases".
SUMMARY : - The effects of LSD on affect, cognition and expression were studied in 5 nor-
mal control subjects and 15 depressed patients. In the latter group 3 patients re-
covered, and four improved after one month's treatment with LSD (20-100
/_g
daily orally).
Four patients showed no improvement°
Treatment discontinued in 4 cases. The improve-
ment obtained during ISD therapy was not greater than that obtained without LSD in
comparable cases.
COMMENT" _ CONDRAU (LSD Noo3) reported that no definite conclusions could be drawn as
to the diagnostic and therapeutic value of ISD. However, BUSCH et al. (LSD Noo4)
and WEYL (LSD No.L¢) thought that LSD might be of aid in psychotherapy.
The observa-
tion that LSD reduced the insulin requirement is of interest and may be related to the
effects of LSD on metabolism (see MAYER-GROSS, ISD Noso i0 and 15)o
INDICATIONS : ®
VI LSD (§102a)
M
M
M
M
320
328@1
398
409
Psyche
Depression
Psychotherapy
Tests of mental functions
(ISD_ eine klinisch=psycholo_ische
Untersuchung_)
Die Wirkungen des ISD auf Affektes Wahrnehmungen und Gef_hlsausdruck wurden an 5
Normalpersonen und 15 deprimierten Patienten untersuchto
Von den Kranken waren
nach einmonatiger ISD_Behandlung (20-100 j_g per os pro die) drei wieder hergestellt_
_ gebessert_ 4 ungebesserto
Bei 4 _rde die Behandlung aus verschiedenen Gr_nden
abgebrocheno
(LSD_
_tude de ses effets cliniques et psycholo_iques.)
Les effets du LSD sur les ph4nom_nes affectifs, les perceptions et les manifestations
de la sensibilit_ ont 4t4 _tudi4s chez 5 sujets normaux et 15 sujets d_prim_so Dans
ce dernier groupe, apr_s un mois de traitement (20 _ lO0 j_g, per os, par jour) 3
malades furent gu_ris, 4 am_lior_s et 4 non influenc4so
Pour diff4rentes raisons,
il a fallu interrompre le traitement dans 4 caso
NKT/Dr oSpi/DroDa/Si
1052

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