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The fact that a synthesized chemical - LSD - produces spectacular effects on consciousness at doses of a few hundred microgrammes has to rank as one of the most amazing serendipitous discoveries ever made by a chemist. It certainly changed Albert Hoffman’s lunch hour when in 1943, he accidentally absorbed some LSD he had just made in the Sandoz (now Novartis) laboratories where he worked in Switzerland. Before we had an understanding of the chemical nature of synaptic transmission or the receptors that make up post-synaptic targets, we could almost have imputed their existence. More concretely, the effects of LSD convinced the first psychopharmacologists to seek a neurochemical explanation for mental illness and drugs that would treat it.
Indeed, psychedelic drugs were used as an adjunct to psychotherapy in the 1940s and 50s in a fairly limited way. The weakness of the research culture in psychiatry at the time makes it difficult to reconstruct how and for whom their use was beneficial or otherwise.
The use of LSD became illegal because the rise of its widespread use in the counter culture of 1960’s America seemed to threaten the fabric of a society already bitterly divided by the Vietnam War. And as an illegal drug, research on its properties in man effectively stopped too. It has been a long time, but efforts to evaluate how it, or related compounds, might be used effectively are starting or re-starting if one wants to put it that way. It is about time.
We must ensure adherence to a responsible, ethically appropriate regulatory framework and then do good experiments on interesting questions. The best argument for maintaining or re-establishing research with any drug is a combination of curiosity and need. I think we should still be very curious about LSD, and serendipity has often been psychiatry’s most potent route to drug discoveries that matter.
In one of the more interesting sessions at ACNP last year, it was described how psilocybin is being used in depressed patients with terminal cancer. The effect of a psychedelic experience in a supporting environment appeared to transform how some patients viewed what remained of their lives. There are other circumstances in psychiatry where just such a radical reframing of the meaning of a person’s life needs to take place. For example, when refractory depression appears beyond either pharmacological or therapeutic help. It is a disturbing fact that in some societies doctors are more prepared to consider euthanasia for such patients than experimental treatment with a psychedelic. So its not just curiosity, the need is there too.
Guy Goodwin
ECNP President |
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