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Lysergic Acid Diethylamide (LSD)

Lysergic acid diethylamide (LSD) is a classical hallucinogen originally synthesized by Albert Hoffman. He accidentally concocted the drug while making experimental substances from ergots to create circulatory and respiratory stimulants. The most pronounced effect on the animals allowed him to create a model for psychosis and study the induced temporary psychotic-like states. During the psychotic state, he also noted permitted recall and produced improved insight.

In 1986, almost 400 patients were treated with LSD. The Danish LSD Damages Law was passed because of the crimes and deaths linked to LSD usage where applicants received financial compensation for harm resulting from the treatments. Many years afterwards, patients still suffered from the side effects of being treated with LSD.

Regulations on hallucinogenic drugs started to be introduced in 1967 to limit the use of LSD and other hallucinogenic drugs to qualified practitioners. The hope was to eliminate or decrease the risky behaviors and resulting in harmful consequences that were brought on by the drug. Despite these efforts, LSD-assisted treatments continued in some European countries in the 1970s. In Switzerland, psychotherapy and research were also conducted from 1988 to 1993 with special permission from their government.  

No approved indications for LSD-assisted therapy exist today. It has been used in the past for non-FDA approved indications: depressive disorders including those with conversion phobia, neurosis, manic-depression and reactive depression, cyclothymic (obsessional) and passive-aggressive (obsessional) compulsive sexual deviation addiction, psychoneurotic disorders, mixed, pan-neuroticism (including schizophrenia), borderline or latent and personality disorders (especially transient situational).

Researchers continue to study the utility of LSD-assisted therapy. The following non-FDA approved indications show the most evidence for serotonin-based psychoactive agents: substance use disorders, especially in the treatment of chronic alcohol addiction, post traumatic stress disorder, anxiety, and depression in patients suffering from life-threatening illnesses. Combining LSD with counseling, researchers were able to create a psychedelic "trip" for the terminally ill, thereby decreasing the anxiety refractory to conventional anxiolytic therapy, depression, and pain associated with the life-threatening diseases such as cancer. Sleep reportedly improved with terminally ill patients, and they were less preoccupied with death.

Research has also begun to look at LSD as a possible treatment for Alzheimer dementia and as a last resort for migraines or cluster headaches. This is in part because patients have self-medicated using LSD off-label as an ablative therapy to treatment-resistant migraines and cluster headaches. Patients obtained the illicit psychoactive substances as a last resort. When patients use LSD as a treatment or a recreational drug, there are few if any reports of psychoactive effects. The effects were reported to be tolerated or avoided using minimal doses.  

LSD-assisted therapy has been found to enhance suggestibility without hypnotic induction. It has shown the most improvement in suggestibility in neurotic and schizophrenic patients but the least in depression. Neural plasticity in the cortex and cognitive flexibility are possibly required for demonstrable improvement in suggestibility.

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