• Ampoules which have not been opened, which have been protected against light and stored in a cool place are stable for an unlimited period. Ampoules which have been opened or diluted solutions retain their effectiveness for 1 to 2 days, if stored in a refrigerator.
INDICATIONS AND DOSAGE
a) Analytical psychotherapy, to elicit release of repressed material and provide mental relaxation, particularly in anxiety states and obsessional neuroses.
The initial dose is 25 µg (1/4 of an ampoule or 1 tablet). This dose is increased at each treatment by 25 µg until the optimum dose (usually between 50 and 200 µg) is found.
The individual treatments are best given at intervals of one week.
b) Experimental studies on the nature of psychoses: By taking Delysid himself, the psychiatrist is able to gain an insight into the world of ideas and sensations of mental patients. Delysid can also be used to induce model psychoses of short duration in normal subjects, thus facilitating studies on the pathogenesis of mental disease.
In normal subjects, doses of 25 to 75 µg re generally sufficient to produce a hallucinatory psychosis (on an average 1 µg/kg body weight). In certain forms of psychosis and in chronic alcoholism, higher doses are necessary (2 to 4 µg/kg body weight).
PRECAUTIONS
Pathological mental conditions may be intensified by Delysid. Particular caution is necessary in subjects with a suicidal tendency and in those cases where a psychotic development appears imminent. The psycho-affective liability and the tendency to commit impulsive acts may occasionally last for some days.
Delysid should only be administered under strict medical supervision. The supervision should not be discontinued until the effects of the drug have completely orn off.
ANTIDOTE
The mental effects of Delysid can be rapidly reversed by the i.m. administration of 50
mg chlorpromazine.
Literature available on request.
SANDOZ LTD., BASLE, SWITZERLAND
The use of LSD in analytical psychotherapy is based mainly on the following psychic effects.
In LSD inebriation the accustomed world view undergoes a deep-seated transformation and disintegration. Connected with this is a loosening or even suspension of the I-you barrier. Patients who are bogged down in an egocentric problem cycle can thereby be helped to release themselves from their fixation and isolation. The result can be an improved rapport with the doctor and a greater susceptibility to psychotherapeutic influence. The enhanced suggestibility under the influence of LSD works toward the same goal.
Another significant, psychotherapeutically valuable characteristic of LSD inebriation is the tendency of long forgotten or suppressed contents of experience to appear again in consciousness. Traumatic events, which are sought in psychoanalysis, may then become accessible to psychotherapeutic treatment. Numerous case histories tell of experiences from even the earliest childhood that were vividly recalled during psychoanalysis under the influence of LSD. This does not involve an ordinary recollection, but rather a true reliving; not a réminiscence, but rather a réviviscence, as the French psychiatrist Jean Delay has formulated it.
LSD does not act as a true medicament; rather it plays the role of a drug aid in the context of psychoanalytic and psychotherapeutic treatment and serves to channel the treatment more effectively and to shorten its duration. It can fulfill this function in two particular ways.
In one procedure, which was developed in European clinics and given the name psychotytic therapy, moderately strong doses of LSD are administered in several successive sessions at regular intervals. Subsequently the LSD experiences are worked out in group discussions, and in expression therapy by drawing and painting. The term psycholytic therapy was coined by Ronald A. Sandison, an English therapist of Jungian orientation and a pioneerof clinical LSD research. The root -lysis or -lytic signifies the dissolution of tension or conflicts in the human psyche.
In a second procedure, which is the favored treatment in the United States, a single, very high LSD dose (0.3 to 0.6 mg) is administered after correspondingly intensive psychological preparation of the patients. This method, described as psychedelic therapy, attempts to induce a mystical-religious experience through the shock effects of LSD. This experience can then serve as a starting point for a restructuring and curing of the patient's personality in the accompanying psychotherapeutic treatment. The term psychedelic, which can be translated as "mind-manifesting" or "mind-expanding," was introduced by Humphry Osmond, a pioneer of LSD research in the United States.
LSD's apparent benefits as a drug auxiliary in psychoanalysis and psychotherapy are derived from properties diametrically opposed to the effects of tranquilizer-type psychopharmaceuticals. Whereas tranquilizers tend to cover up the patient's problems and conflicts, reducing their apparent gravity and importance: LSD, on the contrary, makes them more exposed and more intensely experienced. This clearer recognition of problems and conflicts makes them, in turn, more susceptible to psychotherapeutic treatment.
The suitability and success of LSD in psychoanalysis and psychotherapy are still a subject of controversy in professional circles. The same could be said, however, of other procedures employed in psychiatry such as electroshock, insulin therapy, or psychosurgery, procedures that entail, moreover, a far greater risk than the use of LSD, which under suitable conditions can be considered practically safe.
Because forgotten or repressed experiences, under the influence of LSD, may become conscious with considerable speed, the treatment can be correspondingly shortened. To some psychiatrists, however, this reduction of the therapy's duration is a disadvantage.
They are of the opinion that this precipitation leaves the patient insufficient time for psychotherapeutic working-through. The therapeutic effect they believe, persists for a shorter time than when there is a gradual treatment, including a slow process of becoming conscious of the traumatic experiences.
Psycholytic and especially psychedelic therapy require thorough preparation of the patient for the LSD experience, to avoid his or her being frightened by the unusual and the unfamiliar. Only then is a positive interpretation of the experience possible. The selection of patients is also important, since not all types of psychic disturbance respond equally well to these methods of treatment. Successful use of LSD-assisted psychoanalysis and psychotherapy presupposes specific knowledge and experience.
In this respect self-examination by psychiatrists, as W. A. Stoll has pointed out, can be most useful. They provide the doctors with direct insight, based on firsthand experience into the strange world of LSD inebriation, and make it possible for them truly to understand these phenomena in their patients, to interpret them properly, and to take full advantage of them.
The following pioneers in use of LSD as a drug aid in psychoanalysis and psychotherapy deserve to be named in the front rank: A. K. Busch and W. C. Johnson, S.
Cohen and B. Eisner, H. A. Abramson, H. Osmond, and A. Hoffer in the United States; R. A. Sandison in England; W. Frederking and H. Leuner in Germany; and G. Roubicek and S. Grof in Czechoslovakia.
The second indication for LSD cited in the Sandoz prospectus on Delysid concerns its use in experimental investigations on the nature of psychoses. This arises from the fact that extraordinary psychic states experimentally produced by LSD in healthy research subjects are similar to many manifestations of certain mental disturbances. In the early days of LSD research, it was often claimed that LSD inebriation has something to do with a type of "model psychosis." This idea was dismissed, however, because extended comparative investigations showed that there were essential differences between the manifestations of psychosis and the LSD experience. With the LSD model, nevertheless, it is possible to study deviations from the normal psychic and mental condition, and to observe the biochemical and electrophysiological alterations associated with them.