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疗效与启示:LSD心理疗法与1962年《药品修正案》

Efficacy and enlightenment: LSD psychotherapy and the Drug Amendments of 1962.

作者信息

Oram Matthew

机构信息

Department of History, School of Philosophical and Historical Inquiry, The University of Sydney, NSW 2006, Australia.

出版信息

J Hist Med Allied Sci. 2014 Apr;69(2):221-50. doi: 10.1093/jhmas/jrs050. Epub 2012 Aug 16.

Abstract

The decline in therapeutic research with lysergic acid diethylamide (LSD) in the United States over the course of the 1960s has commonly been attributed to the growing controversy surrounding its recreational use. However, research difficulties played an equal role in LSD psychotherapy's demise, as they frustrated researchers' efforts to clearly establish the efficacy of treatment. Once the Kefauver Harris Drug Amendments of 1962 introduced the requirement that proof of efficacy be established through controlled clinical trials before a drug could be approved to market, the value of clinical research became increasingly dependent on the scientific rigor of the trial's design. LSD psychotherapy's complex method of utilizing drug effects to catalyze a psychological treatment clashed with the controlled trial methodology on both theoretical and practical levels, making proof of efficacy difficult to obtain. Through a close examination of clinical trials performed after 1962, this article explores how the new emphasis on controlled clinical trials frustrated the progress of LSD psychotherapy research by focusing researchers' attention on trial design to the detriment of their therapeutic method. This analysis provides a new perspective on the death of LSD psychotherapy and explores the implications of the Drug Amendments of 1962.

摘要

20世纪60年代,美国对麦角酸二乙酰胺(LSD)的治疗性研究逐渐减少,这通常被归因于围绕其娱乐性使用的争议日益增加。然而,研究困难在LSD心理治疗的衰落中起到了同样重要的作用,因为这些困难挫败了研究人员明确确立治疗效果的努力。1962年的《凯弗维尔-哈里斯药品修正案》提出,在药物获批上市之前,必须通过对照临床试验来证明其疗效,此后,临床研究的价值越来越依赖于试验设计的科学严谨性。LSD心理治疗利用药物效果来催化心理治疗的复杂方法,在理论和实践层面都与对照试验方法相冲突,使得疗效证明难以获得。通过仔细研究1962年以后进行的临床试验,本文探讨了对对照临床试验的新强调是如何通过将研究人员的注意力集中在试验设计上而损害其治疗方法,从而阻碍了LSD心理治疗研究的进展。这一分析为LSD心理治疗的消亡提供了新的视角,并探讨了1962年药品修正案的影响。

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