Larsen Jens Knud
a Department Q , University Hospital of Aarhus , Risskov , Denmark.
Nord J Psychiatry. 2017 Oct;71(7):489-495. doi: 10.1080/08039488.2017.1336251. Epub 2017 Jul 5.
New research has suggested the clinical use of lysergic acid diethylamide (LSD) and psilocybin in selected patient populations. However, concerns about the clinical use of LSD were advanced in a large Danish follow-up study that assessed 151 LSD-treated psychiatric patients approximately 25 years after their treatment in the 1960s.
The purpose of the present study was to give a retrospective account of the short-term outcome of LSD treatment in these 151 Danish psychiatric patients.
The LSD case material in the Danish State Archives consists of medical case records of 151 LSD-treated patients, who complained and received economic compensation with the LSD Damages Law. The author carefully read and reviewed the LSD case material.
LSD was used to treat a wide spectrum of mental disorders. Independent of diagnoses, 52 patients improved, and 48 patients worsened acutely with the LSD treatment. In a subgroup of 82 neurotic patients, the LSD dose-index (number of treatments multiplied by the maximal LSD dose) indicated the risk of acute worsening. In another subgroup of 19 patients with obsessive-compulsive neurosis, five patients later underwent psychosurgery. A small subgroup of 12 patients was treated with psilocybin. The long-term outcome was poor in most of the patients.
Despite the significant limitations to a retrospective design, this database warrants caution in mental health patients. The use of LSD and psilocybin in mental health patients may be associated with serious short- and long-term side effects. Until further trials with rigorous designs have cleared these drugs of their potential harms, their clinical utility in these groups of patients has not been fully clarified.
新研究表明,麦角酸二乙酰胺(LSD)和裸盖菇素在特定患者群体中具有临床应用价值。然而,在一项大型丹麦随访研究中,人们对LSD的临床应用提出了担忧。该研究评估了20世纪60年代接受LSD治疗的151名精神病患者,随访时间约为25年。
本研究旨在回顾这151名丹麦精神病患者接受LSD治疗的短期结果。
丹麦国家档案馆的LSD病例资料包括151名接受LSD治疗患者的医疗病例记录,这些患者曾依据LSD损害赔偿法提出申诉并获得经济赔偿。作者仔细阅读并审查了这些LSD病例资料。
LSD被用于治疗多种精神障碍。无论诊断如何,52名患者病情改善,48名患者在接受LSD治疗后急性恶化。在82名神经症患者亚组中,LSD剂量指数(治疗次数乘以最大LSD剂量)表明了急性恶化的风险。在另一个由19名强迫症患者组成的亚组中,有5名患者后来接受了精神外科手术。一小部分12名患者接受了裸盖菇素治疗。大多数患者的长期预后较差。
尽管回顾性设计存在显著局限性,但该数据库警示心理健康患者需谨慎使用。在心理健康患者中使用LSD和裸盖菇素可能会带来严重的短期和长期副作用。在经过严格设计的进一步试验消除这些药物的潜在危害之前,它们在这些患者群体中的临床效用尚未完全明确。