1955_cholden_4047_1.pdf

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I_D Noo162 (§102a)
. B0L (§91c)
_n_LAE (§102d)
_mescaline
(§102b)
_
M 360 schizophrenia
Z 355 tolerance
M 500 LSD iomo
Co
(Nat oInst oOf MentoHealth,
_LDEN,
L.So, KURLAND, Ao, SAVAGE,
_ethesda, Mdo> Spring Grove State Hospital, Catcnsville_ Mdo)
Clinical reactions and _olerance to LSD in chronic schizophrenia.°
_
JoNervoMentoDisoi22,211(1955)o
__
The reaction of chronic schizophrenics to LSD given iomo
Observations on tolerance (to LSD) and cross-tolerance (to LSD_BOL
and LAE)o
MATE_IAL_ Four chronic schizophrenics (detailed study)° LSD used in
20 cases altogether° Reference made to 6 patsoto be reported on e!se_
where o
DO_AGE:
100_g
iomo daily for 2 weeks°
In tolerance
studies dosage
increased by lOOj,_g daily_ up to 500_go
merit ioned o
Dosage of B0L and LAE not
METHOD_
The 4 patients satisfied the following criteria_ lo hospit-
alized for 15 years_
2o relatively stable in symptomatology for
past 5 years9
3o undeT age of 409 40 chronic regressed schizophren_
50 comple_edgrammar
school education_
6o some time spent in ward
without benefit° Obse_ation
period (no treatment) lasted 3 weeks_
followed by placebo period lasting 3 weeks°
Subsequently, lO0_g
I_D given iomo daily in 2 patso_ while the others continued with
placebos° La_er_ these were also given LSDo Behaviou_ ratings were
assessed by nurses and medical s_s_o_
_.
RESULfS_
lo Cl_nica_
reactions_
In all 4 pats
the first administz_.
tion of LSD caused a marked change in behaviour° The change was sligh_
ter on the 2nd day and no_ noticeable on subsequent days° Although
LSD was continued for 2 weeks_ no further effect was noted° It was
presumed t_hat tolerance was evident on the 2nd day and complete on
the third°
2o Tolerance_
After experimentally varying the time inter_
vals between doses of ISD, it was found that a reaction similar to
that on the 1st day could be obtained if there were a 5-day interval
between injections_ Some patients showed a slight reaction after a
4_day intervalo
One pat° showed a somewhat slighter reaction on the
5th day and a stronger reaction on the 6th day° Dosage was increased
in an attempt to overcome tolerance and it was found that 100/_g on
_he l_ day caused a large response_ 200_g
on the 2nd day ca"sed a
u
_!igh erresponse 9 300(g on the 3rd day caused no response_ 400_g
}n the 4th day cause_ no response and 5001_g on 5th day caused a
/'
questionable
response°
3o Cross=tolerance was noted with LSD_ LAE and BOL, ioe.
a patient not responding to LSD because of tolerance did not respond
to LAE or BOLo In one case LiE caused marked gastric upset (vomitlng_
_usea
and gastric pain) but none of the psychological manifestation, s
observed with LIE when the patient was in a non=tolerant state c Patio
who were tolerant to LSD did not exhibit tolerance to mescaline iomo%
when LSD was given on the 1st and 2nd days and mescaline was g_v@Z_
-_"
on the 3rd_ the latter drug producing its usual responseo
The order
and type of behavioural response to ISD and mescaline seemed very
similar° It is thought that the tolerance has a physiological rather
than a psychological
basis°
4o Other clinical reactions_
Other groups of patsowere
studied in a similar manner and a few of the typical clinical reac-
tions are cited° Each
subject
showed
some unusual
behavioural
manifest°
ationo In the 20 patsogiven LSD_ the following general categories of
reaction to LSD were noted_
a) covert_ marked_ albeit subtle effeet_
b) intensification_
usual symptoms and behaviour patterns were
intensified_ this was more common in acute schizophrenics_
c) revorsal_
striking reversal of accustomed beh_viour_ sometimes followed by
intensification°
_
5o Therapeutic value of LSD_
In a study to be reported late_
6 pats o were transferred to a better equipped hospital and closely
studied for 2 months before being given LSDo In the very permissive
and understanding envzronment with an unusually high nurse_patient
ratio° considerable change was noted in be_viOUro
iO0_g LSD caused
considerably less behavioural changes in these 6 cases than tho_e
noted in the patsoreported aboTe_ e_go no outbursts of laughter and
fewer marked behavioura_ changes° Th_
there are indications t]_t
the
reaction
_o LSD may be determined in part by the milieuo
COMMENT_
F_rst report _n English
on LSD given iomo Tolerance to LSD
was first reported by ISBELL et aio (LSD 82) and confirmed by ABRAMSON
et alo (LSD 147)o With regard to the therapeutic use of LSD, i_ should
be noted that SANDISON et al_ (LSD 48) advise treatment at ap; ,xo
weekly
inter_als o
wlO (E 8616)
NKT/bh 656
_Dg3

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