Lysergic acid diethylamide: a drug of ‘use’?

Lysergic acid diethylamide (LSD), a classical hallucinogen accidentally discovered in the mid-20th century, has been used both as a substance of abuse and as a potential therapeutic adjunct. This review describes its receptor pharmacology, mechanism of action, effects on the body, and adverse effects, including its addictive potential and tolerance development. Therapeutic uses explored include anxiety relief, creativity enhancement, suggestibility, performance enhancement, and treatment of drug and alcohol dependence, as well as psychedelic peak therapy for terminally ill patients. Based on available evidence, LSD could be tried therapeutically under controlled settings, but its use requires expertise, caution, and ethical considerations due to safety concerns.

Study at a glance

Abstract

Lysergic acid diethylamide (LSD), described as a classical hallucinogen, began its journey from the middle of the last century following an accidental discovery. Since then, it was used as a popular and notorious substance of abuse in various parts of the world. Its beneficial role as an adjunct to psychotherapy was much unknown, until some 'benevolent' experiments were carried out over time to explore some of its potential uses. But, many of its effects were unclear and seemed to be a psychedelic enigma. In this review article, we have described the receptor pharmacology, mechanism of action, effects and adverse effects of LSD on the normal body system. We have also highlighted its addictive potentials and the chances of developing tolerance. We have assimilated some of the interesting therapeutic uses of this drug, such as an antianxiety agent, a creativity enhancer, a suggestibility enhancer, and a performance enhancer. We have also described LSD to be successfully used in drug and alcohol dependence, and as a part of psychedelic peak therapy in terminally ill patients. The relevant chronological history and literature in the light of present knowledge and scenarios have been discussed. Based on available evidence, LSD could be tried therapeutically in certain specific conditions under controlled settings. But as we mention, due to all the safety concerns, the use of this nonaddictive 'entheogen' in actual practice warrants a lot of expertise, caution, cooperation and ethical considerations.