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Introduction
Lysergic acid diethylamide (LSD) is a potent serotonergic hallucinogen or 'psychedelic' that alters consciousness in a marked and unusual way. The drug was first intentionally consumed by the Swiss chemist Albert Hofmann in 1943 in a self-experiment in which he ingested 250 µg (a high dose) in his laboratory before travelling home. In a detailed report of his experience, written a few days later, Hofmann describes an initially unpleasant experience, characterized by altered perception, fear and paranoia: his next-door neighbour transformed into a 'malevolent, insidious witch with a coloured mask', he sensed a 'disintegration of the outer world', a 'dissolution of [his] ego' and was 'seized by a dreadful fear of going insane' (Hofmann, 1980).
From this account, it would be reasonable to suspect that Dr Hofmann was negatively affected by this experience but his description of his mental state the next day suggests otherwise: 'I then slept, to awake the next morning with a clear head... A sensation of wellbeing and renewed life flowed through me. Breakfast tasted delicious and gave me extraordinary pleasure. When I later walked out into the garden, in which the sun shone now after a spring rain, everything glistened and sparkled in a fresh light. The world was as if newly created.'(Hofmann, 1980)
When LSD was first distributed by Sandoz pharmaceuticals in 1948, product guidelines stipulated two main applications: (1) analytical psychotherapy and (2) experimental studies on psychoses. The rationale for the former was that LSD could 'elicit [the] release of repressed material and provide mental relaxation for anxiety and obsessional neuroses', and, for the latter, that it could model aspects of psychosis and facilitate an understanding of its nature and pathogenesis (Hofmann, 1980). These two properties formed the basis of a large number of research projects with LSD in the 1950s and 1960s. However, the apparent paradox by which the same compound can be both a model of, and yet a treatment for, psychopathology has never been properly addressed.
In the early years of research with LSD, its remarkable potency (LSD is psychoactive in doses of 25 µg or lower; Hintzen & Passie, 2010) led psychiatrists to speculate about the existence of an...