Erowid References Database
Amer J Psychiat. 1972;128:1154-1155.
Dr. Muller Replies
SIR: Let me respond directly to the points raised by Dr. Liskow.
1. I totally agree that the nature and dosage of illegally
used drugs are difficult, if not impossible,
to determine. I believe, however, that the average
user can distinguish between LSD and marijuana,
2. It is clear from the literature that LSD can
cause prolonged psychoses(3). Too many educated
people are still skeptical about this despite
clear evidence. A similar lack of objectivity has
been seen in regard to the dangers of cigarette
smoking. The extent to which other illegal drugs or
the chemicals added to them can cause prolonged
psychoses remains to be more fully explored,
Talbott and Teague (4) described 12 patients with
toxic psychoses associated with marijuana usage.
Treated supportively, the longest case lasted only
11 days, but the exact nature of the offending agent
was assumed, as with my patients, on the basis of
3) It is well known that functional psychoses
responded to electroconvuisivc therapy (ECT) before LSD was available to the public. My paper
refers to organic or toxic psychoses, however, and
my last reference was to work done in this area (5).
Dr. Kiskow is correct in pointing out how little is
actuaily known about this subject. The absolute
test of the effectiveness of ECT in LSD psychoses
would have to be done on experimental subjects.
But in lieu of the dangers involved, such a study is
not likely. Since I wrote my paper, I might add, I
have treated with ECT four more patients with refractory
cases of presumed LSD psychosis. These
psychoses had persisted for one to three months
despite the administration of various medications
before the administration of and dramatic response to ECT. I have not yet had
a treatment failure with ECT in patients with this type of psychosis.
The references are:
1) Cohen S: Lysergic acid diethylamide side effects and complications. J Nerv Ment
Dis 130: 30-40, 1960.
2) Mallesop N: Acute adverse reactions to LSD in clinical and experimental use in the United Kingdom.
Brig J Psychiat 118: 229-230. 1971.
3) Smart T, Bateman K: Unfavourable reactions to LSD: a review and analysis of the available case reports.
Canad Med Ass J 97:1214-1221. 1967
4) Talbott J, Teague J: Marijuana psychosis. JAMA 210.299-302.1969
5) Roberts A: The value of ECT in delerium. Brit J Psychiat 109: 653-655, 1963.
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