There is no doubt that psychedelic therapy often produces powerful immediate effects on a patients personality, spiritual development, psychosemantic description of states of consciousness, life values and even worldview. These effects have been demonstrated in numerous investigations (Grinspoon, Bakalar, 1979; Leuner, 1981), including our studies of ketamine psychedelic therapy of alcoholism and neuroses (Krupitsky et al, 1992; Krupitsky, 1992)
We have been carrying out ketamine psychedelic therapy since 1985. As a rule, we have noted dramatic psychological changes and dazzling clinical success after one psychedelic session. However, sometimes such improvements last only from several days to several weeks or months. That is, our data confirms the reality of the psychedelic afterglow (the psychological and clinical improvements produced by the psychedelic session). However, several important questions remain to be answered. What is the likely duration (length) of the psychedelic afterglow in each patient? What personality or clinical features of the patients determine the duration of such improvements? Do subsequent psychedelic sessions produce a set of effects more beneficial, comparable, or less beneficial than the effects from the first session? Are improvements produced by subsequent sessions more stable than the effects of the first session? Would treatment outcome be improved if the psychedelic session was repeated several weeks or months after the first session?
To answer all these questions, we hope to carry out a special study into the effects of repeated ketamine psychedelic therapy on alcohol dependence. The goal of this research into ketamine psychedelic therapy of alcoholism is to investigate the following aspects of the psychedelic afterglow phenomena:
1) Can the afterglow be changed (diminished or increased) after a few psychedelic sessions? The first hypothesis of this investigation is that repeated psychedelic sessions will change the afterglow by improving treatment outcome. We intend to compare the treatment outcome (i.e. clinical and psychological improvements) in two groups of alcoholic patients. The patients in the first group will receive just one ketamine session, whereas the patients in the second group will receive 5 ketamine sessions during one month (one session a week).
2) Can the afterglow be changed (diminished or increased) if the subsequent psychedelic sessions are administered over a longer period of time involving a year rather than a month? The second hypothesis of this investigation is that ketamine psychedelic sessions can be repeated periodically (within several months) with the useful effect of renewing the afterglow and improving the treatment outcome. This hypothesis can be evaluated through the use of a third group of alcoholics. These subjects would receive five ketamine psychedelic sessions during one year (one session each three months) in comparison with subjects of the second group, who would receive five sessions during one month (one session a week). If our hypothesis is correct, at the end of treatment and throughout the follow-up period of one year, these subjects will demonstrate, in comparison to subjects in the first and second group, a significantly smaller amount of alcohol abuse, less psychopathology, a greater and/or more sustained period of sobriety, and a greater set of positive changes in personality characteristics, value orientations, spiritual growth and personality attitudes.
3) Does the afterglow depend on personality characteristics? The third hypothesis of this study is that alcoholic patients with different personality features will have different psychedelic experiences during the ketamine session and will demonstrate a differential duration of clinical and psychological improvements (psychedelic afterglow) after the psychedelic therapy. If our hypothesis is correct, at the end of the therapy and throughout the follow-up period of one year, patients with different psychological and clinical characteristics would demonstrate differential alcohol abuse, psychopathology, and changes in personality characteristics, value orientations, and attitudes towards themselves and the world around them. Data from this experiment will hopefully allow researchers to specify the personal psychological and clinical indications for ketamine psychedelic therapy of alcoholics.
These proposals are just in the planning stage. Unfortunately, due to the financial crises in Russia, we need additional financial support to carry out this research. But at least at the level of our paradigm, we have already progressed from our previous approach of a one session miracle cure. We now believe that psychedelic therapy should be a prolonged process which should consist of at least several sessions, with special therapeutic goals and tasks for each session. We hope our new paradigm will open new opportunities in psychedelic therapy and allows us to better discern some underlying mechanisms of psychedelic therapy.
1) Grinspoon, L., and Bakalar, J. (1979) Psychedelic Drugs Reconsidered. New York, Basic Books, Inc.
2) Krupitsky, E.M., Grinenko, A.Ya., Berkaliev, T.N., Paley, A.I., Petrov, V.N., Mushkov, K.A., Borodkin, Yu.S. (1992) The combination of psychedelic and aversive approaches in alcoholism treatment: the affective contra-attribution method. Alcoholism Treatment Quarterly, 9, 99-105.
3) Krupitsky, E.M. (1992) Ketamine psychedelic therapy (KPT) of alcoholism and neuroses. Multidisciplinary Association for Psychedelic Studies Newsletter, 3, 24-28.
4) Leuner, H. (1981) Halluzinogene: Psychische Grenzzustande in Forschung und Psychotherapie, Bern, Verlag Hans Huber.