Pharmaceutical Hypocrisy: Prozac vs LSD

The Question

“Why is Prozac legal, sometimes recommended by doctors, sometimes forced on patients who refuse to give consent, and LSD illegal?”

Why ask the Question?

1. Prozac seems to have more severe and more probable side-effects than LSD
2. LSD seems to have clinical applications in treating a variety of mental illnesses

1. Fluoxetine! (AKA: Prozac, Sarafem, Fontex)

The effects with the greatest difference from placebo are nausea (22% vs 9% for placebo), insomnia (19% vs 10% for placebo), somnolence (12% vs 5% for placebo), anorexia (10% vs 3% for placebo), anxiety (12% vs 6% for placebo), nervousness (13% vs 8% for placebo), asthenia (11% vs 6% for placebo) and tremor (9% vs 2% for placebo).

Similarly to other SSRIs, sexual side effects are common with fluoxetine; they include anorgasmia and reduced libido. Akathisia, that is inner tension, restlessness, and the inability to stay still, often accompanied by “constant pacing, purposeless movements of the feet and legs, and marked anxiety”, is a common side effect of fluoxetine.

Fluoxetine taken during pregnancy also increases rate of poor neonatal adaptation. It has also been known to cause rashes and skin conditions.

Crucially, suicidal tendencies may be encouraged by the use of flueoxetine ( FDA experts that found a 2-fold increase of the suicidal ideation and behavior in children and adolescents, and 1.5-fold increase of suicidality in the 18–24 age group.) It is becoming increasingly the view of experts that SSRIs in general may lead to dependancy (i.e. addiction…like heroin and crack…)

The efficacy of Fluoxetine in treating depression is highly contentious. Many studies have shown it to be barely more effective than placebo. Breggin (1994) author of ‘Talking back to Prozac’ writes:

“The FDA found only four [studies undertaken by the manufacturer] were adequate enough to consider. One of these showed that Prozac was no better than placebo. Three others supposedly showed Prozac to be somewhat superior to the sugar pill, but not as good as older antidepressants. However, due to adverse drug effects and lack of drug effectiveness, the dropout rates in most of these studies was very high.”

Indeed, according to Breggin’s analysis: when the manufacturer did trials on 5000 individuals, only 286 patients finished the four- to six-week trials used to determine Prozac’s efficacy. This was because many of them could not bare the adverse effects.

“Because of the high dropout rates and because Prozac was often no better than placebo in many trials, many statistical maneuvers were required to make the studies look positive. In one of the key studies, involving six different sites around the country, results at five sites showed Prozac to have no benefit. One site–representing 25 percent of the patients who finished the trials–was discarded. Then the data from the remaining sites were pooled.”

This is all very interesting because:

• The anti-LSD hysteria of popular press repeatedly played on the notion that it can lead people to suicide. Prozac is known to do the same, perhaps more so, and is dished out by the NHS like there’s no tomorrow.
• The adverse reactions are both more likely and more severe when compared with LSD.
• Fluoxetine is one of the better anti-depressants on the market: there are many that have worse side-effects, that are legal and prescribed by doctors. How do these other psychiatric “medicines” compare to LSD? Isn’t there an obvious double standard?
• Prozac can cause dependancy. LSD (and other psychedelics) do not cause dependancy.

 2. Lysergic Acid Diethylamide

Let’s start with the basics: ‘FRANK’ (an “unbiased” UK drugs education website) describes the risks of LSD:

• LSD or ‘acid’ has very random, and sometimes very frightening, effects. Trips feed off a person’s imagination.
• If panic sets in, the experience can be scary and confusing. Bad trips can be terrifying.
• Flashbacks sometimes happen. This is when part of the trip is subsequently re-lived after the original experience. (This usually occurs within weeks or months after taking the LSD but can be longer).
• There’s no evidence to suggest LSD does any long-term damage to the body or long-term psychological damage. 
• Avoid taking acid if you’re in a bad mood. People have been known to harm themselves during a bad trip. [a bit like prozac then, or mortgage debts, or school exams]
• LSD could have serious, longer term implications for somebody who had a history of mental problems and may also be responsible for triggering a mental health problem that had previously gone undetected.

I repeat: “There’s no evidence to suggest LSD does any long-term damage to the body or long-term psychological damage.” Let’s not forget that various independent British scientific bodies have consistently ranked LSD as amongst the least harmful of the controlled substances. FRANK’s list of adverse side-effects of LSD seems far less intimidating (and likely) than those associated with prozac: given a choice of the two, knowing what you’ve just read, which would you prefer?

If the government justifies drug-criminalisation based on a drug’s ability to cause harm, the situation seems quite hard to understand: It seems that Prozac may be consistently more harmful than LSD.

LSD’s outlaw status may be attributed to its ‘potential for abuse’, other drugs such as MDMA and Ketamine have also had their illegality justified with this term. The reason that they have ‘potential for abuse’ though, is surely that they cause enjoyable experiences that people wish to repeat. But it seems obvious that one of the measures of a good anti-depressant would be that it would cause good-feeling: the very condition of depression is defined by the presence of persistent negative emotional states, what better sign of effective treatment than the presence of positive ones?

Over-simplistic perhaps? Afterall, what is of real importance is how long the changes in emotional state last. But psychedelics, especially LSD, are known to cause lasting positive changes in both personality and emotional state: psychedelics often cause peak-experiences or transformative mystical experiences. The benefits of LSD use are maximised through a process of ‘LSD psychotherapy’ where a trained psychotherapist serves as a guide to the patient: this practice is currently outlawed, though there are some psychotherapists who still operate clandestine psychedelic-therapy services. For more on LSD assisted psychotherapy see Grov’s ‘History of LSD Therapy’ and ‘The Use of LSD in Psychotherapy and Alcoholism‘ by Abramson.

Then there is the cold scientific data. Due to its criminal status, research into LSD, its potential harms/risk and potential benefits, is hard to come by. One of the negative side-effects of drug prohibition is that it slows the scientific understanding of psychoactive chemicals that may have clinical applications.

Thankfully, new life has been breathed into psychedelic research in the last couple of decades, times are changing, the truth can only be suppressed for so long. Cognitive Liberty UK would like to express gratitude to the following psychedelic research organisations for their hard work:

•  MAPS: Multidisciplinary Association for Psychedelic Studies
• The Beckley Foundation
• The University of Kent in Canterbury Psychedelics Society

Research indicates that:

1. Long term negative effects of LSD are rare (Source)
2. Most users conclude that the experience is positive. (Source)
3. “Psychedelic-assisted psychotherapy can help dying be of more than medical significance. This relatively short and effective therapy can help alleviate the emotional and physical distress of dying.” (Source)
4. LSD can help people deal with the emotional aspects of terminal illnesses: (Pahnke, W., Kurland, A., Unger, S., Savage, C., Wolf, S., Goodman, L. (1970). Psychedelic therapy (utilizing LSD) with cancer patients. Journal of Psychedelic Drugs, 3, 63-75.)
5. LSD is associated with long-lasting positive personality changes. (Source)
6. LSD can be used to treat alcoholism and other addictions. (Source)

Then we have the compelling self reports, rational intelligent adults who report that LSD is good for them: ‘There is no hiding with LSD’ by Sue Blackmore is a recent example of such a confession. In truth, most the people who think it is harmful seem to be the people who haven’t done it.

Of course, more research needs to be done. Sadly, this task is made more difficult by the current legislation. Organisations such as The Berkley Foundation and MAPS (see Links menu to your right) currently lead the battle against legislation in order to allow objective, unbiased, scientific research in LSD. It is interesting to consider how legislators would react if studies were allowed to directly compare the efficacy of LSD and Prozac.

Ironically, one of the earliest discovered clinical applications for LSD is the treatment of severe alcoholism. A class-A controlled substance may be one of the most effective treatments of the greatest substance abuse problem our country faces: the addiction to the legal drug alcohol.

There is an obvious double-standard at play here: British MPs need to explain why LSD is banned and Fluoxetine is not.  LSD carries a lower risk and has far fewer side-effects when compared to fluoxetine. It is shown to be a highly effective antidepressant. In many years people will look back and think what a great shame it was that this chemical’s vast potential was suppressed. It will be one of history’s many great mysteries: like witch-hunts, inquisitions, and hysterias.

• antidepressants
• big pharma
• clinical psychology
• depression
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• grov
• hypocrisy
• lsd
• medication
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• mental illness
• neuroscience
• NHS
• pharmaceutical
• prozac
• psychedelic science
• psychedelics
• psychology
• psychotherapy
• science
• SSRIs
• therapy