Psychopharmacology DOI 10.1007/s00213-015-4014-y ORIGINAL INVESTIGATION LSD enhances the emotional response to music M. Kaelen1 & F. S. Barrett2 & L. Roseman1,3 & R. Lorenz 3 & N. Family4 & M. Bolstridge 1 & H. V. Curran5 & A. Feilding6 & D. J. Nutt1 & R. L. Carhart-Harris1 Received: 4 February 2015 /Accepted: 29 June 2015 # Springer-Verlag Berlin Heidelberg 2015 Abstract Subjective ratings were completed after each music track and Rationale There is renewed interest in the therapeutic poten- included a visual analogue scale (VAS) and the nine-item Ge- tial of psychedelic drugs such as lysergic acid diethylamide neva Emotional Music Scale (GEMS-9). (LSD). LSD was used extensively in the 1950s and 1960s as Results Results demonstrated that the emotional response to an adjunct in psychotherapy, reportedly enhancing emotional- music is enhanced by LSD, especially the emotions ity. Music is an effective tool to evoke and study emotion and Bwonder^, Btranscendence^, Bpower^ and Btenderness^. is considered an important element in psychedelic-assisted Conclusions These findings reinforce the long-held assump- psychotherapy; however, the hypothesis that psychedelics en- tion that psychedelics enhance music-evoked emotion, and hance the emotional response to music has yet to be investi- provide tentative and indirect support for the notion that this gated in a modern placebo-controlled study. effect can be harnessed in the context of psychedelic-assisted Objectives The present study sought to test the hypothesis that psychotherapy. Further research is required to test this link music-evoked emotions are enhanced under LSD. directly. Methods Ten healthy volunteers listenedtofivedifferent tracks of instrumental music during each of two study days, Keywords LSD . Serotonin 2A receptor . Psychotherapy . a placebo day followed by an LSD day, separated by 5–7days. Psychedelic . Music . Emotion Electronic supplementary material The online version of this article (doi:10.1007/s00213-015-4014-y) contains supplementary material, Introduction which is available to authorized users. Lysergic acid diethylamide (LSD) is a Bclassic^ psychedelic1 * M. Kaelen drug that elicits profound changes in consciousness with a [email protected] remarkable potency (Schmid et al. 2015; Passie et al. 2008; Nichols 2004). Although much emphasis has been placed on 1 Centre for Neuropsychopharmacology, Division of Brain Sciences, their hallucinogenic properties, psychedelic drugs have a Faculty of Medicine, Imperial College London, London, UK range of other interesting psychological effects. For ex- 2 Behavioral Pharmacology Research Unit, Johns Hopkins School of ample, they have marked effects on emotion, which is Medicine, Baltimore, MD, USA 1 The word psychedelic is derived from combining the Greek words 3 The Computational, Cognitive and Clinical Neuroimaging psychḗ meaning Bmind^ or Bsoul^ and dêlos,meaningBto manifest^ or Laboratory, The Centre for Neuroscience, Division of Brain Bmake visible^. In addition to LSD, other drugs considered classic psy- Sciences, Imperial College London, London, UK chedelics include psilocybin (the major psychoactive constituent of magic 4 Psycholinguistics and Language Department, Faculty of Social mushrooms), mescaline (a psychoactive constituent of peyote and San Sciences, University of Kaiserslautern, Kaiserslautern, Germany Pedro cacti) and DMT (a major psychoactive ingredient in the Amazo- nian brew ayahuasca). All these drugs share the property of being ago- 5 Clinical Psychopharmacology Unit, University College London, nists at the serotonin 2A receptor. The use of the term Bpsychedelics^ in London, UK this paper refers specifically to classic psychedelics such as those listed 6 The Beckley Foundation, Beckley Park, Oxford, UK above. Psychopharmacology one of the reasons why they were used in psychothera- Methods py in the 1950s and 1960s. The dominant therapeutic model at the time maintained that by dismantling Bego Approvals defences^, psychedelics facilitate emotional release (i.e. Bcatharsis^) and insight (Busch and Johnson 1950; This study was approved by the National Research Ethics Leuner 1983;Cohen1970). Broadly speaking, this ap- Service (NRES) London—West London and was conducted proach is still adopted today in clinical studies with in accordance with the revised declaration of Helsinki (2000), psychedelics (Bogenschutz et al. 2015;Johnsonetal. the International Committee on Harmonisation Good Clinical 2014;Gasseretal.2014a, b;Grobetal.2011). Practice guidelines and NHS Research Governance Frame- Music is a classic means of evoking emotion, and like LSD, work. Imperial College London sponsored the research which it has also been used as an adjunct to psychotherapy (Koelsch was conducted under a Home Office licence for research with 2014;Moore2013). Music has accompanied ceremonial use schedule 1 drugs. of psychedelics for many centuries (Nettl 1956), was a staple component in psychedelic-assisted psychotherapy in the Recruitment and screening of participants 1950s and 1960s (Bonny and Pahnke 1972;Grof1980)and remains so today (Bogenschutz et al. 2015; Johnson et al. Participants were recruited via word of mouth and gave writ- 2014;Gasseretal.2014a, b;Grobetal.2011). It has been ten informed consent before participating. They were briefed proposed that listening to music during a psychedelic experi- on the general experimental procedures, but no information ence is useful for (1) encouraging the relinquishment of regarding hypotheses of the experiments was shared. Prior to control, (2) facilitating emotional arousal and release, study enrolment, all participants were screened in a clinical (3) promoting the occurrence of Bpeak^ or spiritual- research centre at the Hammersmith hospital campus of Im- type experiences, (4) directing and/or structuring the ex- perial College London (the Wellcome Trust Clinical Research perience and (5) stimulating the imagination (Bonny and Facility, WTCRF). Demographic information was recorded Pahnke 1972;Grof1980). Profound spiritual- or and medical history taken. A physical examination was per- mystical-type experiences were reported by a majority formed, including electrocardiogram (ECG), routine blood of participants in a study with another psychedelic drug, tests and blood pressure measurement. A psychiatric assess- psilocybin, while they listened to emotionally evocative ment was conducted and participants gave full disclosure of music (Griffiths et al. 2006, 2011). This raises an im- their drug taking histories. Participants completed the Beck portant question: what is the role of music in producing Depression Inventory (BDI) (Beck et al. 1961)andthe60- such profound psychological experiences? item Neuroticism-Extraversion-Openness Five-Factor Inven- The significance of music in psychedelic-assisted psycho- tory (NEO-FFI) personality scale (McCrae and Costa 1987) therapy has previously been discussed (Eagle 1972; Gaston and were properly briefed on the study and the potential drug and Eagle 1970; Bonny and Pahnke 1972; Turek et al. 1974) effects. but has never been investigated in a modern placebo- Key exclusion criteria were as follows: <21 years of age, controlled study. The present study sought to address this personal history of diagnosed psychiatric illness, immediate knowledge gap by testing the hypothesis that the emotional family history of a psychotic disorder, an absence of previous response to music is enhanced under LSD. Participants lis- experience with a classic psychedelic (e.g. LSD, mescaline, tened to five different instrumental music tracks on each of psilocybin/magic mushrooms or DMT/ayahuasca), having ex- two study days: a placebo day followed by an LSD day, sep- perienced a persistent adverse reaction after psychedelic drug arated by 5–7 days. The question BHow emotionally affected use, pregnancy, problematic alcohol use (i.e. >40 units con- were you by the music?^ was asked immediately after sumed per week) or a medically significant condition render- each track and served as the study’s primary outcome. ing the volunteer unsuitable for the study. To probe more specific aspects of participants’ emotion- al experiences during music listening, the Geneva Emo- Drug dosing tional Music Scale (GEMS-9) was also used (Zentner et al. 2008).TheGEMS-9hasbeendevelopedtomea- One thousand micrograms of LSD freebase (certified 99.4 % sure a range of emotions that can be experienced during purity) was reconstituted with 10 ml saline and sterile filtered, music listening, and this was completed after each mu- yielding a 100 μg:1 ml sterile solution. Since a primary moti- sic track. It was predicted that it would be specifically vation of the study was to determine a safe and appropriate emotions related to Btranscendence^ that would be en- dose of LSD for a subsequent neuroimaging study, the dosage hanced, i.e. feeling Bfascinated and overwhelmed^ and of LSD varied among participants, i.e. one received 40 μg, Bfeelings of transcendence and spirituality^,asdefined two 50 μg, six 70 μg and one 80 μg. For each administration, by the GEMS-9. the appropriate amount of LSD solution (e.g. 0.7 ml=70 μg) Psychopharmacology was transferred to a 10-ml syringe and made up to 10 ml with testing. Participants reported first noticing subjective drug ef- saline. The 10-ml solution was then infused intravenously fects between 5 to 15 min post-dosing, and these approached over a 3-min period, followed by a 60-s infusion (Bflush^) peak intensity between 45 to 90 min post-dosing.