Clinical applications of hallucinogens: A review.

Abstract

Hallucinogens fall into several different classes, as broadly defined by pharmacological mechanism of action, and chemical structure. These include psychedelics, entactogens, dissociatives, and other atypical hallucinogens. Although these classes do not share a common primary mechanism of action, they do exhibit important similarities in their ability to occasion temporary but profound alterations of consciousness, involving acute changes in somatic, perceptual, cognitive, and affective processes. Such effects likely contribute to their recreational use. However, a growing body of evidence indicates that these drugs may have therapeutic applications beyond their potential for abuse. This review will present data on several classes of hallucinogens with a particular focus on psychedelics, entactogens, and dissociatives, for which clinical utility has been most extensively documented. Information on each class is presented in turn, tracing relevant historical insights, highlighting similarities and differences between the classes from the molecular to the behavioral level, and presenting the most up-to-date information on clinically oriented research with these substances, with important ramifications for their potential therapeutic value.

Hallucinogen Persisting Perception Disorder: Etiology, Clinical Features, and Therapeutic Perspectives

“…Benzodiazepines may be useful and effective in eliminating benign HPPD I and ameliorating, but not completely eradicating, pervasive HPPD II symptoms [ 18 , 67 ]. The effectiveness of Benzodiazepines may be related to their activity on the cortical serotonergic-inhibitory inter-neurons with GABAergic outputs [ 2 , 4 ]. Alprazolam (0.25–0.75 mg/day) has been prescribed with some success and Clonazepam (0.5–1.5 mg/day) appears to be the most reliable and effective benzodiazepine even at low doses [ 17 , 18 , 51 , 67 ].…”

“…Hallucinogens represent an enormous group of natural and synthetic agents [ 1 , 2 ]. The core features of hallucinogens include their being empathogenic and being able to induce alterations of consciousness, cognition, emotions, and perception.…”

Lessons to be learned from early psychedelic therapy in Denmark

“…Thus, in these trials, vigilant attention has been given to doses as well as to set and setting in line with recommendations for good practice in clinical research with psychedelics (8,9). Notably, no significant adverse events, hereunder occurrence of flashbacks, flashbacks have been reported, and the results have overall been positive across these conditions that have been investigated (10,11). Of further significance for the potential impact of this evolving field, treatment effects of single sessions with psychedelic assisted therapy on depressive symptoms, anxiety, and/or drinking/smoking behavior have been shown to be long-lasting (months-years), and thus way beyond the pure pharmacological effect of the compounds.…”

Dimethyltryptamine: Endogenous Role and Therapeutic Potential

“…While research on pure DMT has focused on the basic physiological effects and psychotomimesis of DMT which is essential for understanding its endogenous role, the rapid growth of ayahuasca as a cultural phenomenon and religious sacrament has ignited curiosity about its exogenous effects. Indeed, as the research on dissociative drugs such as psilocybin has been of increasing importance in the affective spectrum pathology 7 the therapeutic potential of ayahuasca has been rising and bringing promising results 8 .…”