Lessons to be learned from early psychedelic therapy in Denmark

Erritzoe, David; Richards, William A.

doi:10.1080/08039488.2017.1336252

Cited by 10 publications

(13 citation statements)

References 15 publications

(14 reference statements)

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“…This led to a series of 151 patients gaining compensation in the 1980s and 1990s for a variety of psychiatric symptomatology that was presumed (but not proven) to have resulted from LSD treatment that was claimed sometimes to have been given under coercion, or without informed consent (Larsen, 2016). A critique of the report of these cases has recently been published (Erritzoe and Richards, 2017).…”

Section: Clinical Trials Prior To Prohibition: Discussionmentioning

confidence: 99%

Psychiatry & the psychedelic drugs. Past, present & future

2018

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a b s t r a c tThe classical psychedelic drugs, including psilocybin, lysergic acid diethylamide and mescaline, were used extensively in psychiatry before they were placed in Schedule I of the UN Convention on Drugs in 1967. Experimentation and clinical trials undertaken prior to legal sanction suggest that they are not helpful for those with established psychotic disorders and should be avoided in those liable to develop them. However, those with so-called 'psychoneurotic' disorders sometimes benefited considerably from their tendency to 'loosen' otherwise fixed, maladaptive patterns of cognition and behaviour, particularly when given in a supportive, therapeutic setting. Pre-prohibition studies in this area were sub-optimal, although a recent systematic review in unipolar mood disorder and a meta-analysis in alcoholism have both suggested efficacy. The incidence of serious adverse events appears to be low. Since 2006, there have been several pilot trials and randomised controlled trials using psychedelics (mostly psilocybin) in various non-psychotic psychiatric disorders. These have provided encouraging results that provide initial evidence of safety and efficacy, however the regulatory and legal hurdles to licensing psychedelics as medicines are formidable. This paper summarises clinical trials using psychedelics pre and post prohibition, discusses the methodological challenges of performing good quality trials in this area and considers a strategic approach to the legal and regulatory barriers to licensing psychedelics as a treatment in mainstream psychiatry.

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Section: Clinical Trials Prior To Prohibition: Discussionmentioning

confidence: 99%

Psychiatry & the psychedelic drugs. Past, present & future

2018

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“…It is therefore worth considering why it was the psychedelic preferring users exclusively – and not also MPUs – who had high Openness scores in our study. The context in which these drugs are taken, or administered, is understood to be of great importance (Erritzoe and Richards, 2017; Hartogsohn, 2016; Johnson et al, 2008), and a therapeutic setting with its focus on exploration of what is happening ‘inside’ in a safe and closely supported environment is likely to be a stronger facilitator of transformative experiences than, for example, when the same drugs are taken in a party context. Where recreational use of MDMA is known to be closely associated with a club/dance/party setting (Schifano et al, 2006; Smit et al, 2009), psychedelics are often taken recreationally under circumstances more closely associated with therapeutic applications, for example to promote introspection (Hallock et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

Recreational use of psychedelics is associated with elevated personality trait openness: Exploration of associations with brain serotonin markers

et al. 2019

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Background: Recent studies have suggested therapeutic benefits of psychedelics for a variety of mental health conditions. The understanding of how single psychedelic administrations can induce long-lasting effects are, in large, still lacking. However, recent studies in both healthy and clinical populations suggest a role for personality changes. Aim: To test support for some of these plausible mechanisms we evaluated (cross-sectional) associations between recreational use of psychedelics and 3,4-methylene-dioxymethamphetamine (MDMA) and (a) personality measures and (b) key markers of cerebral serotonergic signalling (serotonin transporter and serotonin-2A-receptor binding). Methods: In 10 psychedelic-preferring recreational users, 14 MDMA-preferring users and 21 non-using controls, personality was assessed using the ‘big five‘ instrument Revised NEO Personality Inventory (NEO-PI-R). Frontal serotonin transporter and serotonin-2A-receptor binding potentials were quantified using [11C]DASB and [18F]altanserin positron emission tomography, respectively. Results: Of the five NEO-PI-R traits, only openness to experience scores differed between the three groups; psychedelic-preferring recreational users showing higher openness to experience scores when compared with both MDMA-preferring users and controls. Openness to experience scores were positively associated with lifetime number of psychedelic exposures, and among all MDMA-preferring user/psychedelic-preferring recreational user individuals, frontal serotonin transporter binding – but not frontal serotonin-2A-receptor binding – was positively associated with openness to experience. Conclusion: Our findings from this cross-sectional study support increasing evidence of a positive association between psychedelic experiences and openness to experience, and (a) expands this to the context of ‘recreational’ psychedelics use, and (b) links serotonergic neurotransmission to openness to experience. A modulation of personality induced by psychedelic experiences may have important therapeutic implications via its impact on peoples’ value systems, cognitive flexibility, and individual and social behaviour.

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“…Typically, researchers did not pay the same stringent attention to patient screening/inclusion, control groups/conditions, blinding procedures, standardized and continuous clinical assessments, and assessment of side effects-limiting the potential for firm conclusions on the clinical efficacy and safety of this form of therapy. 24 However, popular and countercultural movements increasingly embraced psychedelics during this period, and in combination with some examples of controversial psychedelic science being carried out, 25,26 this eventually led to legislations that put an end to this period of early psychedelic research. In addition, it has also been suggested that the introduction of novel conventions about how to conduct state of the art randomized clinical trials, exemplified by the "1962 Drug Efficacy Amendment" to the Federal Food, Drug, and Cosmetic Act in the USA, might have played a role in the field's downfall.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies

Andersen

Carhart-Harris

Nutt

et al. 2020

Acta Psychiatr Scand

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187

198

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Objective To conduct a systematic review of modern‐era (post‐millennium) clinical studies assessing the therapeutic effects of serotonergic psychedelics drugs for mental health conditions. Although the main focus was on efficacy and safety, study characteristics, duration of antidepressants effects across studies, and the role of the subjective drug experiences were also reviewed and presented. Method A systematic literature search (1 Jan 2000 to 1 May 2020) was conducted in PubMed and PsychINFO for studies of patients undergoing treatment with a serotonergic psychedelic. Results Data from 16 papers, representing 10 independent psychedelic‐assisted therapy trials (psilocybin = 7, ayahuasca = 2, LSD = 1), were extracted, presented in figures and tables, and narratively synthesized and discussed. Across these studies, a total of 188 patients suffering either cancer‐ or illness‐related anxiety and depression disorders (C/I‐RADD), major depressive disorder (MDD), obsessive‐compulsive disorder (OCD) or substance use disorder (SUD) were included. The reviewed studies established feasibility and evidence of safety, alongside promising early data of efficacy in the treatment of depression, anxiety, OCD, and tobacco and alcohol use disorders. For a majority of patients, the therapeutic effects appeared to be long‐lasting (weeks‐months) after only 1 to 3 treatment session(s). All studies were conducted in line with guidelines for the safe conduct of psychedelic therapy, and no severe adverse events were reported. Conclusion The resurrection of clinical psychedelic research provides early evidence for treatment efficacy and safety for a range of psychiatric conditions, and constitutes an exciting new treatment avenue in a health area with major unmet needs.

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Lessons to be learned from early psychedelic therapy in Denmark

Cited by 10 publications

References 15 publications

Psychiatry & the psychedelic drugs. Past, present & future

Psychiatry & the psychedelic drugs. Past, present & future

Recreational use of psychedelics is associated with elevated personality trait openness: Exploration of associations with brain serotonin markers

Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies

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