Psychedelics for treating psychiatric disorders: Are they safe?

Thakur, Madonna

doi:10.12788/cp.0309

Cited by 3 publications

(5 citation statements)

References 42 publications

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“…The most common adverse effects include anxiety, dysphoria, fear, confusion, increased blood pressure and heart rate, headache, nausea, fatigue, and dizziness which are typically dose-dependent and regarded as well-tolerated. Specific adverse effects of illusions (LSD), dissociation and sedation (ketamine), muscle tightening and jaw clenching (MDMA), and emesis (ayahuasca) are more compound specific, and similarly regarded as well-tolerated or essential to the therapeutic effect ( 67 , 68 ).…”

Section: Discussionmentioning

confidence: 99%

Systematic review and rationale of using psychedelics in the treatment of cannabis use disorder

Phan

Terry

2023

Front. Psychiatry

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IntroductionCannabis use disorder (CUD) is prevalent in ~2–5% of adults in the United States and is anticipated to increase as restrictions to cannabis decrease and tetrahydrocannabinol (THC) content in cannabis products increase. No FDA-approved medications for CUD are currently available, despite trials of dozens of re-purposed and novel drugs. Psychedelics have garnered interest as a therapeutic class in other substance use disorders, and self-report surveys suggest they may result in positive outcomes for CUD. Herein, we review the existing literature pertaining to psychedelic use in persons with or at risk for CUD and consider the potential rationale underpinning psychedelics as a treatment for CUD.MethodsA systematic search was performed in several databases. Inclusion criteria were primary research reporting use of psychedelics or related substances and CUD for treatment in human subjects. Exclusion criteria were results including psychedelics or related substances without changes in cannabis use or risks associated with CUD.ResultsThree hundred and five unique results were returned. One article was identified using the non-classical psychedelic ketamine in CUD; three articles were identified as topically relevant based on their secondary data or consideration of mechanism. Additional articles were reviewed for purposes of background, review of safety considerations, and formulating rationale.ConclusionLimited data and reporting are available on the use of psychedelics in persons with CUD, and more research is needed given the anticipated increase in CUD incidence and increasing interest in psychedelic use. While psychedelics, broadly, have a high therapeutic index with infrequent serious adverse effects, particular adverse effects at risk in the CUD population, such as psychosis and cardiovascular events, should be considered. Possible mechanisms by which psychedelics have therapeutic potential in CUD are explored.

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Section: Discussionmentioning

confidence: 99%

Systematic review and rationale of using psychedelics in the treatment of cannabis use disorder

Phan

Terry

2023

Front. Psychiatry

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“…Indeed, serotonin 5-HT2A agonists like psilocybin are relatively safe substances pharmacologically (Nichols, 2016). However, due to their mind-altering capabilities, risks incurred with psychedelics are predominantly psychological (Anderson, Danforth, & Grob, 2020;Nichols, 2016;Thakur, 2022). For instance, psychedelics appear to increase suggestibility and affective instability (Anderson et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

“…For example, Goodwin et al (2022) found psilocybin dosage to dose-dependently predict suicidality and self-harm. As such, how psychological safety can be ensured during psilocybin-assisted therapy has yet to be fully illuminated (Thakur, 2022).…”

Section: Introductionmentioning

confidence: 99%

“…Nonetheless, the psychological safety profile of psilocybin is promising when combined with psychotherapy in controlled environments (Nutt, Erritzoe, & Carhart-Harris, 2020;Rucker et al, 2018). However, although there is a low incidence of severe adverse effects (Andersen et al, 2021;Thakur, 2022), many studies lack both appropriate followup sessions that would facilitate our understanding of potential long-term adverse effects (for a notable exception, see Carhart-Harris et al, 2018) and adequate considerations for ethical problems posed by psychedelic research (Beckman, Poulsen, Doss, & Stenbaek, 2023). Indeed, psychedelics can have detrimental effects even when used with caution (Anderson et al, 2020;Thakur, 2022).…”

Section: Introductionmentioning

confidence: 99%

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A double-edged sword: Insights from practitioners on the short and long-term negative effects of psilocybin-assisted psychological interventions

Nordin,

Hlynsson,

Håkansson

et al. 2024

JPS

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Background and aimsInterest in psychedelic research has grown significantly in recent years and the naturally derived substance psilocybin, in combination with therapy, has shown promising results as a treatment for a range of psychiatric conditions. However, the negative effects and risks of psilocybin-assisted treatment are not well-established. The purpose of this study was to investigate the potential negative effects of psilocybin-assisted psychological interventions in both the short and long term.MethodSemi-structured interviews were conducted with eight psychedelic treatment providers and facilitators. Their content was thematically interpreted.ResultsThree themes of short-term negative effects were identified. They included negative reactions to psilocybin dosing sessions, undesirable processes in the therapeutic relationship, and difficult self-experiences. Four themes of long-term negative effects were identified. They included destabilization of the client, difficulties adapting to life post-treatment, complications in the treatment relationship, and undesirable outcomes.ConclusionsThese results highlight the multifaceted challenges clients may face, emphasizing the need for thorough pre-intervention assessment and post-intervention support. The findings both confirm previous research and highlight new aspects that can contribute to increased safety and be relevant for clinical implementation. Further rigorous research is needed to ensure safety, establish ethical guidelines, and optimize the positive effects of these experimental medicines. Integrating various research approaches and types of measurements will be vital to further our understanding of negative effects of psychedelic-assisted therapy.

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“…Ketamine and Esketamine are both NMDA antagonists. 3 The therapeutic benefits of psychedelics are believed to arise from their capacity to induce significant alterations in consciousness, resulting in enduring changes in perspective and behavior. These substances seem to facilitate the brain's ability to create new neural connections (neuroplasticity), which can be advantageous for individuals with inflexible thought patterns linked to various mental health conditions.…”

Section: Introductionmentioning

confidence: 99%

Is Psychedelic Treatment of Mental Health Disorders Ready for Prime Time?

Ashraf

2024

J Pak Psychiatr Soc

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Psychedelics, substances known to alter perception, mood, and consciousness, have been used across various cultures for centuries, often in religious ceremonies to facilitate spiritual experiences. Lysergic acid diethylamide (LSD) was used clinically from the 1950s until its ban in 1967. Recently, there has been a resurgence of interest in psychedelics for treating mental health disorders such as PTSD, anxiety, depression, and substance use disorders. The FDA has designated several psychedelic compounds as "breakthrough therapies," acknowledging their potential for safety and effectiveness. Psychedelics like Psilocybin, LSD, DMT/Ayahuasca, MDMA, Peyote, and Ketamine work through various mechanisms, including agonism at 5HT2A receptors and NMDA antagonism. These substances promote neuroplasticity and can disrupt pathological activity patterns in the brain's default mode network (DMN), facilitating new perspectives and emotional processing. Psychedelic-assisted therapy leverages these properties to help patients gain insight into repressed conflicts and reduce maladaptive defenses. The therapeutic process involves preparation, support during dosing, and integration phases. Safety concerns include hallucinogen persisting perception disorder (HPPD), serotonin toxicity, and potential boundary violations. Despite promising early results, comprehensive research is needed to fully understand the therapeutic potential and limitations of psychedelics. Psychedelic-assisted therapy could offer hope and transformation for millions suffering from mental illnesses if proven safe and effective.

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Psychedelics for treating psychiatric disorders: Are they safe?

Cited by 3 publications

References 42 publications

Systematic review and rationale of using psychedelics in the treatment of cannabis use disorder

Systematic review and rationale of using psychedelics in the treatment of cannabis use disorder

A double-edged sword: Insights from practitioners on the short and long-term negative effects of psilocybin-assisted psychological interventions

Is Psychedelic Treatment of Mental Health Disorders Ready for Prime Time?

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