He Benny Chang
Clinical Applications of Psychedelic Drugs
What is the difference between a hallucinogen and a psychedelic drug?
Hallucinogens are a broad category of drugs that cause ‘hallucinations’. Psychedelics are a type of hallucinogen that work via 5-HT2A receptor agonism.
Briefly recount the history of psychedelic drugs.
Psychedelics have been used for thousands of years, but have had a surge during the past century. It became a schedule I controlled substance in 1970.
How safe are psychedelic drugs?
Among illicit/recreational substances, psychedelic drugs relatively lower levels of harm to both the individual and society at large. It is not associated with decreased mental health.
How might psychedelic drugs provide clinical benefit?
It could potentially improve psychologic wellness in certain patient populations, eg. Patients with terminal illness. The effects might also be long-lasting, with clinical effects seen well beyond the timeframe of acute usage.
How do psychedelics work?
Serotonin (5-HT2A ) agonist. It has decreases the activity of the default mode network in the brain, which is elevated in certain disorders.
Beaussant, Y., Sanders, J., Sager, Z., Tulsky, J. A., Braun, I. M., Blinderman, C. D., Bossis, A. P., & Byock, I. (2020). Defining the Roles and Research Priorities for Psychedelic-Assisted Therapies in Patients with Serious Illness: Expert Clinicians’ and Investigators’ Perspectives. Journal of Palliative Medicine, 23(10), 1323–1334. https://doi.org/10.1089/jpm.2019.060
Carhart-Harris, R. L., Leech, R., Hellyer, P. J., Shanahan, M., Feilding, A., Tagliazucchi, E., Chialvo, D. R., & Nutt, D. (2014). The entropic brain: a theory of conscious states informed by neuroimaging research with psychedelic drugs. Frontiers in Human Neuroscience, 8. https://doi.org/10.3389/fnhum.2014.00020
Carhart-Harris, R., Giribaldi, B., Watts, R., Baker-Jones, M., Murphy-Beiner, A., Murphy, R., Martell, J., Blemings, A., Erritzoe, D., & Nutt, D. J. (2021). Trial of Psilocybin versus Escitalopram for Depression. New England Journal of Medicine, 384(15), 1402–1411.
El-Seedi, H R et al. 2005. “Prehistoric peyote use: Alkaloid analysis and radiocarbon dating of archaeological specimens of Lophophora from Texas”, Journal of Ethnopharmacology 101 (1-3): 238-242.
Griffiths, R., Richards, W., Johnson, M., McCann, U., & Jesse, R. (2008). Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later. Journal of Psychopharmacology, 22(6), 621–632. https://doi.org/10.1177/0269881108094300
Hendricks, P. S., Thorne, C. B., Clark, C. B., Coombs, D. W., & Johnson, M. W. (2015). Classic psychedelic use is associated with reduced psychological distress and suicidality in the United States adult population. Journal of Psychopharmacology, 29(3), 280–288. https://doi.org/10.1177/0269881114565653
Kast, E. (1966). LSD and the dying patient. Chic Med Sch Q 26, 80-87.
Kast, E.C., and Collins, V.J. (1964). Study of lysergic acid diethylamide as an analgesic agent. Anesth Analg 43, 285-291.
Krebs, T. S., & Johansen, P.-Ø. (2013). Psychedelics and Mental Health: A Population Study. PLoS ONE, 8(8), e63972. https://doi.org/10.1371/journal.pone.0063972
Nutt, D., King, L. A., Saulsbury, W., & Blakemore, C. (2007). Development of a rational scale to assess the harm of drugs of potential misuse. The Lancet, 369(9566), 1047–1053. https://doi.org/10.1016/s0140-6736(07)60464-4