Psychedelic substances such as psilocybin, ayahuasca, LSD, and MDMA are gaining renewed medical interest due to the need for new psychiatric treatments and promising study results. This viewpoint reflects on the Royal Australian and New Zealand College of Psychiatrists' Clinical Memorandum on Psychedelics and notes regulatory developments, including applications for down-scheduling and access approvals. The authors argue that rigorous research is needed to assess benefits, safety, and therapeutic mechanisms. They summarize recent findings on mechanisms of action and the psychedelic-assisted psychotherapy model, suggesting medicinal psychedelics could become a new class of psychiatric treatments when used under medical supervision with psychotherapeutic support. However, sufficiently powered trials and safety protocols are required before clinical use, and untrained practitioner access could be harmful.
GHB withdrawal can be far more prolonged than the typical 5-7 days, sometimes recurring over 56 days despite initial stabilization and toxicological evidence of abstinence. A male patient in his 30s with a 15-year history of daily high-dose GHB use experienced three hospital admissions over 8 weeks, each requiring intravenous sedation and intubation for agitated delirium. His withdrawal delirium was successfully treated with a slow, six-month taper of benzodiazepines and baclofen, preventing further re-emergence of the debilitating delirium. This case demonstrates that severe GHB withdrawal may require extended support and slow medication tapering, with benzodiazepines and GABA-B agonists as effective treatments.