Psychedelics show promise for treating mental disorders, but their use remains controversial. Preclinical evidence from genetic, histological, and behavioral studies consistently indicates that psychedelics can induce neuroplasticity. Clinical evidence, despite methodological challenges, generally aligns with these preclinical findings. However, it remains unclear whether the neuroplastic effects of classic psychedelics can be separated from their psychodysleptic effects, which could reduce associated psychopathological risks. Additionally, the assumption that a 'relaxation of priors' is always beneficial is debatable. Further research is needed to clarify indications and contraindications for psychedelic psychoplastogens within a precision medicine framework.
After decades of neglect, psychedelics are again being studied for clinical use, but the current enthusiasm risks overstating their benefits and downplaying their harms. The authors review the literature to give a balanced account of both therapeutic potential and risks. Psychedelics show promise for many conditions and appear to have limited risk of abuse or dependence when given under controlled conditions by trained staff. However, many questions remain, and more research is needed to identify which patients and conditions will benefit and which face greater risk of adverse effects.