Regional Anesthesia & Pain Medicine
May 4, 2020
Joel Castellanos, C. Leonard Woolley, Kelly Bruno et al.
118 citations
Chronic pain develops through complex mechanisms involving strengthened neural circuitry from repeated pain signals, leading to peripheral and central sensitization. Psychedelics, through serotonin 2A receptor agonism, may 'reset' brain functional connectivity involved in central neuropathic pain. They have a favorable safety profile compared to opioid analgesics. Clinical evidence for chronic pain is limited, but studies over 50 years show potential benefit for cancer pain, phantom limb pain, and cluster headache. The mechanisms are unclear but may involve similarities between psychedelic activation pathways and nociceptive modulation. Functional connectivity changes from psychedelics could help reverse neural changes in chronic pain. Further research is needed given the opioid epidemic and limited non-opioid options.
Pain
September 5, 2022
Matthew Lyes, Joel Castellanos, Timothy Furnish et al.
55 citations
Three individuals with chronic neuropathic pain, unresponsive to standard treatments and impairing quality of life, self-administered low doses of psilocybin. Despite differences in pain origin and preparation potency, all three achieved substantial pain relief without experiencing a psychedelic state or significant side effects. The analgesic effect was enhanced when combined with functional exercise, and in one case, repeated dosing appeared to increase relief, hinting at a possible long-term plasticity-mediated effect. The patients also reduced their reliance on conventional pain medications. These observations suggest psilocybin's therapeutic potential for chronic pain deserves further study.
Cureus
September 1, 2022
Joshua S Kurtz, Neal A Patel, Julian L Gendreau et al.
35 citations
A systematic review of clinicaltrials.gov identified 105 registered clinical trials on psychedelic drugs from 2007 to 2020, with 77.1% starting in 2017 or later. The recent uptrend in psychedelic trials mirrors the overall increase in registered trials. Most studies were early-phase (53.3% phase 1, 25.7% phase 2). Common conditions studied include substance addiction, post-traumatic stress disorder, and major depressive disorder. Potential research gaps were identified, such as studying psychedelics for symptomatic treatment during opioid tapering and for depression that does not respond to selective serotonin reuptake inhibitors.
Front Pain Res (Lausanne)
April 19, 2024
Maya Armstrong, Joel Castellanos, Devon Christie
15 citations
Chronic pain can be understood as an emergent property of a complex biopsychosocial system, where physiology, neuroscience, psychology, learning, and epigenetics interact with changing socioenvironmental conditions. This complexity may explain why current treatments often fail. Therapies that are both disruptive and adaptive at higher system levels, such as psychedelic-assisted therapies and mindfulness-based approaches, may offer benefits. Both have transdiagnostic value by disrupting rigid cognitive, emotional, and behavioral patterns and promoting neuroplasticity. Psychedelic therapies may hold unique promise for managing chronic pain.
Clinical Case Reports
September 1, 2024
David S Jevotovsky, Harman Chopra, Court Wing et al.
9 citations
A single patient with complex regional pain syndrome (CRPS) that did not respond to standard treatments experienced substantial pain relief and improved function after taking psilocybin. This case suggests psilocybin may be a promising therapy for refractory CRPS, but more research is needed to determine its effectiveness and the best dosage for chronic pain.
Regional Anesthesia & Pain Medicine
August 5, 2024
Harman Chopra, Shravani Durbhakula, Alexander Shustorovich et al.
8 citations
A systematic review of 28 studies on psilocybin for chronic pain management found that most evidence is low or very low quality (76.2% of studies). Several moderate-to-low-quality studies used a 0.14 mg/kg dosing protocol. The results suggest promise for psilocybin in relieving chronic pain, but methodological weaknesses and a lack of high-quality evidence highlight the need for further research with standardized protocols.
Clinical Case Reports
May 28, 2024
Harman Chopra, Tim Furnish, Monica Verduzco-Gutierrez et al.
6 citations
A 41-year-old fully vaccinated woman with Long-COVID syndrome experienced significant symptom relief after self-medicating with psilocybin and MDMA. Long-COVID, a condition persisting after the acute phase of COVID-19, currently lacks effective holistic treatments. This case suggests potential benefit from these substances, but further research is required to evaluate their safety and efficacy.
Pain Medicine
December 10, 2024
Christopher L. Robinson, Pawan Solanki, S Snyder et al.
Psychedelics such as LSD and psilocybin primarily act as 5HT2A receptor partial agonists, influencing mood, perception, and decision-making. Research suggests they can promote synaptic growth, release oxytocin, and exhibit anti-inflammatory effects. MRI studies indicate psilocybin disrupts connections between the anterior hippocampus and the default mode network, potentially explaining therapeutic effects. From 2015 to 2020, psychedelic use among people over age 12 in the United States increased by over 40%, with over 7.1 million reporting use between 2019 and 2020. Despite this, formal training on psychedelics in medical education remains limited. The report outlines a proposed curriculum to prepare future clinicians for integrating psychedelics into practice, emphasizing the need for education on mechanisms, therapeutic uses, risks, and legal considerations.
April 2, 2024
Harman Chopra, Timothy Furnish, Monica Verduzco-Gutierrez et al.
COVID-19 is a highly contagious respiratory illness caused by the SARS-CoV-2 virus, first identified in Wuhan, China in December 2019, and has since spread globally.