European Psychiatry
April 1, 2021
I. Figueiredo, Filipa Viegas, F. Ferreira et al.
2 citations
Post-traumatic stress disorder (PTSD) often persists despite available evidence-based treatments, and psychotherapy remains the first-line approach, though many patients have high rates of psychiatric and medical comorbidity. Psychedelic-assisted psychotherapy may offer new treatment opportunities. A literature review of the Medline database found that MDMA-assisted psychotherapy appears to be a potentially safe, effective, and durable treatment for individuals with treatment-refractory PTSD. Ketamine administration, based on a small number of studies, appears to provide temporary symptom relief and, combined with psychotherapy, may lead to lasting reductions in PTSD symptoms. Psilocybin and LSD have psychoactive effects that could contribute to psychotherapeutic treatment, though controlled studies are lacking. More research on safety, efficacy, cost-effectiveness, and therapist training is needed.
European Psychiatry
April 1, 2021
Jackelyne Gabrielle Jesus de Miranda, Mario Barbosa, I. Figueiredo et al.
Classic psychedelics such as LSD, mescaline, and psilocybin have been used in sacramental contexts since ancient times and were studied in psychiatry in the 1950s–1960s before research halted due to countercultural associations. Modern research has renewed interest in these substances for treating cancer-related distress and addiction. This review of articles from 2010–2020 finds that psychedelics, as 5HT2AR agonists, can occasion mystical experiences—characterized by a strong sense of unity—that may produce abrupt, sustained changes in behavior and perception. Research on psychedelics for substance use disorders is at an early stage, but results show promise with no clinically significant adverse events when high-risk individuals are excluded. Psilocybin for specific addictions may become available in the near future if safety and efficacy continue to be demonstrated.
August 14, 2019
S. Penedos, I. Figueiredo, Maria Margarida Magalhães Lopes et al.
Regularly ingesting a non-hallucinogenic dose of LSD, known as microdosing, is reported by advocates to provide long-lasting psychological benefits without altering consciousness. Despite promising preliminary findings, few clinical studies exist, including interviews, an open-label study, and a cross-sectional study. Recent pharmacokinetic findings may improve future study interpretation and replicability. A proposed neurobiological mechanism from preclinical research involves rebalancing hippocampal 5-HT2/5-HT1A signaling and associated plasticity, which appears to bias emotional processing toward positive information and reduce responses to fearful stimuli. Neuroimaging suggests psychedelics may influence connectivity between cortical areas responsible for maintaining the sense of self.