Penn Lifespan Informatics and Neuroimaging Center (PennLINC), Philadelphia, PA, United States; Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, United States. Electronic address: sattertt@pennmedicine.upenn.edu.
2 papers in the library · 37 citations · publishing 2022-2023
Psychedelic substances have been used historically for spiritual and mystical experiences, and recent interest focuses on their potential to treat chronic pain. Clinical trials support psychedelics' effectiveness for psychiatric conditions, but studies on chronic pain—such as cancer pain, phantom limb pain, migraine, and cluster headache—are few and mostly uncontrolled. Risks are relatively rare with careful patient screening and supervision. Key challenges include identifying mechanisms of action, selecting appropriate pain conditions, designing rigorous trials with proper control groups, minimizing unblinding bias, and accounting for patient mindset and setting. Evidence-based recommendations are needed for future research to yield informative results.
A systematic review of 91 fMRI studies on acute psychedelic effects found substantial methodological heterogeneity. Only 51 unique samples were used across the 91 papers, and 54% of studies did not meet current standards for correcting Type I errors or controlling motion artifacts. Psilocybin and LSD consistently modulated connectivity along the sensorimotor-association cortical axis. Ketamine consistently increased activation in the dorsomedial prefrontal cortex. The review calls for future adoption of pre-registration, standardized processing and statistical testing, and data sharing to improve rigor.