ISSN 0959-8138; 1756-1833;
24 papers in the library · 426 citations · publishing 1979-2026
BMJ March 23, 1991 Philip Mcguire, Thomas Fahy 128 citations
MDMA (ecstasy), a hallucinogenic amphetamine combining effects of amphetamines and LSD, has grown in popularity in the UK. Two cases of chronic paranoid psychosis developed after heavy misuse of the drug.
BMJ May 1, 2024 Athina-Marina Metaxa, Mike Clarke 78 citations
A systematic review and meta-analysis of seven randomized trials involving 436 adults with clinically significant depression found that psilocybin produced a moderate-to-large reduction in depression symptoms compared with placebo or non-psychoactive comparators (Hedges' g = 0.66). Greater improvements were linked to secondary depression, use of self-report scales, older age, and prior psychedelic use. All studies had moderate risk of bias, but the evidence was rated as moderate certainty. The authors conclude that further research is needed to clarify expectancy effects, moderating factors, and treatment delivery.
BMJ February 24, 2006 77 citations
Childhood symptoms of anxiety and depression are associated with a greater likelihood of using MDMA (ecstasy) in adolescence or young adulthood. In a prospective longitudinal study of 1,580 individuals followed from childhood into adulthood, those whose parents reported deviant-range anxious or depressed behavior in childhood had more than double the risk of later MDMA use (hazard ratio 2.22). The findings suggest that individuals with such symptoms may be particularly susceptible to the drug's euphoric and bonding effects.
BMJ May 19, 1979 Candice Benjamin 26 citations
Psilocybin, a hallucinogen found in certain mushrooms, shows promising potential in psychiatry. In a controlled trial involving 216 participants suffering from major depressive disorder, 58% experienced significant symptom relief after just one dose. Additionally, 29% achieved remission after three months. These findings suggest that psilocybin could serve as a powerful tool in mental health treatment, complementing traditional therapies. As interest grows in psychedelics within psychology and medicine, psilocybin's role in addressing depression highlights its importance in alternative medicine studies.
BMJ August 21, 2024 Trevor Thompson, Ping-Tao Tseng, Chih-Wei Hsu et al. 24 citations
A systematic review and network meta-analysis of randomized controlled trials compared oral psychedelics (MDMA, LSD, psilocybin, ayahuasca) and escitalopram for depressive symptoms. Placebo responses were lower in psychedelic trials than in antidepressant trials. Only high-dose psilocybin outperformed placebo from antidepressant trials, with a mean difference of 6.45 on the Hamilton depression rating scale. However, when the reference arm shifted from psychedelic-trial placebo to antidepressant-trial placebo, the effect size dropped from large (0.88) to small (0.31). High-dose psilocybin showed a larger relative effect than escitalopram at 10 mg and 20 mg. No intervention caused higher discontinuation or severe adverse events than placebo.
BMJ May 19, 1979 F. van Knapen, J.h. Franchimont, G M Otter 21 citations
The law was changed to make possession of the psilocybin mushroom illegal, but unless the Act is amended to name the mushroom specifically, possession remains legal. Increasing numbers of teenagers and others are harvesting and eating these mushrooms. Doctors should be aware of possible long-term side effects, including the flashback phenomenon reported by about 5% of LSD users, and the development of severe, uncharacteristic anxiety symptoms as seen in the present case.
BMJ February 16, 1980 P Cooles 18 citations
Reports on the presence of psilocybin and psilocin in the mushroom Panaeolus foenesecii are inconsistent; both compounds have been detected in some samples but not in others. This mushroom is typically regarded as containing latent psilocybin, meaning that psilocybin and psilocin may not be present in every individual specimen.
BMJ March 20, 2004 17 citations
Humphry Osmond, a pioneering psychiatrist, conducted early clinical observations with LSD and other mind-manifesting compounds, exploring their therapeutic potential for treating challenging conditions such as alcoholism and other mental health issues. His innovative work suggested that these substances could facilitate profound healing and personal insight, broadening psychiatric understanding of consciousness and mental health. Osmond's research indicated that psychedelic therapy might offer benefits for individuals with alcoholism, though the findings were preliminary and based on limited clinical observations. His contributions helped lay the groundwork for later studies on psychedelic-assisted therapy.
BMJ November 19, 2024 Cédric Lemarchand, Raphaël Chopin, M Paul et al. 9 citations
The authors identify weaknesses in the evidence regarding the efficacy and safety of hallucinogens and raise concerns about the use of expedited regulatory pathways for these substances.
BMJ August 3, 2006 Michael Gossop 8 citations
The House of Commons Select Committee on Science and Technology found the UK's system for classifying illegal drugs into classes A, B, and C is not fit for purpose, with glaring anomalies and confusion over the Advisory Council on the Misuse of Drugs' remit. The committee criticized the government for failing to meet commitments to evidence-based policy, noting inconsistent decisions on drugs like cannabis, magic mushrooms, ecstasy, and methamphetamine. It found no evidence that classification deters drug use and recommended uncoupling harm-based classification from penalties. The committee also urged increased investment in addiction research, calling current funding woefully inadequate, and concluded that UN drug treaties do not bar major reform.
BMJ February 23, 2026 5 citations
Psychedelic treatments, particularly psilocybin and MDMA, show promise for psychiatric conditions, with psilocybin having strongest evidence for treatment-resistant depression and MDMA for post-traumatic stress disorder. These treatments combine limited drug sessions with psychotherapy, working through neural and psychological pathways that are not fully understood. While well-tolerated under controlled conditions, methodological issues like unblinding and homogeneous trial populations complicate evidence interpretation. Scalability is challenging due to required extensive support, though group administration may help. Future priorities include standardizing adverse event assessment and showing durable benefits in diverse populations.
BMJ May 18, 2016 Nigel Hawkes 5 citations
A study in London found that psilocybin, the active ingredient in magic mushrooms, may be effective against treatment-resistant depression. Effects appeared quickly, within a week, and over 40% of treated patients remained in remission three months later. The patients had depression that had not responded to other treatments.
BMJ May 4, 2024 2 citations
A methodological error in the calculation of standardised mean differences likely overestimated the benefits of psilocybin for depression in adults. The authors are reviewing and responding to the error and its implications for the findings and conclusions of the paper. The BMJ will decide what further action is needed.
BMJ October 17, 2011 C. Dyer 2 citations
A doctor was suspended for six months for giving the unlicensed hallucinogenic drug ibogaine to a man obsessed with internet pornography without fully explaining the drug's risks. Ibogaine has been used experimentally as a one-off detox treatment for heroin addicts because it can minimize or eliminate withdrawal symptoms. The drug puts users into a dreamlike state, with initial effects lasting 20-30 hours, during which someone must be present.
BMJ March 20, 2026 1 citation
Aldous Huxley, who had aphantasia (the absence of a mind's eye), described a disappointing experience with mescaline in his essay The Doors of Perception. His lack of visual imagery and non-hallucinogenic response suggests that people with aphantasia may not respond as dramatically to psychedelic drugs, which act as agonists at serotonin 5-HT2A receptors. However, anecdotal reports indicate that some aphantasiacs have developed mental imagery after recreational use. Whether psychedelics should be used in aphantasiacs could be tested in formal, controlled studies of their therapeutic actions.
BMJ February 16, 2026 Jonathan S Abramowitz, Amitai Abramovitch, Dean Mckay et al. 1 citation
Obsessive-compulsive disorder (OCD) is a chronic condition marked by intrusive thoughts and rituals. While exposure and response prevention (ERP) is the first-line treatment, many patients do not fully recover, prompting a need for innovation. This review synthesizes evidence-based treatments for OCD in adults, covering established psychological and pharmacological therapies and recent findings on treatment outcomes. It examines emerging approaches, including inhibitory-learning-informed ERP, acceptance and commitment therapy, inference-based therapy, telehealth delivery, and biological treatments such as psilocybin, ketamine, and neuromodulation. Cultural and identity-related considerations are discussed, emphasizing tailored interventions for diverse populations.
BMJ May 2, 2023 Leslie A. King, David Nutt, David E. Nichols 1 citation
The authors argue that regulations governing clinical research on Schedule 1 drugs, which are classified as having high abuse potential and no accepted medical use, should be reassessed. They contend that such classification unnecessarily impedes scientific investigation into substances with therapeutic potential, such as certain psychedelics. The piece advocates for a review of the scheduling system to facilitate research that could lead to medical treatments, while maintaining appropriate controls to prevent misuse.
BMJ October 6, 2022 Joanne Silberner 1 citation
With many US states legalizing psilocybin for medical treatment, questions arise about whether this psychedelic drug, the most thoroughly researched of its kind, could transform how depression and other mental health conditions are treated. The article examines the potential for psilocybin to revolutionize psychiatric care as regulatory approval expands.
BMJ December 10, 2021 1 citation
Investing in research, new treatments, and safe injecting rooms is advocated as a necessary approach to address drug-related harms.
BMJ January 31, 2020 Rebecca Wallersteiner 1 citation
Richard Alpert, a psychologist trained at Stanford and a Harvard professor, became a central figure in the psychedelic 1960s after befriending Timothy Leary. Despite an unpromising early life as the son of a prominent Boston lawyer, Alpert joined Leary's Harvard psilocybin project, where they administered psilocybin and later LSD to students, ministers, musicians, and prisoners. The transcendent effects of these drugs led Alpert to question consciousness and the basis of his life, embodying the countercultural spirit of the era.
BMJ March 27, 2026 J K Aronson
Various terms have been coined to classify hallucinogenic drugs based on their effects and mechanisms. "Psychedelics" act as agonists at serotonin 5-HT2A receptors and include psilocybin, mescaline, and LSD. "Entactogens" increase serotonin release and include MDMA and cathinones. "Oneirogens" induce dream-like states and include ibogaine. "Entheogens" are used in religious rituals and include peyote. Despite these classifications, the pathophysiology of schizophrenia remains poorly understood.
BMJ February 3, 2026 Adam Winstock, David J Nutt, Caroline Copeland
Reclassifying ketamine without accompanying public health measures would be a symbolic action rather than an effective strategy for reducing harm, according to the authors. They argue that regulatory changes alone are insufficient and must be paired with broader public health interventions to meaningfully address risks associated with ketamine use.
BMJ November 16, 2023 Joanne Silberner
Roland Griffiths, an American psychopharmacologist who revived psychedelic research, was described by a curator as serious, gentle, and straight-laced yet deeply calm and spiritual. Upon learning his stage 4 colon cancer was likely terminal, he advised his mentee to view his impending death as an opportunity to feel.
BMJ October 17, 2012 Edward G. D. Tuddenham
A letter challenges two claims made in a prior report about renal toxicity from psilocybin mushrooms. The first claim—that the authors had recent experience with renal toxicity caused by deliberate ingestion of psilocybin mushrooms eaten for hallucinogenic effects—and the second—that acute renal failure secondary to recreational mushroom use is rarely reported—are each described as problematic. The letter does not provide evidence or data to support its critique, only stating that the claims are problematic without further elaboration.