Curr Top Behav Neurosci
January 1, 2018
Frederick S. Barrett, Roland R. Griffiths
268 citations
Mystical-type experiences, historically linked to classic hallucinogens, can be reliably measured with a validated questionnaire. Under double-blind conditions controlling for expectancy, psilocybin produces complete mystical experiences in most people, with effects that are dose-dependent and specific compared to placebo or an active control. These experiences have lasting positive impacts on mood, attitudes, and behavior, as reported by participants and community observers. In healthy volunteers, they generate enduring personal meaning; in patients, they are associated with reduced substance abuse and decreased anxiety and depression, including in those with life-threatening cancer. Parallels in brain activity between hallucinogens and meditative practices suggest a neural model based on changes in the default mode network.
Curr Top Behav Neurosci
January 1, 2018
Michael P. Bogenschutz, Stephen Ross
84 citations
This chapter reviews therapeutic uses of serotonergic hallucinogens like LSD and psilocybin, which act primarily on serotonin 2A receptors. After covering history and human use, it summarizes clinical data, including work on treating alcoholism and other addictions, using LSD and psilocybin to relieve death-related distress in advanced cancer patients, and limited data on mood and anxiety disorders. Safety of these drugs is well-established. Early-phase research from the 1950s to early 1970s strongly suggested clinically relevant effects, particularly for LSD in alcoholism, but was discontinued before firm conclusions. Recent trials have resumed, showing encouraging outcomes for existential distress in cancer and addictions, though not yet sufficient to establish efficacy. Mechanisms of persisting effects remain poorly understood.
Curr Top Behav Neurosci
January 1, 2018
Dennis McKenna, Jordi Riba
67 citations
New World indigenous peoples use psychedelic plants in shamanic and ethnomedical practices far more than in the Old World. Almost all these botanically diverse preparations share tryptamine derivatives, either DMT or related constituents, as active principles. Part 1 of this paper gives an ethnopharmacological overview of major tryptamine-containing New World hallucinogens. Part 2 focuses on ayahuasca and its effects on the human brain. Using SPECT, ayahuasca modulated activity in higher order association areas, increasing blood perfusion mainly in anterior brain regions (frontomedial and anterior cingulate cortices) and medial temporal lobes.
Curr Top Behav Neurosci
November 24, 2024
Marc Aixalà
8 citations
Psychedelic integration—the process of making sense of and applying insights from psychedelic experiences—is complex and often hindered by unsupportive settings, personal struggles, and a lack of safe, tailored interventions. This work argues that effective integration requires addressing users' unique challenges, such as difficult emotions or life circumstances, and implementing structured support systems. The authors suggest that without careful attention to these factors, the potential for positive change and mental well-being is diminished. They advocate for interventions that are personalized and safety-focused to help individuals translate profound experiences into lasting improvements in their lives.
Curr Top Behav Neurosci
November 2, 2024
Chiara Caporuscio, Sascha Benjamin Fink
7 citations
Belief change is central to therapeutic benefit in psychedelic-assisted therapy, but it poses unique challenges. Psychedelics can cause drastic belief shifts faster than in regular therapy, leading to confusion and disorientation. Hallucinatory experiences often carry a high degree of confidence and noetic certainty despite not necessarily being connected to reality. Telling a patient which beliefs are true is beyond a therapist's competence and risks abuse of authority, especially given the power imbalance and patient suggestibility during altered states. This chapter explores, through a philosophical and epistemological lens, how therapists can help patients navigate epistemic uncertainty around psychedelic insights while preserving autonomy. It argues that dynamically adapting strategies to individual patient needs can significantly reduce epistemic risks.
Curr Top Behav Neurosci
December 10, 2024
Xiaojue Hu, Ingmar Gorman, Elizabeth Nielson
3 citations
Psychedelic Harm Reduction and Integration (PHRI) is a clinical model that combines principles from harm reduction, psychedelic-assisted therapy, mindfulness, and psychodynamic therapy to help clients prepare for and integrate psychedelic experiences without directly administering psychedelics. It uses non-pathologizing, client-empowering strategies, emphasizing non-directive and inner-directed approaches, somatic awareness, and psychological flexibility. The model addresses common integration challenges such as fear, ego dissolution, and increased emotional sensitivity, aiming to translate psychedelic experiences into lasting positive changes while reducing potential harms. The chapter outlines PHRI's theoretical foundations, distinguishes it from other approaches, and explores its clinical application, focusing on the integration phase.