Nervenheilkunde
April 1, 2024
Uwe Herwig
3 citations
Psychedelics are attracting renewed scientific and clinical interest in psychiatry. After a period of therapeutic use in the mid-20th century, research largely ceased following legal prohibitions. Only in recent years has their clinical potential been investigated again with modern methods. The ability of psychedelics to induce qualitatively altered states of consciousness, including psychodynamic experiences and insights, suggests they could support psychotherapeutic processes. Current clinical trials focus on indications such as treatment-resistant depression, post-traumatic stress disorder, and alcohol dependence. However, a specific psychedelic-assisted psychotherapy in the strict sense is not yet being studied. Beyond expanding the evidence base, much work remains before broader clinical use becomes possible.
Nervenheilkunde
June 1, 2024
Uwe Herwig
1 citation
Humans have used psychedelic substances for millennia. Scientific investigation, first pharmacological then psychiatric, began in the late 19th century. Clinical applications, especially to support psychotherapy, were implemented from the mid-20th century and saw broader use in the 1950s and 1960s. After criminalization in the 1970s, few studies occurred until the late 20th century, mainly on neurobiological basics. From the 2000s onward, new clinical studies emerged, with a sharp increase in recent years, particularly regarding psilocybin for depression. Today, broader professional and societal discussion is underway, and the question of introducing psychedelics into clinical psychiatry in Germany is being considered.
Nervenheilkunde
April 1, 2024
Torsten Passie
1 citation
Hanscarl Leuner (1919–1996) was the central figure of psycholytic therapy in Europe, which uses low doses of hallucinogens like LSD or psilocybin to loosen defense structures and access unconscious conflicts. Unlike psychedelic therapy, which relies on 1–2 high-dose sessions for mystical experiences, psycholytic therapy involves 5–25 substance applications embedded in long-term psychotherapy. The approach focuses on personal themes both during altered states and in regular sessions. This article outlines the fundamentals of psycholytic therapy and presents Leuner's research on its foundations.
Nervenheilkunde
April 1, 2024
Manuela Brand, Luca V. Faerber, Laura Kaertner et al.
1 citation
This article examines the treatment of mental illnesses with psychedelic substances from a psychotherapeutic perspective, focusing on the role of integrating psychedelic experiences. It asks how extraordinary experiences under the influence of psychedelics can be harnessed for psychotherapeutic progress. After an introductory overview of phases of psychedelic-assisted therapy (PAT), it describes a possibility for psychotherapeutically guided integration of psychedelic experiences using the example of treating treatment-resistant depressed patients with psilocybin in a clinical trial (EudraCT: 2019–003984–24; NCT04670081). The integration of psychedelic experiences into daily life is a scientifically little-studied but essential part of PAT. Evidence-based protocols should be developed to increase the efficacy and safety of therapy through integration methods. With the introduction of PAT into established healthcare systems, integration of psychedelic experiences is expected to become increasingly important.
Nervenheilkunde
February 1, 2026
Dimitris Repantis, Michael Koslowski, Felix Betzler et al.
Psychedelics such as psilocybin and LSD have undergone a remarkable history, from early psychiatric applications through recreational use and prohibition in the 1970s to their current rediscovery in clinical trials. MDMA has been evaluated for the treatment of post-traumatic stress disorder for about 15 years. Treatment closely combines pharmacotherapy and psychotherapy.
Nervenheilkunde
June 1, 2024
Ricarda Evens, Tomislav Majić
Classic psychedelics such as psilocybin and LSD are being reinvestigated for treating psychiatric disorders. After acute effects subside, post-acute effects—divided into subacute and long-term phases—play a key role in their therapeutic potential. Subacute effects include the psychedelic "afterglow": well-being, lightness, deeper self-connection, increased openness to interpersonal encounters, and reduced repetitive rumination. However, complications can also arise, including frequent headaches, and less commonly depressive and anxiety symptoms, sleep disturbances, dissociative symptoms, visual perceptual disturbances, and psychotic syndromes. In some cases, these complications may develop into persistent mental disorders requiring psychiatric-psychotherapeutic care.
Nervenheilkunde
May 14, 2024
Jörg Daumann, Uwe Herwig
The use of psychedelics in psychotherapy raises significant ethical, social, and clinical questions. Key areas include health risks, specifics of informed consent, media influence, the role of therapists, safety aspects, and legal status. Scientific evaluation of psychedelic-augmented psychotherapy also faces numerous methodological challenges, such as appropriate control conditions, placebo specifics, and blinding procedures to generate robust findings. Expectation biases must be minimized or statistically accounted for. Continuous research, training, and collaboration among different stakeholders are necessary to effectively address the complex clinical, ethical, and methodological dimensions of psychedelic research and therapy.
Nervenheilkunde
April 1, 2024
Eva Maria Schindowski, Franz X. Vollenweider
The article presents two treatment courses of patients with recurrent depression who were treated with psilocybin. Worldwide, the number of studies examining the use of psilocybin for depression is steadily growing, increasing interest in this therapy. While some researchers note a current 'hype' around psychedelics, patients and their accompanying clinicians have very different experiences with the substance. There are few detailed descriptions of long-term courses that allow outsiders deeper insight. The case examples show both the enormous potential of psilocybin to positively influence depressed patients' lives and that some patients, even with repeated use, do not experience long-term benefit.
Nervenheilkunde
June 11, 2024
In 11 focus group interviews with 31 participants divided into physicians, psychotherapists, and (ex-)patients, attitudes, wishes, and concerns regarding the possible introduction of psychedelic therapies into the German healthcare system were discussed. Topics included risks and potentials, expectations, regulation and accessibility, therapeutic accompaniment, training, framework conditions, safety precautions, presumed mechanisms of action, and fears. Most participants expressed optimism and desired patient-centered, risk-minimizing regulation.