Psychopathological descriptive model of hallucinogenic/psychedelic drugs effect in the treatment of depression and addictions

The efficacy of hallucinogenic drugs (ayahuasca, psilocybin, LSD, ketamine) in treating depression and addictions is accompanied by intense emotional states and mystical-type experiences, including feelings of oneness, transcendence, ineffability, and awe. These common psychopathological elements may mediate the drugs' therapeutic action. The paper reviews literature on subjective experiences during such treatments and compares them with other life-changing experiences, discussing the evolutionary value of these emotions for group cohesiveness and the recalibration of cognitions and emotions.

Study at a glance

Abstract

Introduction There is a growing and renewed interest in the use of hallucinogenic drugs in the treatment of psychiatric disorders, especially since the FDA approval of esketamine treatment for resistant depression. The response to hallucinogenic psychedelic substances (ayahuasca, psilocybin, LSD, ketamine) in the treatment of depression and addictions calls for a theoretical explanatory model. Objectives Provide a descriptive / explanatory psychopathological model of the response to treatment with hallucinogenic drugs based on the descriptions of the subjects and the comparison with other extreme life experiences. Methods Relevant published literature on subjective experiences in treatment with hallucinogenic drugs for depression and addictions is reviewed. It is compared with subjective experiences in life changing experiences. Results Intense emotional states, mystical-type experiences including feelings of oneness, transcendence, ineffability, and the complex emotion of awe seem to be consistently presented as psychic elements related to the efficacy of these treatments. The genetic and cultural (memetic) evolutionary value of these emotions in the cohesiveness of human groups and the genesis of affective symptoms, and in the recalibration of cognitions and emotions, is discussed. Conclusions The efficacy of hallucinogenic drugs used in the treatment of depression and addictions is accompanied by complex and varied emotions but with common psychopathological elements that could mediate their action.