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Psychiatry & the psychedelic drugs. Past, present & future
Open accessAbstract
The classical psychedelic drugs, including psilocybin, lysergic acid diethylamide and mescaline, were used extensively in psychiatry before they were placed in Schedule I of the UN Convention on Drugs in 1967. Experimentation and clinical trials undertaken prior to legal sanction suggest that they are not helpful for those with established psychotic disorders and should be avoided in those liable to develop them. However, those with so-called 'psychoneurotic' disorders sometimes benefited considerably from their tendency to 'loosen' otherwise fixed, maladaptive patterns of cognition and behaviour, particularly when given in a supportive, therapeutic setting. Pre-prohibition studies in this area were sub-optimal, although a recent systematic review in unipolar mood disorder and a meta-analysis in alcoholism have both suggested efficacy. The incidence of serious adverse events appears to be low. Since 2006, there have been several pilot trials and randomised controlled trials using psychedelics (mostly psilocybin) in various non-psychotic psychiatric disorders. These have provided encouraging results that provide initial evidence of safety and efficacy, however the regulatory and legal hurdles to licensing psychedelics as medicines are formidable. This paper summarises clinical trials using psychedelics pre and post prohibition, discusses the methodological challenges of performing good quality trials in this area and considers a strategic approach to the legal and regulatory barriers to licensing psychedelics as a treatment in mainstream psychiatry. This article is part of the Special Issue entitled 'Psychedelics: New Doors, Altered Perceptions'.
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“Although considerable stigma is associated with this class of drugs, very few studies have reported long-term adverse effects as a result of psychedelic administration, and in almost all cases where adverse reactions were reported, they were attributed to the unsupportive context in which they were administered (34, 41, 160).”
From Examining the Potential Synergistic Effects Between Mindfulness Training and Psychedelic-Assisted Therapy (2021) · cites this paper as [34]
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“Most of these studies however suffer from low methodological validity and are mostly open-label, yet they have yielded preliminary evidence for the capacity of psychedelic substances for treating addiction, depression, anxiety, and eating disorders (29–35).”
From Examining the Potential Synergistic Effects Between Mindfulness Training and Psychedelic-Assisted Therapy (2021) · cites this paper as [34]
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Barman, R., Bora, P. K., Saikia, J., Kemprai, P., Saikia, S. P., Haldar, S., & Banik, D. (2021) · Phytotherapy Research · doi:10.1002/ptr.7098 · Cited by 35
Wulff, A. B., Nichols, C. D., & Thompson, S. M. (2023) · Neuropharmacology · doi:10.1016/j.neuropharm.2023.109504 · Cited by 35
An Improved, Practical, and Scalable Five-Step Synthesis of Psilocybin
Kargbo, R. B., Sherwood, A. M., Meisenheimer, P. L., & Tarpley, G. (2020) · Synthesis · doi:10.1055/s-0039-1691565 · Cited by 35
Entheogens and psychedelics in Canada: Proposal for a new paradigm.
Rochester, J., Vallely, A., Grof, P., Williams, M. T., Chang, H., & Caldwell, K. (2021) · Canadian Psychology/Psychologie canadienne · doi:10.1037/cap0000285 · Cited by 40
Hallinan, C. M., Gunn, J. M., & Bonomo, Y. A. (2021) · BMJ Open · doi:10.1136/bmjopen-2021-054044 · Cited by 33
Analysis of Psilocybin-Assisted Therapy in Medicine: A Narrative Review
Ziff, S., Stern, B., Lewis, G., Majeed, M., & Gorantla, V. R. (2022) · Cureus · doi:10.7759/cureus.21944 · Cited by 48
The Safety and Efficacy of Psychedelic-Assisted Therapies for Older Adults: Knowns and Unknowns
Johnston, C. B., Mangini, M., Grob, C. S., & Anderson, B. T. (2022) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2022.08.007 · Cited by 36
Sinha, J. K., Trisal, A., Ghosh, S., Gupta, S., Singh, D. K. K., Han, S. S., Mahapatra, M., Abomughaid, M. M., Abomughayedh, A. M., Almutary, A. G., et al. (2024) · Ageing Research Reviews · doi:10.1016/j.arr.2024.102211 · Cited by 31
Cavanna, F., Pallavicini, C., Milano, V., Cuiule, J. I., Tella, R. D., González, P., & Tagliazucchi, E. (2021) · Journal of Psychedelic Studies · doi:10.1556/2054.2021.00172 · Cited by 34
Serotonergic Psychedelics in Neural Plasticity
Łukasiewicz, K., Baker, J. J., Zuo, Y., & Lu, J. (2021) · Frontiers in Molecular Neuroscience · doi:10.3389/fnmol.2021.748359 · Cited by 37
Pearson, C., Siegel, J. S., & Gold, J. A. (2021) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2021.120096 · Cited by 34
Coppola, M., Bevione, F., & Mondola, R. (2022) · Journal of Xenobiotics · doi:10.3390/jox12010004 · Cited by 38
Frymann, T., Whitney, S., Yaden, D. B., & Lipson, J. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.863247 · Cited by 30
Psychedelic Cognition—The Unreached Frontier of Psychedelic Science
Bălăeţ, M. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.832375 · Cited by 34
Molecular targets of psychedelic‐induced plasticity
Jaster, A. M., Revenga, M. D. L. F., & González‐Maeso, J. (2021) · Journal of Neurochemistry · doi:10.1111/jnc.15536 · Cited by 33
Psychedelics and dissociative substances
WINSTOCK, A. R., & Rucker, J. (2020) · doi:10.1093/med/9780198713005.003.0054 · Cited by 29
Self-citationNeuropsychiatric Disorders: Bridging the Gap Between Neurology and Psychiatry
Taslim, S., Shadmani, S., Saleem, A. R., Kumar, A., Brahma, F., Blank, N., Bashir, M. A., Ansari, D., Kumari, K., Tanveer, M. U., et al. (2024) · Cureus · doi:10.7759/cureus.51655 · Cited by 29
RetractedHupli, A., Berning, M., Zhuparris, A., & Fadiman, J. (2019) · Performance Enhancement & Health · doi:10.1016/j.peh.2019.01.001 · Cited by 31
Psilocybin occasioned mystical‐type experiences
James, E., Robertshaw, T. L., Hoskins, M. D., & Sessa, B. (2020) · Human Psychopharmacology Clinical and Experimental · doi:10.1002/hup.2742 · Cited by 36
The Chronic Treatment With 5-HT2A Receptor Agonists Affects the Behavior and the BDNF System in Mice
Tsybko, A. S., Ilchibaeva, T. V., Filimonova, E., Eremin, D. V., Popova, N. K., & Naumenko, V. S. (2020) · Neurochemical Research · doi:10.1007/s11064-020-03153-5 · Cited by 29
A Comprehensive Review of the Current Status of the Cellular Neurobiology of Psychedelics
Banushi, B., & Polito, V. (2023) · Biology · doi:10.3390/biology12111380 · Cited by 33
Narratives of the mystical among users of psychedelics
Pedersen, W., Copes, H., & Gashi, L. (2021) · Acta Sociologica · doi:10.1177/0001699320980050 · Cited by 26
Metadata
- Authors
- Rucker, J. J. H., Iliff, J., & Nutt, D. J.
- Affiliations
- King's College London (GB)
- University College London (GB)
- Imperial College London (GB)
- Corresponding author
- Rucker, James J.H.
- Venue
- Neuropharmacology
- Publisher
- Elsevier BV
- Published
- 2018-11
- Volume
- 142
- Pages
- 200-218
- ISSN
- 0028-3908 (ISSN-L)
- OpenAlex
- W2781316183
- Cited by
- 343
- References
- 137
- Citations by year
- 2026: 38 · 2025: 40 · 2024: 59 · 2023: 49 · 2022: 50 · 2021: 50 · 2020: 36 · 2019: 14 · 2018: 7
- FWCI
- 2.38
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Neuropharmacology (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion, cc-by-nc-nd)
- Spiral (Imperial College London) (submittedVersion, cc-by)
- Funders
- National Institute for Health Research (NIHR) Biomedical Research Centre at South London
- Maudsley NHS Foundation Trust
- King's College London
- UK Medical Research Council (MR/J00460X/1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychedelics and Drug Studies
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Forensic Toxicology and Drug Analysis
- Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
- Keywords
- psychedelics, psilocybin, lysergic acid diethylamide, mescaline, psychedelic-assisted psychotherapy, unipolar mood disorders, alcoholism, adverse events, psychosis risk
- MeSH terms
- Animals, Mental Disorders, Clinical Trials as Topic, Hallucinogens, Humans, Psychiatry
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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