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Psychiatry & the psychedelic drugs. Past, present & future
James J H Rucker1, Jonathan Iliff2, David J Nutt3
1The Institute of Psychiatry, Psychology & Neuroscience, King's College London, 16 De Crespigny Park, London, SE5 8AF, United Kingdom; South West London & St George's Mental Health NHS Trust, Glenburnie Road, London, SW17 7DJ, United Kingdom; Centre for Psychiatry, Division of Brain Sciences, Imperial College London, Burlington Danes Building, Hammersmith Campus, 160 Du Cane Road, London, W12 0NN, United Kingdom.
Neuropharmacology
|December 29, 2017
Summary
Classical psychedelics show promise for treating psychoneurotic disorders, with low adverse events. Despite legal hurdles, recent trials suggest safety and efficacy for conditions like mood disorders and alcoholism.
Area of Science:
- Psychiatry and Psychopharmacology
- Neuroscience
- Clinical Psychology
Background:
- Classical psychedelics (psilocybin, LSD, mescaline) were used in psychiatry before 1967.
- Pre-1967 research indicated psychedelics are unsuitable for psychotic disorders but may benefit 'psychoneurotic' conditions.
- Early studies were suboptimal, but recent reviews suggest efficacy for mood disorders and alcoholism.
Purpose of the Study:
- To review clinical trials of psychedelics before and after their prohibition.
- To discuss methodological challenges in psychedelic research.
- To consider strategies for overcoming legal and regulatory barriers to psychedelic medicine licensing.
Main Methods:
- Systematic review of pre- and post-prohibition clinical trials.
- Analysis of randomized controlled trials and pilot studies.
- Discussion of methodological and regulatory challenges.
Main Results:
- Classical psychedelics are not indicated for psychotic disorders.
- Psychedelics may help 'psychoneurotic' disorders by loosening maladaptive patterns in a therapeutic setting.
- Recent trials (since 2006) show promising safety and efficacy for non-psychotic psychiatric disorders, particularly psilocybin.
Conclusions:
- Psychedelics demonstrate potential as treatments for certain psychiatric conditions.
- Significant legal and regulatory obstacles impede the licensing of psychedelics as mainstream psychiatric medicines.
- Further high-quality research and strategic navigation of regulatory pathways are essential for clinical integration.
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