Contemplating versus having used psychedelics in bipolar disorder - What makes the difference?

In recent years psychedelics have gained popularity and potential promise in the field of mental health, but for patients diagnosed with bipolar disorder (BD), fears of emerging manic or psychotic symptoms have caused investigators to exclude them from psychedelic research. In this observational study, we explore the motivations, expectations, and personality characteristics of individuals with BD who have either used (i.e., experimenters) a classic psychedelic (i.e., psilocybin, LSD) or were considering using (i.e., contemplators) in the near future. We compared so-called experimenters to contemplators across various sociodemographic, psychological, and mental health variables. The groups did not differ in socio-demographic variables or mental health, however, experimenters demonstrated more positive attitudes towards psychedelics and more 'openness to experience.' Furthermore, certain motives for use were more strongly endorsed while contemplators expressed concerns about potential negative effects and outcomes. These findings highlight that previous psychedelic experience is associated with more positive perceptions and motivations for use, which might have also been shaped by the actual experience. While we do not advocate for unsupervised use of psychedelics outside of a clinical setting, the study provides some information what areas need to be discussed with individuals with BD who contemplate using psychedelics, even in the context of a clinical trial.