Psychedelic

There are many different kinds of psychedelics. Some occur naturally, in trees, vines, seeds, fungi and leaves. Others are made in laboratories.2 They come in many forms including tablets, blotter paper, dried mushrooms, powders and crystalline powders.

Psychedelic

Mixing psychedelics with stimulant drugs increases the stimulant effect and can further increase heart rate and place the body under extreme stress. Stimulants can also increase anxiety which can lead to a negative experience.10

Located at Mount Sinai and the James J. Peters Department of Veterans Affairs Medical Center, the Center for Psychedelic Psychotherapy and Trauma Research examines the therapeutic potential of psychedelic compounds for post-traumatic stress disorder (PTSD) and other trauma-related symptoms.

Our Center is initially focusing on MDMA-assisted psychotherapy and psilocybin but will expand to studying psychedelic-assisted therapy with other compounds. Using clinical trials, computational genetics, molecular biology, blood samples, and neuroimaging, we hope to accelerate understanding of how MDMA and psilocybin work. We will also hold clinical trainings for therapists in anticipation of FDA approval and lead public and scientific education, including a monthly lecture series.

Recently, psychedelic drugs have once again taken popular culture by storm. From the psychedelic startup companies newly forming on Wall Street to a recent New York Timesarticle that claims "psychedelic drugs are closer to medicinal use," it seems that there is a renewed media and medical interest in acid (LSD), mushrooms (psilocybin), ecstasy (MDMA), ayahuasca, DMT (dimethyltryptamine), and ketamine.

There is also great interest in the use of psychedelic medicines in hospice/end of life care. These medications can help people overcome their fear of death, and can help make the process of dying a more meaningful and spiritual experience.

Some of these drugs, such as MDMA, are considered to be potential drugs of misuse, given the euphoria they can cause. Possible adverse effects of some psychedelics could include dizziness, drowsiness, extreme dissociation from reality, panic attacks, and nausea. Their illegality makes them more dangerous, and people using street drugs can suffer medical complications from taking contaminated drugs.

Despite their burgeoning promise in the field of psychiatry, psychedelic drugs are not yet considered to be mainstream medicine, and their use is still largely condoned only in experimental or monitored settings. These substances can cause severe impairment and should not be used without a guide who is not under the influence, who can provide calming support and/or call for help if someone is having a bad trip or an adverse reaction.

On the plus side, for the conditions described above, they present a novel and incredibly promising treatment avenue for some of the most difficult-to-treat psychiatric conditions, such as PTSD or treatment-resistant depression. With proper supervision, they are relatively safe. Some patients say the experience of psychedelics can truly be life-altering. This is thought to be in part because the use of psychedelics frequently helps people to experience what is best described as mystical experiences, and that these experiences have been associated with improved outcomes.

SACRAMENTO - Senator Scott Wiener (D-San Francisco) introduced Senate Bill 58, to decriminalize the possession and personal use of certain psychedelic drugs. SB 58 is backed by a broad coalition, including combat veterans.

SB 58 is sponsored by Heroic Hearts Project, a veteran service organization. Heroic Hearts connects veterans to psychedelic therapy for treating complex trauma. In the past few years, Heroic Hearts has become an international voice for veterans demanding effective mental health treatment options.

The most famous--or notorious--of the psychedelic drugs is LSD, a compound that can be obtained from various mushrooms and other fungi but is usually created in the lab. The other well-known psychedelics are psilocybin (likewise obtained from fungi) and mescaline (obtained from peyote cactus). How psychedelics produce their effects is still fairly mysterious, partly because research ceased for almost 20 years because of their reputation, but scientists are determined to find the answers and much research is now under way. Psychedelics are now used to treat anxiety in patients with cancer, and are being tested in the treatment of such serious conditions as severe depression, alcoholism, and drug addiction.

A Washington, D.C., resident has an operation growing psilocybin mushrooms. Brain researchers are increasingly studying psychedelic compounds like psilocybin and LSD as potential treatments for anxiety, depression and other disorders. Jahi Chikwendiu/The Washington Post via Getty Images hide caption

"When people have been through a psychedelic experience in my lab, they say, 'Wow this was amazing, this was just a fantastic experience,'" she says. "And you ask them, 'Well, would you like to come back next week for another session?' They say, 'Thank you, but no thank you.' "

That has led to some large studies of psychedelics, including one published in The New England Journal of Medicine in November showing that psilocybin helped people with major depression who hadn't been helped by other treatments.

But the effects found in large studies of psychedelics have been much less dramatic than in some of the earlier, smaller studies, Gordon says. Also, he says, some companies hoping to market psychedelics have overstated their benefits.

The Center for Psychedelic Research and Therapy at Dell Medical School at The University of Texas at Austin aims to advance the application of psychedelics for the treatment of mental health disorders through impactful clinical research.

The center pursues research to develop clinical decision-making tools that assist clinicians to better psychedelic-assisted therapy, from treatment selection to administration. This includes the identification of biological markers of treatment response and the development of artificial intelligence-based or machine-learning approaches to individualized prediction.

With the goal of developing more effective forms of treatment and discovering breakthroughs, the center investigates the mechanisms that underlie the therapeutic effects of psychedelic-assisted therapies across levels and processes, including brain function and structure, neuroendocrine signaling, neuroimmune signaling, inflammation, epigenetics, and psychological and neuropsychological domains.

The center contributes to the improvement of mental health in the Austin and greater Central Texas community by affording eligible individuals access to psychedelic-assisted therapies through clinical research studies.

The center contributes to educating both the public as well as aspiring and practicing mental health professionals regarding the latest scientific advances and practical applications of psychedelics for mental health purposes.

The workshop covered the mechanistic understanding of how different psychedelic compounds act and whether perceptual and therapeutic effects might be separated. Clinical study data was presented to understand the current state of understanding of their mode of action and the signs of efficacy seen in trials conducted to date with different patient populations. Those trials highlighted some of the promise of these agents but also the challenge of overcoming confounds in demonstrating clinical therapeutic efficacy of psychedelics. How one might design clinical trials to investigate the safety and efficacy of psychedelic agents to the satisfaction of drug regulatory agencies was then discussed, as was how the settings under which the drugs are administered influences the therapeutic outcomes. Finally, the workshop looked forward to a hypothetical future and the ethical, financial, and practical considerations that might delimit the use of a psychedelic medicine.

Researchers discuss the results from clinical trials testing psychedelics as therapeutics for serious mental illnesses, and substance, or alcohol use disorders. The speakers consider what they have learned with regards to safety and efficacy of the compounds, but also outline the confounds they encountered in conducting the research and how they addressed the issues.

Presenters clarify the role and impact of psychotherapeutic conditions on psychedelic clinical trial outcomes. They also detail the confounds presented by trying to conduct efficacy research with such highly perceptible agents. Whether vulnerable populations should be included in clinical trials is also considered as is how an approved psychedelic drug would be used if approved. An FDA physician-scientist also considers these questions from a regulatory standpoint, discusses potential trial designs that might be used to demonstrate efficacy, and outlines strategies that could be employed to ensure safe use.

Plant-based psychedelics, such as psilocybin, have an ancient history of medicinal use. After the first English language report on LSD in 1950, psychedelics enjoyed a short-lived relationship with psychology and psychiatry. Used most notably as aids to psychotherapy for the treatment of mood disorders and alcohol dependence, drugs such as LSD showed initial therapeutic promise before prohibitive legislature in the mid-1960s effectively ended all major psychedelic research programs. Since the early 1990s, there has been a steady revival of human psychedelic research: last year saw reports on the first modern brain imaging study with LSD and three separate clinical trials of psilocybin for depressive symptoms. In this circumspective piece, RLC-H and GMG share their opinions on the promises and pitfalls of renewed psychedelic research, with a focus on the development of psilocybin as a treatment for depression.

Plant-based psychedelics have been used for hundreds if not thousands of years for holistic healing (Hofmann, 1980) and there remains an active culture of self-medication with psychedelics for mental health (Carhart-Harris and Nutt, 2010; Waldman, 2017). Contrary to the alarmist campaigning that so negatively affected perceptions of psychedelics after the 1960s, subjective (Carhart-Harris and Nutt, 2010, 2013; van Amsterdam et al, 2015), naturalistic/observational (Bouso et al, 2012), and population-based data (Hendricks et al, 2015) indicate a positive association between psychedelic drug use and mental health, albeit with some important caveats, which will be discussed below. 041b061a72