This review article (2018) looks at the pre- and post-prohibition clinical studies on psychedelics and offers strategic advice on the legal and regulatory hurdles.
Abstract of Psychiatry & the psychedelic drugs. Past, present & future
“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.”
Authors: James J. H. Rucker, Jonathan Iliff & David J. Nutt
Summary of Psychiatry & the psychedelic drugs. Past, present & future
Psychedelics were used long before the Western world was introduced to them in 1897. Carbon-dated buttons of peyote cacti and red beans containing mescaline were found in caves used for human habitation in the north eastern region of Mexico.
LSD was first synthesized in 1938 by Albert Hofmann as part of a systematic investigation of compounds derived from the ergot alkaloids at the Sandoz laboratories in Switzerland. It was subsequently shelved, but Hofmann resynthesized LSD in 1943 and accidentally ingested 250 mcg 3 days later. Sandoz found that LSD was a non-toxic compound, and marketed it under the trade name Delysid. Hofmann isolated the active component of psilocybe ‘magic’ mushrooms, and marketed it under the brand name Indocybin.
At a time when psychiatry lacked effective medical therapies, the discovery of LSD was of interest. It was thought to have therapeutic potential in patients with non-psychotic mental health problems, and had a low risk of toxicity.
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Psychiatry & the psychedelic drugs. Past, present & future
https://doi.org/10.1016/j.neuropharm.2017.12.040
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Cite this paper (APA)
Rucker, J. J., Iliff, J., & Nutt, D. J. (2018). Psychiatry & the psychedelic drugs. Past, present & future. Neuropharmacology, 142, 200-218.