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LSD psychosis or LSD-induced schizophrenia?

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Abstract

• We studied whether patients hospitalized for LSD psychosis are clinically separable from acute schizophrenics. The family histories, manifest symptoms, premorbid adjustment, and profiles on an extensive test battery were analyzed for 52 LSD psychotics and 29 matched first-break schizophrenics. The LSD patients did not differ from schizophrenics in incidence of psychosis or suicide among the parents. However, the rate of parental alcoholism for LSD psychotics far exceeded that for schizophrenics and the general population. The two groups were distinguished on some clinical features but were equivalent in premorbid adjustment, on most cognitive measures when initially hospitalized or reassessed three to five years later, and in number of subsequent rehospitalizations. Thus, in most respects the LSD psychotics were fundamentally similar to schizophrenics in genealogy, phenomenology, and course of illness. The findings supported a model of LSD psychosis as a drug-induced schizophreniform reaction in persons vulnerable to both substance abuse and psychosis.

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... Of these, 4,980 were rejected after title and abstract screening for not dealing with the effects of SPs on neuropsychological functioning, leaving 421 articles for full-text screening. After subsequent full-text screening, a total of 13 studies were left for inclusion in the systematic review (Cohen and Edwards, 1969;McGlothlin et al., 1969;Wright and Hogan, 1972;Culver and King, 1974;Matefy et al., 1979;Vardy and Kay, 1983;Grob et al., 1996;Doering-Silveira et al., 2005b;Halpern et al., 2005;Bouso et al., 2012Bouso et al., , 2015Barbosa et al., 2016;Kaasik and Kreegipuu, 2020). Five of these articles met the criteria for inclusion in the meta-analysis (Grob et al., 1996;Doering-Silveira et al., 2005b;Halpern et al., 2005;Bouso et al., 2012;Barbosa et al., 2016). ...
... All included studies were cross-sectional studies, comparing cohorts of users of SPs (n 539) to various groups of non-users. Five of the selected studies investigated the effects of repeated LSD use (n 101) (Cohen and Edwards, 1969;McGlothlin et al., 1969;Wright and Hogan, 1972;Culver and King, 1974;Vardy and Kay, 1983), six explored the effects of ayahuasca (n 343) (Grob et al., 1996;Doering-Silveira et al., 2005b; Frontiers in Pharmacology | www.frontiersin.org September 2021 | Volume 12 | Article 739966 2012, 2015; Barbosa et al., 2016;Kaasik and Kreegipuu, 2020), one dealt with peyote users (n 61) (Halpern et al., 2005), and one study did not specify which SPs had been used by the participants (n 34) (Matefy et al., 1979). ...
... Visuospatial and perceptual abilities were evaluated using eleven different tests (the Rey-Osterrieth Complex Figure task (ROCF), the Minnesota Percepto-Diagnostic Tests, the Porteus Maze, the embedded figures task, a map-reading task, the WAIS picture completion task, the Bender-Gestalt test, the Benton test, and the tactual performance, spatial orientation hidden pattern, and cube comparison subtests from the Halstead-Reitan battery (HR)) in eight studies (Cohen and Edwards, 1969;McGlothlin et al., 1969;Wright and Hogan, 1972;Culver and King, 1974;Vardy and Kay, 1983;Doering-Silveira et al., 2005b;Halpern et al., 2005;Barbosa et al., 2016). Overall, 232 SP users were included (70 ayahuasca, 61 peyote, 101 LSD) and compared to 246 non-users. ...
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Background: Serotonergic psychedelics (SPs) like LSD, psilocybin, DMT, and mescaline are a heterogeneous group of substances that share agonism at 5-HT 2a receptors. Besides the ability of these substances to facilitate profoundly altered states of consciousness, persisting psychological effects have been reported after single administrations, which outlast the acute psychedelic effects. In this review and meta-analysis, we investigated if repeated SP use associates with a characteristic neuropsychological profile indicating persisting effects on neuropsychological function. Methods: We conducted a systematic review of studies investigating the neuropsychological performance in SP users, searching studies in Medline, Web of Science, embase, ClinicalTrials.gov, and EudraCT. Studies were included if they reported at least one neuropsychological measurement in users of SPs. Studies comparing SP users and non-users that reported mean scores and standard deviations were included in an exploratory meta-analysis. Results: 13 studies (N 539) published between 1969 and 2020 were included in this systematic review. Overall, we found that only three SPs were specifically investigated: ayahuasca (6 studies, n 343), LSD (5 studies, n 135), and peyote (1 study, n 61). However, heterogeneity of the methodological quality was high across studies, with matching problems representing the most important limitation. Across all SPs, no uniform pattern of neuropsychological impairment was identified. Rather, the individual SPs seemed to be associated with distinct neuropsychological profiles. For instance, one study (n 42) found LSD users to perform worse in trials A and B of the Trail-Making task, whereas meta-analytic assessment (5 studies, n 352) of eleven individual neuropsychological measures indicated a better performance of ayahuasca users in the Stroop incongruent task (p 0.03) and no differences in the others (all p > 0.05). Conclusion: The majority of the included studies were not completely successful in controlling for confounders such as differences in non-psychedelic substance use between SP-users and non-users. Our analysis suggests that LSD, ayahuasca and peyote may have different neuropsychological consequences associated with their use. While LSD users showed reduced executive functioning and peyote users showed no differences across domains, there is some evidence that ayahuasca use is associated with increased executive functioning.
... 1 Other similarities include distorted perception of senses, time, space, self, and body, thought disturbances, perceived loss of control (Bercel, Travis, Olinger, Dreikurs, & Polos, 1956;Carhart-Harris et al., 2016;Gouzoulis-Mayfrank et al., 1998Osmond & Smythies, 1952;Rinkel, Hyde, Solomon, & Hoagland, 1955;Vardy & Kay, 1983;Young, 1974), reduced organization and adjustment of behavior (Bercel et al., 1956;Rinkel et al., 1955;Savage & Cholden, 1956), impaired cognition (attention, concentration, inhibition), disorganized language (Carter et al., 2005;Krus, Wapner, Freeman, & Casey, 1963;Sanz et al., 2021;Sloane & Doust, 1954;Spitzer et al., 1996) and several neurophysiological parameters (Carhart-Harris et al., 2013;Carter et al., 2007;Heekeren et al., 2008;Hermle et al., 1992;Quednow, Kometer, Geyer, & Vollenweider, 2012;Schmid et al., 2015;Vollenweider, Csomor, Knappe, Geyer, & Quednow, 2007;Vollenweider et al., 1997). Most studies compared psychedelic effects in healthy subjects to experiences of patients with psychotic disorders (Bercel et al., 1956;Bowers & Freedman, 1966;Carhart-Harris et al., 2016;Cohen, 1962Cohen, , 1966Gouzoulis-Mayfrank et al., 1998Guttmann, 1936;Klüver, 1928;Middlefell, 1967;Osmond & Smythies, 1952;Rinkel et al., 1955;Savage & Cholden, 1956;Vardy & Kay, 1983;Young, 1974). ...
... 1 Other similarities include distorted perception of senses, time, space, self, and body, thought disturbances, perceived loss of control (Bercel, Travis, Olinger, Dreikurs, & Polos, 1956;Carhart-Harris et al., 2016;Gouzoulis-Mayfrank et al., 1998Osmond & Smythies, 1952;Rinkel, Hyde, Solomon, & Hoagland, 1955;Vardy & Kay, 1983;Young, 1974), reduced organization and adjustment of behavior (Bercel et al., 1956;Rinkel et al., 1955;Savage & Cholden, 1956), impaired cognition (attention, concentration, inhibition), disorganized language (Carter et al., 2005;Krus, Wapner, Freeman, & Casey, 1963;Sanz et al., 2021;Sloane & Doust, 1954;Spitzer et al., 1996) and several neurophysiological parameters (Carhart-Harris et al., 2013;Carter et al., 2007;Heekeren et al., 2008;Hermle et al., 1992;Quednow, Kometer, Geyer, & Vollenweider, 2012;Schmid et al., 2015;Vollenweider, Csomor, Knappe, Geyer, & Quednow, 2007;Vollenweider et al., 1997). Most studies compared psychedelic effects in healthy subjects to experiences of patients with psychotic disorders (Bercel et al., 1956;Bowers & Freedman, 1966;Carhart-Harris et al., 2016;Cohen, 1962Cohen, , 1966Gouzoulis-Mayfrank et al., 1998Guttmann, 1936;Klüver, 1928;Middlefell, 1967;Osmond & Smythies, 1952;Rinkel et al., 1955;Savage & Cholden, 1956;Vardy & Kay, 1983;Young, 1974). Interestingly, a number of studies even administered psychedelics to patients with, or people with predisposition to, schizophrenia. ...
Article
Background For a century, psychedelics have been investigated as models of psychosis for demonstrating phenomenological similarities with psychotic experiences and as therapeutic models for treating depression, anxiety, and substance use disorders. This study sought to explore this paradoxical relationship connecting key parameters of the psychotic experience, psychotherapy, and psychedelic experience. Methods In a randomized, double-blind, placebo-controlled, crossover design, 24 healthy volunteers received 50 μg d -lysergic acid diethylamide (LSD) or inactive placebo. Psychotic experience was assessed by aberrant salience (Aberrant Salience Inventory, ASI), therapeutic potential by suggestibility (Creative Imagination Scale, CIS) and mindfulness (Five Facet Mindfulness Questionnaire, FFMQ; Mindful Attention Awareness Scale, MAAS; Experiences Questionnaire, EQ), and psychedelic experience by four questionnaires (Altered State of Consciousness Questionnaire, ASC; Mystical Experiences Questionnaire, MEQ; Challenging Experiences Questionnaire, CEQ; Ego-Dissolution Inventory, EDI). Relationships between LSD-induced effects were examined. Results LSD induced psychedelic experiences, including alteration of consciousness, mystical experiences, ego-dissolution, and mildly challenging experiences, increased aberrant salience and suggestibility, but not mindfulness. LSD-induced aberrant salience correlated highly with complex imagery, mystical experiences, and ego-dissolution. LSD-induced suggestibility correlated with no other effects. Individual mindfulness changes correlated with aspects of aberrant salience and psychedelic experience. Conclusions The LSD state resembles a psychotic experience and offers a tool for healing. The link between psychosis model and therapeutic model seems to lie in mystical experiences. The results point to the importance of meaning attribution for the LSD psychosis model and indicate that psychedelic-assisted therapy might benefit from therapeutic suggestions fostering mystical experiences.
... Around this time, Wilson's auditory hallucinations also started worsening, until by 1969 they had all the characteristics recognisable in his contemporary hallucinations (namely those of accusations and threats in the second-person, making liberal reference to the devil). Though Wilson indulged in LSD far less than other drugs he used (various sources stating that he took it no more than three times), it would seem foolish to discount the role the substance played in his mental degradation post-1965, especially in light of circumstantial evidence of similarities between LSD psychosis and actual psychosis (Young 1974; Vardy & Kay, 1983) and more explicit findings that LSD presents a significant independent risk for psychosis in predisposed individuals (Abraham & Aldridge, 1993; Vardy & Kay, 1983). Furthermore, only the truly cynical would discount its additional effects on his creative exploits. ...
... Around this time, Wilson's auditory hallucinations also started worsening, until by 1969 they had all the characteristics recognisable in his contemporary hallucinations (namely those of accusations and threats in the second-person, making liberal reference to the devil). Though Wilson indulged in LSD far less than other drugs he used (various sources stating that he took it no more than three times), it would seem foolish to discount the role the substance played in his mental degradation post-1965, especially in light of circumstantial evidence of similarities between LSD psychosis and actual psychosis (Young 1974; Vardy & Kay, 1983) and more explicit findings that LSD presents a significant independent risk for psychosis in predisposed individuals (Abraham & Aldridge, 1993; Vardy & Kay, 1983). Furthermore, only the truly cynical would discount its additional effects on his creative exploits. ...
Article
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The suggestion of a relationship between creativity and mental disorder has existed for centuries, and has been advocated by many psychological researchers. The present analysis offers a consideration of the nature of mental disorder present in Brian Wilson, an individual recognised as one of the most creative figures in 20th century popular music. Using converging biographical evidence, and the diagnostic program Opcrit, Wilson’s diagnosis is concluded to be schizoaffective. Employing details of his drug abuse, various models of schizoaffective spectra are examined, in particular a reconsideration of the LSD model of schizophrenia. The model is shown to be useful for positive schizophrenic symptoms including overinclusion, a potentially key element of creativity. In doing so, this psychobiographical analysis allows examination of potential relationships between mental disorder and creativity, the effects of various narcotics on creativity and various elements of mental disorder, the efficacy of various drug models of psychotic disorders, and the overlap between psychotic and affective disorders.
... An early second generation neuroleptic drug, risperidone, was suggested to have significant benefits compared to first generation neuroleptic drugs [12] which were presumed to be due, at least in part, to its ability to antagonise the serotonin 2A receptor [13] . The clinical benefit obtained by risperidone, added to the observation that drugs such as lysergic acid diethylamide could cause psychotic symptoms by stimulating the serotonergic system [14] , became the evidence to support the serotonin hypothesis of schizophrenia. ...
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Schizophrenia is a psychiatric disorder affecting approximately 1% of the population worldwide and is characterised by the presence of positive and negative symptoms and cognitive deficits. Whilst current therapeutics ameliorate positive symptoms, they are largely ineffective in improving negative symptoms and cognitive deficits. The cholinergic neurotransmitter system heavily influences cognitive function and there is evidence that implicates disruption of the central cholinergic system in schizophrenia. Historically, targeting the cholinergic system has been impeded by poor selectivity leading to intolerable side effects warranting the need to develop more targeted therapeutic compounds. In this review we will summarise evidence supporting the roles of the cholinergic system, particularly the muscarinic M1 receptor, in the pathophysiology of schizophrenia and discuss the potential of a promising new class of candidate compounds, allosteric ligands, for addressing the difficulties involved in targeting this system. The body of evidence presented here highlights the dysfunction of the cholinergic system in schizophrenia and that targeting this system by taking advantage of allosteric ligands is having clinically meaningful effect on cognitive deficits.
... Of particular note, LSD-induced psychotic symptoms were more pronounced in 18 out of 20 relatives of schizophrenics [24], suggesting that persons with a greater genetic predisposition to schizophrenia are more susceptible to an LSD-induced psychotic response, as likewise suggested by studies of cannabis [25,26]. In keeping with these results, Vardy and Kay [27] suggested that LSD-induced psychosis was a drug-induced schizophreniform reaction, and that there was a greater response to LSD in individuals with a genetic predisposition to schizophrenia. ...
Article
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D-Lysergic Acid Diethylamide (LSD) is known for its hallucinogenic properties and psychotic-like symptoms, especially at high doses. It is indeed used as a pharmacological model of psychosis in preclinical research. The goal of this review was to understand the mechanism of action of psychotic-like effects of LSD. We searched Pubmed, Web of Science, Scopus, Google Scholar and articles’ reference lists for preclinical studies regarding the mechanism of action involved in the psychotic-like effects induced by LSD. LSD’s mechanism of action is pleiotropic, primarily mediated by the serotonergic system in the Dorsal Raphe, binding the 5-HT2A receptor as a partial agonist and 5-HT1A as an agonist. LSD also modulates the Ventral Tegmental Area, at higher doses, by stimulating dopamine D2, Trace Amine Associate receptor 1 (TAAR1) and 5-HT2A. More studies clarifying the mechanism of action of the psychotic-like symptoms or psychosis induced by LSD in humans are needed. LSD’s effects are mediated by a pleiotropic mechanism involving serotonergic, dopaminergic, and glutamatergic neurotransmission. Thus, the LSD-induced psychosis is a useful model to test the therapeutic efficacy of potential novel antipsychotic drugs, particularly drugs with dual serotonergic and dopaminergic (DA) mechanism or acting on TAAR1 receptors.
... Moreover, the population in which MDMA use is most prevalent (young adults) is also the one in which psychiatric disorders are most likely to develop, independent of drug use. Additional grounds for caution in interpretation are the absence of means of verifying or quantifying previous MDMA use (although this may now be feasible with hair drug analysis), and the fact that most MDMA users also use other psychoactive drugs such as cannabis, amphetamines , LSD and cocaine, which can themselves have psychiatric effects (Connell, 1958; Vardy and Kay, 1983; McGuire et al., 1994b). If MDMA use does lead to chronic symptoms, this may be more likely in subjects who are already predisposed to psychiatric disorders. ...
Article
Clinical case reports suggest that regular MDMA use can be associated with chronic psychiatric symptoms which persist after the cessation of drug use. Neuropsychological comparisons of regular MDMA users and controls also suggest that MDMA use may lead to memory deficits, with other cognitive processes relatively unaffected. This paper reviews these studies and discusses a number of methodological issues that impact on the interpretation of the findings. Methods for examining the biological effects of MDMA use in man are also outlined. Future research should clarify whether MDMA use has long term psychological effects, and if these are related to changes in central serotonergic function.
... Similarly, Krebs and Johansen (2013), using data from 2001 to 2004 from the National Survey on Drug Use and Health, found that psychedelic use was associated with a decreased likelihood of psychiatric symptoms. However, although psychedelics do not appear to evoke spontaneous mental illness or psychoses in otherwise healthy individuals, it has been proposed that they may precipitate these problems in predisposed individuals (Nichols, 2016;Vardy & Kay, 1983). Accordingly, the use of psychedelics with those who have a psychotic disorder or are at risk of developing one is typically considered one of their major contraindications (Cohen, 1985;Johnson et al., 2008). ...
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Although existential suffering is amongst the most devastating forms of distress experienced by many patients nearing the end-of-life, it is often unsatisfactorily addressed due to a paucity of effective interventions. However, both historic and recent studies of psychedelic-assisted psychotherapy have reported marked alleviation of this suffering. As such, this article seeks to advance the rationale for the use of psychedelic substances in the provision of psychedelic-assisted psychotherapy for patients nearing the end-of-life. It begins with an overview of the classic psychedelics and their application in psychotherapy, highlighting recent studies. This is followed with a conceptual overview of existential suffering at the end-of-life and the process of self-transcendence. These sections are then integrated in a theoretical rationale for psychedelic-assisted mystical states as a means of facilitating the development of self-transcendence and, through it, the remediation of existential suffering. The paper concludes with a discussion of practical and philosophical considerations germane to the safe and ethical application of psychedelics in healthcare. In particular, developmental considerations for assessing both therapist and patient applicability in utilizing this modality are proposed.
... Similarly, Hendricks et al. (2015) utilized data from a nationally representative sample of the adult population in the United States (n ¼ 190,000) and found that classic psychedelic use was correlated with a significantly reduced likelihood of psychological distress, suicidal thinking, and suicide attempts, whereas the use of various other illicit substances was correlated with an increased likelihood of these outcomes. Although classic psychedelics do not appear to evoke spontaneous mental disturbances, it has been suggested that in some instances they may precipitate these problems in those predisposed to psychotic illness (Cohen, 1985;Nichols, 2016;Vardy & Kay, 1983). Thus, it is advised that individuals with a personal or familial history of psychotic disorders avoid the use of these substances. ...
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This article advances the proposition that contemporary perspectives on psychoactive drug use are epistemologically limited and that a broadened conceptualization of substance use would aid the development of more effective drug policy and education. It contends that psychoactive substance use cannot be accounted for from an exclusively pathological frame of reference and that by neglecting positive drug instrumentalization, opportunities to advance public health, safety, and well-being are being overlooked. Using the field of positive psychology as a point of comparison, this article thus argues for greater acknowledgment of, and research on, beneficial recreational substance use. The adaptive function of psychoactive drug use and the limitations of conceptual discourse which fails to distinguish between deleterious and salubrious use are first discussed. This is followed by an overview of the cartography of psychoactive drug use and consideration of biopsychosocial parameters germane to positive drug instrumentalization. The classic psychedelics are highlighted due to their psychopharmacological properties and tendency to evoke self-transcendent states. Limitations of regulatory and educational approaches grounded exclusively in the pathological paradigm are broached, with a discussion of how incorporating perspectives on positive drug use would complement extant models of prevention and harm reduction. Areas for future research are considered.
... The prevalence of schizophrenia is significantly higher in people with ASD compared to neurotypical individuals (Zheng et al., 2018). Since psychedelic use is associated with the development of psychosis in people with genetic predispositions (Breakey et al., 1974;Vardy and Kay, 1983), the risk of psychosis and schizophrenia must be carefully considered when assessing the potential adverse effects of psychedelic administration in this population. Altogether, although some therapeutic effects of psychedelics in children with ASD have been reported, the extended list of reported adverse effects demands caution. ...
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Recent clinical and preclinical evidence points towards empathogenic and prosocial effects elicited by psychedelic compounds, notably the serotonin 5-HT 2A agonists lysergic acid diethylamide (LSD), psilocybin, N,N-Dimethyltryptamine (DMT), and their derivatives. These findings suggest a therapeutic potential of psychedelic compounds for some of the behavioural traits associated with autism spectrum disorder (ASD), a neurodevelopmental condition characterized by atypical social behaviour. In this review, we highlight evidence suggesting that psychedelics may potentially ameliorate some of the behavioural atypicalities of ASD, including reduced social behaviour and highly co-occurring anxiety and depression. Next, we discuss dysregulated neurobiological systems in ASD and how they may underlie or potentially limit the therapeutic effects of psychedelics. These phenomena include: 1) synaptic function, 2) serotonergic signaling, 3) prefrontal cortex activity, and 4) thalamocortical signaling. Lastly, we discuss clinical studies from the 1960s and 70s that assessed the use of psychedelics in the treatment of children with ASD. We highlight the positive behavioural outcomes of these studies, including enhanced mood and social behaviour, as well as the adverse effects of these trials, including increases in aggressive behaviour and dissociative and psychotic states. Despite preliminary evidence, further studies are needed to determine whether the benefits of psychedelic treatment in ASD outweigh the risks associated with the use of these compounds in this population, and if the 5-HT 2A receptor may represent a target for social-behavioural disorders.
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This is the opening chapter and editors foreword of our 2008 book on Therapy with Psychoactive Substances. At that time we mainly focussed on the work of a Swiss group called the Schweizerische Ärztevereinigung für Psycholytische Therapie (SÄPT). Our qualitative and historical work about them was compemented by original texts from authors in the field. Since this is a highly divisive and strangely underresearched field the value of this book is to narrate historical practice and evidence and bring it into connection with beginning research at that time. In the year 2015 (when writing this abstract) things have changed dramatically. Neuroscience and even some therapy research with LSD, MDMA and other mind-opening drugs has begun at a number of University and even outside of the academic field.
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This is my main research chapter in our 2008 book on Therapy with Psychoactive Substances. At that time we mainly focussed on the work of a Swiss group called the Schweizerische Ärztevereinigung für Psycholytische Therapie (SÄPT). My qualitative and partly historical work about them resulted in a structured set of topics and "rules" that the therapists applied in their endeavour to conduct responsible and patient-centered psychotherapy with LSD, MDMA or psilocybin. The field was still very much developing when the Swiss Association for Psycholytic Medicine was able to legally practice this form of therapy. The text still provides very interesting insights into the challenges facing therapists and researchers when it comes to developing effective therapies with entactogenes and psychedelics. Since this is a highly divisive and strangely underresearched field the value of this book is to narrate historical practice and evidence and bring it into connection with beginning research at that time. In the year 2015 (when writing this abstract) things have changed dramatically. Neuroscience and even some therapy research with LSD, MDMA and other mind-opening drugs has begun at a number of University and even outside of the academic field. Die Professionalisierung Substanz-unterstützter Psychotherapie (SPT). Available from: https://www.researchgate.net/publication/265514154_Die_Professionalisierung_Substanz-untersttzter_Psychotherapie_(SPT)?fulltextDialog=true [accessed May 27, 2015].
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Purpose of Review With the continuous emergence of new psychoactive substances, drug checking (DC) services are challenged by an increasingly complex drug market. Considering the resumed scientific and public interest in serotonergic psychedelics (SPs) like LSD, psilocybin, and 2C-B, we present the results of a literature search investigating the presence and proportion of SPs in DC samples. Recent Findings In 15 identified reports, submission and detection rates of SPs were comparably low, but increasing. Samples contained considerable amounts of adulterations or analogues, mostly novel SPs with unknown toxicological profiles and in some cases potentially life-threatening effects. The detection of SPs, however, requires advanced analysis techniques currently not available to most DC services. Summary Given the substantial proportion of novel SPs in DC samples and the associated risks, DC can be a valuable harm reduction and monitoring tool for SPs if analysis techniques with high sensitivity are employed.
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Hallucinogens represent a promising but controversial treatment for substance use disorders. Research into their efficacy and clinical feasibility has been hampered, however, by legal, cultural, and political restrictions since the late 1960s, when many of these substances were criminalized. In light of these substantial limitations, this chapter evaluates what is known about the uses of hallucinogens in the treatment of substance use disorders. First, the neurobiological and psychoactive effects of hallucinogens are summarized. The relevance of these effects to therapeutic mechanisms is explored, with special attention given to recent findings that elucidate the prefrontal effects of hallucinogens. Set and setting are defined and discussed, and consideration is given to how the cultural use of hallucinogens, in developed as well as preindustrial societies, can inform how they might be used appropriately in medical settings. A variety of hallucinogen-oriented therapeutic strategies are reviewed, including behavioral, psychedelic, psychodynamic, and neurobiological models. A review of the available research subjects that while the therapeutic utility of hallucinogens may be highly promising, the evidence is far from conclusive. The chapter concludes with a discussion of future directions for research.
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Aims This article argues that despite a resurgence in research on psychedelics over the last two decades, we still have little insight into the psychedelics user population. Furthermore, there is currently little agreement between researchers as to the long-term mental health consequences of psychedelics use. Design In a methodological review of a range of studies in psychedelics use, it is demonstrated that these studies tend to focus on specific segments of the user population while excluding others. These population segments are probably connected to different patterns of use, which in turn are likely to result in different long-term consequences. Results The divergent findings on the consequences of psychedelics use may be explained, at least in part, by the fact that different research strategies explore different segments of the user population. Studies focusing on user segments with problematic usage patterns tend to find that psychedelics use is negative for mental health, while studies on infrequent users tend to find that psychedelics use is positive for mental health. Conclusion Because the field of psychedelics studies lacks a reliable model of the user population, it is difficult for researchers to contextualise and assess the broader validity of their findings. To remedy this situation, the article presents three theoretical models of the user population that afford us with tentative means of contextualising findings and thereby may clarify present disagreements.
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This article argues that despite a resurgence in research on psychedelics over the last two decades, we still have little insight into the psychedelics user population. Furthermore, there is currently little agreement between researchers as to the long-term mental health consequences of psychedelics use. In a review of a range of studies in psychedelics use, it is demonstrated that these studies tend to focus on specific segments of the user population while excluding others. These population segments are probably connected to different patterns of use, which in turn are likely to result in different long-term consequences. The article therefore suggests that the divergent findings on the consequences of psychedelics use may be explained, at least in part, by the fact that different research strategies explore different segments of the user population. Studies focusing on user segments with problematic usage patterns tend to find that psychedelics use is negative for mental health, while studies on infrequent users tend to find that psychedelics use is positive for mental health. Because the field of psychedelics studies lacks a reliable model of the user population, it is difficult for researchers to contextualize and assess the broader validity of their findings, and to remedy this situation, the article presents three theoretical models of the user population that afford us with tentative means of contextualizing findings and thereby may clarify present disagreements.
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Serotonerge Halluzinogene wie LSD und Psilocybin besitzen kein abhängigkeitserzeugendes Potenzial und zeigen eine niedrige Toxizität. Sie stehen jedoch im Verdacht, das Auftreten von Störungsbildern begünstigen zu können, die die akute Wirkung der Substanz überdauern oder erst verzögert auftreten. Zu diesen zählt vor allem die Gruppe der Flashbacks und der anhaltenden Wahrnehmungsstörung nach Einnahme von Halluzinogenen (HPPD), die in internationalen Klassifikationssystemen operationalisiert wird. In diesem Artikel konzeptuelle, klinische und epidemiologische Aspekte dieser Phänomene dargestellt, um einen Beitrag zur Einschätzung des Risikopotenzials dieser Substanzen geben zu können.
Chapter
Serotonerge Halluzinogene wie LSD und Psilocybin besitzen kein abhängigkeitserzeugendes Potenzial und zeigen eine niedrige Toxizität. Sie stehen jedoch im Verdacht, das Auftreten von Störungsbildern begünstigen zu können, die die akute Wirkung der Substanz überdauern oder erst verzögert auftreten. Zu diesen zählt vor allem die Gruppe der Flashbacks und der anhaltenden Wahrnehmungsstörung nach Einnahme von Halluzinogenen (HPPD), die in internationalen Klassifikationssystemen operationalisiert wird. In diesem Artikel konzeptuelle, klinische und epidemiologische Aspekte dieser Phänomene dargestellt, um einen Beitrag zur Einschätzung des Risikopotenzials dieser Substanzen geben zu können.
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Der Begriff Halluzination umfaßt eine Reihe von unter sich recht verschiedenen wahrnehmungsähnlichen Erfahrungsmodalitäten. Je nach dem Wachheits- und Bewußtseinszustand, in dem sie erlebt werden, können sie in ihrer Charakteristik variieren. Und ihre Bedeutung ist unterschiedlich nach dem biographischen, situativen und kulturellen Kontext ihres Auftretens. Unsere Kultur und mit ihr ihre Psychiater neigen vielfach zu einer vorschnellen Pathologisierung von halluzinationsähnlichen Erfahrungen und besonderen Bedeutungsgebungen. Dabei lehrt uns die Ethnopsychologie, die Religionsphänomenologie, die Erfahrung bei der Meditation, in nicht-pharmakologisch induzierten psychedelischen Zuständen veränderten Wachbewußtseins, daß der Mensch auch außerhalb der Psychopathologie ein viel größeres Spektrum wahrnehmungsähnlicher Erfahrungen erleben kann, als die westliche Zivilisation und das Normenwissen der Psychiater es wahrhaben wollen (Scharfetter 1982).
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The fundamental cause or causes of schizophrenia are unknown in a majority of cases. As accepted by most neurologists, developmental disorders include a diversity of developmental malformations and diseases acquired during the intrauterine period of life (Adams and Victor 1977). In contrast degenerative disorders include “an inexplicable decline from a previous level of normalcy to a lower level of function” (Adams and Victor 1977). A change in our understanding of the etiology of many genetic, metabolic, toxic, and nutritional disorders has changed the definition of some disorders formerly deemed degenerative to one or more of these designations. What about schizophrenia? Clinical and pharmacological data suggest that schizophrenia results from an imbalance between specific excitatory and inhibitory systems in specific brain regions that occurs most frequently but not exclusively during adolescence and young adult life (Stevens 2002).
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This chapter covers the variety of substances listed in Table 8.1, each of which can enhance sensory perceptions such as colors and sounds. However, the hallucinogens rarely produce schizophrenialike auditory hallucinations without insight in the context of a clear sensorium and, thus, are not truly “psychotomimetic.”1–4 In fact, when hallucinations do occur at high doses of these drugs, they are usually visual in nature, most often involving lights, colors, or geometric shapes, and the user is likely to understand (or have insight) into the relationship between the drug and the hallucinations.
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A study was carried out on a group of 95 schizophrenic patients (DSM-III-R criteria) under the age of 35, 23 of whom were cannabis abusers in the past year. The objective of the study was to evaluate the effect of cannabis on positive and negative schizophrenic symptoms, evaluated using Andreasen's Scales for the Assessment of Positive and Negative Symptoms (SAPS and SANS). There were no statistically significant differences between the groups on the SAPS; the group of cannabis abusers had higher scores except for the delusions subscale. On the SANS nonabusers scored higher, with a significant difference on the alogia subscale. The results suggest that the consumption of cannabis by schizophrenic patients could attenuate negative symptoms, which would support the self-medication hypothesis of cannabis abuse.
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