BookPDF Available




Sixteen articles by leading researchers document the evidence for the therapeutic applications of a wide range of psychedelics-- LSD, psilocybin, ayahuasca, ketamine, MDMA.
Michael Winkelman
and Ben Sessa, Editors
Advances in
Advances in Psychedelic Medicine
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Advances in Psychedelic Medicine
State-of-the-Art Therapeutic Applications
Michael Winkelman and Ben Sessa, Editors
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Copyright © 2019 by abc-clio, llc
All rights reserved. No part of this publication may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording, or otherwise, except for the inclusion of brief quotations
in a review, without prior permission in writing from the publisher.
Library of Congress Cataloging-in-Publication Data
Names: Winkelman, Michael, editor. | Sessa, Ben, editor.
Title: Advances in psychedelic medicine : state-of-the-art therapeutic applications /
Michael Winkelman and Ben Sessa, editors.
Description: Santa Barbara : ABC-CLIO, LLC, [2019] | Includes bibliographical
references and index.
Identifi ers: LCCN 2018053052 (print) | LCCN 2018053771 (ebook) |
ISBN 9781440864117 (ebook) | ISBN 9781440864100 (hardcover : alk. paper)
Subjects: | MESH: Mental Disorders—drug therapy | Hallucinogens |
Hallucinogens—therapeutic use
Classifi cation: LCC RC483 (ebook) | LCC RC483 (print) | NLM WM 402 |
DDC 616.89/18—dc23
LC record available at
ISBN: 978-1-4408-6410-0 (print)
978-1-4408-6411-7 (ebook)
23 22 21 20 19 1 2 3 4 5
This book is also available as an eBook.
An Imprint of ABC-CLIO, LLC
147 Castilian Drive
Santa Barbara, CA 93117
This book is printed on acid-free paper
Manufactured in the United States of America
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Acknowledgments ix
Chapter 1 Introduction: The Psychedelic Renaissance
Continues 1
Michael Winkelman and Ben Sessa
Part One Psychiatry 11
Chapter 2 Psychedelics and Psychiatry: A New Treatment
Model for the 21st Century 13
Charles S. Grob and Gary Bravo
Chapter 3 Therapeutic Applications of
3,4-methylenedioxymethamphetamine (MDMA) 38
Ben Sessa
Chapter 4 Psilocybin Therapy for Major Depressive Disorder 59
James JH Rucker
Chapter 5 Ketamine Therapy for Treatment-Resistant
Depression 81
L. Alison McInnes and Marc Ettensohn
Chapter 6 Evidence for the Therapeutic Effects of Ayahuasca 102
Dráulio Barros de Araújo
Part Two Substance Abuse 125
Chapter 7 Psilocybin for the Treatment of Substance
Use Disorders 127
Ishani Rao and Greg Lydall
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vi Contents
Chapter 8 Potential Applications of Cannabis and
Cannabinoids in the Treatment of Substance
Use Disorder and in Harm Reduction 148
José Carlos Bouso, Rafael G. dos Santos,
and Jaime Hallak
Chapter 9 Psychedelic Therapy as a Complementary
Treatment Approach for Alcohol Use Disorders 170
Peter Eischens and William Leigh Atherton
Part Three Medical Hypotheses 191
Chapter 10 Effects of Psychedelics on In ammation and
Immunity 193
Attila Szabo
Chapter 11 The Protective Role of Dimethyltryptamine against
Ischemia-Reperfusion Injury 214
Ede Frecska, Attila Kovacs, and Attila Szabo
Chapter 12 Psychedelic Treatment of Disruptive Personality
Patterns 232
Petr Winkler and Rita Ko cˇ árová
Part Four Treatment and Training 251
Chapter 13 Guidelines in Applying Psychedelic Therapies 253
Friederike Meckel
Chapter 14 Training Psychedelic Therapists 274
Janis Phelps
Part Five Societal Engagement with Psychedelics 295
Chapter 15 Community-Based Full-Spectrum Harm
Reduction Approaches When Caring for
Psychoactive- and Psychedelic-Related Problems
at a Transformational Festival 297
Maria Carmo Carvalho, Cristiana V. Pires,
Ana Luísa Costa, Daniel Martins, Helena Valente,
Inês Macedo, Paula Frango, and Raquel Lira
Chapter 16 Microdosing Psychedelics 318
James Fadiman and Sophia Korb
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Contents vii
Chapter 17 Bringing Psychedelics and Entactogens
into Mainstream Pharmaceuticals:
A Focus on MDMA 336
Anne C. Wagner, Michael C. Mithoefer,
and Rick Doblin
About the Editors and Contributors 357
Index 000
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The editors would like to thank our contributors for their work in bring-
ing to you a state-of-the-art understanding of the potential for the imme-
diate therapeutic applications of psychedelics. The editors thank Tom
Roberts for his perspicacity in recommending that Ben Sessa join the
project when he was committed to other publications. We also thank
Praeger/ABC-CLIO acquisitions editor Debbie Carvalko for her persis-
tence in asking for a sequel to Psychedelic Medicine: Volumes 1 and 2 . We
would also like to acknowledge the contributions of Arnold E. Ruoho,
Nicholas Cuzzi, and Charles Nichols as reviewers. Thanks also to Cindy
Winkelman for assistance in formatting the manuscript.
D e d i c a t i o n
This book is dedicated to the psychedelic scientist, the psyche-
delic explorer, the secret researcher, the daring therapist, the rebellious
patients, and all of humanity that is willing to open their eyes to evidence-
based science regarding psychedelics, and also to reclaiming a spiritual
and therapeutic heritage of humanity. Psychedelics have languished for
too long under the oppression of inquisitions, the persecution of shamans
and healers, and the postmodern assault of the draconian war on drugs.
We wish to change this situation by seeing psychedelics legally approved
and used as prescribed medicines, while also learning from and preserv-
ing their indigenous use around the world. It is in this spirit that we
dedicate this book to people in all walks of life who wish to lift the veils of
ignorance and see the great therapeutic and spiritual potential of psych-
edelics to change lives and heal the affl icted.
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Introduction to
in Psychedelic Medicine:
The Psychedelic Renaissance
Michael Winkelman and Ben Sessa
Following the groundbreaking success of Psychedelic Medicine: Volumes 1
and 2 (Winkelman & Roberts, 2007), it is with great pleasure that we
bring you Advances in Psychedelic Medicine: State-of-the-Art Therapeutic
Applications .
The words “psychedelic renaissance” have been used with increasing
frequency in recent years—with good reason. When Psychedelic Medicine
was released a decade ago, we were at the beginning of the new profes-
sional wave of interest in psychedelics heralding the “psychedelic renais-
sance” (Sessa, 2012/2017). The opening of research in the rst decade of
the 21st century made possible an evaluation of the therapeutic potential
of psychedelics, and we are now in the midst of a new understanding of
the potentials of psychedelics. The sheer volume of published papers on
psychedelics reviewed in the chapters here, and the growing number of
research institutions with active psychedelic research programs, attests to
this ongoing revolution.
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2 Advances in Psychedelic Medicine
Across the globe major neuroscientifi c and medical institutions are
now running psychedelic research programs, including Imperial College
London, Johns Hopkins University, New York University, University Col-
lege London, Oxford University, Harvard, University of California Los
Angeles, Cambridge University, Yale University, the Maudsley Institute,
Cardiff University, Kings College London, University of New Mexico, and
Bristol University, to name but a few. These are not fringe institutions.
Psychedelics are now at the cutting edge of contemporary psychophar-
macology and neuroscience. Not a month goes by without a major, high-
impact peer-reviewed medical or scientifi c journal publishing original
research on psychedelics. From the Lancet , the Journal of Psychopharma-
cology , Nature , Science , the British Journal of Psychiatry , the British Medical
Journal , the Journal of Addiction , Neuropharmacology , Frontiers in Neurosci-
ence , Frontiers in Psychiatry , Psychopharmacology , Archives of General Psy-
chiatry , Neuroscience Letters , Journal of Affective Disorders , the New Scientist ,
Journal of Psychoactive Drugs , PLOS One , Biological Psychiatry , and many
other peer-reviewed publications, we see a plethora of scienti c articles
establishing the positive effects of psychedelic medicines and an enthusi-
astic outpouring of interest and support for psychedelic drug studies and
treatments and their implications.
Given the worldwide prevalent use of psychedelics today and the rapid
increase in international psychedelic societies for professionals and the
interested public alike, we have begun to eclipse the initial impact of a
comparatively small—but nonetheless hugely infl uential—era during the
1960s when a cultural revolution inspired by psychedelics blossomed
brie y. Indeed, the advances in research over the last two decades are so
profound that the fame of the “psychedelic sixties” pales in comparison to
the immense biomedical knowledge we now have about psychedelic effects,
safe use, and medicinal applications that we present here in Advances in
Psychedelic Medicine .
Much has transpired since LSD and the other psychedelics were banned
in the late 1960s, resulting in a “dark agesof psychedelic research through
the 1970s and 1980s. But even those quiet decades were not completely
without psychedelic discovery, as clinical MDMA brie y emerged, only
to quickly sink again in political response to the party rave scene culture
that accompanied the introduction of MDMA to the public.
The History of the Renaissance
The path toward a psychedelic renaissance arguably may have begun
with Rick Strassman’s landmark DMT study at the University of New
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Introduction to Advances in Psychedelic Medicine 3
Mexico in the 1990s (Strassman, Qualls, Uhlenhuth, & Kellner, 1994).
While his studies were designed primarily to assess toxicology and dosage,
the phenomenological data of entering alien worlds, shared in his accounts
of the experience in DMT: The Spirit Molecule (Strassman, 2000), kept the
psychedelic community interested and engaged. Federally funded research
by the U.S. National Institute on Drug Abuse (NIDA) at the University of
Miami, School of Medicine on the toxicity of ibogaine (see the chapter
by Alper and Lotsof in Psychedelic Medicine: Vol. 2 ) provided another early
step. It was abortive, however, as NIDA withdrew funding for continued
research. Psychedelic research continued to emerge in the rst decade of
the 21st century when a research team at the University of Arizona evalu-
ated the use of psilocybin for treatment of obsessive-compulsive disorder
(OCD) (see Moreno and Delgado’s chapter in Psychedelic Medicine: Vol. 1 ).
Perhaps the new era of psychedelic research nally exploded into pub-
lic and professional consciousness with the publication of a study at the
Johns Hopkins University School of Medicine by Roland Griffi ths and col-
leagues. Their double-blind study (fi rst published in the journal Psychop-
harmacology ; also see Psychedelic Medicine: Vol. 2 ) showed that psilocybin
caused mystical types of experiences and lasting personality change, with
implications that have reverberated across anthropology, religious studies,
psychology, psychiatry, and other fi elds. Strassman’s “spirit molecule” was
obviously also a candidate for the genesis of religion, mysticism, shaman-
ism, and other noteworthy human achievements.
From there emerged a growing number of academic institutions inter-
ested in psychedelic research. Now the eld of psychedelic research is no
longer the preserve of a few scattered, esoteric institutions and New Age
communities, but has begun to emerge from the shadows of unregulated
and clandestine research to form part of the research programs at the top-
tier research universities mentioned above. This rapid growth of the eld
of psychedelic research refl ects multiple threads, including a new genera-
tion of young people—and politicians alike—who don’t even know the
name of Timothy Leary and the storm of media-driven antipsychedelic
backlash that brought down the fi eld of research in the late 1960s. Rather,
newcomers to the subject—both within and outside the psychedelic
community—are regarding these compounds with fresh, open-minded
approaches to their therapeutic potentials. Rather than Leary’s revolution-
ary call for a global chemical utopia to transform society, the emphasis
today is placed on taking an objective, evidence-based, scientifi c, and,
dare we say it, sober view of the potential benefi ts of these medicines for
treating some of the most recalcitrant problems faced by medicine and
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4 Advances in Psychedelic Medicine
An Overview of
Advances in Psychedelic Medicine
It is in the spirit of this objective approach that we present Advances in
Psychedelic Medicine . This book expands on the issues addressed in Psy-
chedelic Medicine: Volumes 1 and 2, but rather than an update to those ear-
lier chapters, it addresses new research, topics, and treatment areas that
have emerged in the past decade.
Psychiatric Applications of Psychedelics
Psychedelic Medicine: Volume 1 presented the evidence for psyche-
delic applications for a range of psychiatric disorders including OCD,
PTSD, depression, and end-of-life issues associated with terminal cancer.
Research on these and other topics has progressed considerably since then,
as documented in the overview in Chapter 2 by Charles Grob and Gary
Bravo on “Psychedelics and Psychiatry: A New Treatment Model for the
21st Century.” This places the resurgence of psychedelic research in his-
torical and clinical context, and shows evidence for successful treatment
of an expanded range of conditions, especially treatment-resistant depres-
sion. Their chapter also addresses some of the challenges that psychedelics
pose to the prevailing psychopharmacological paradigm of psychiatry, and
the importance of the shamanic traditions of using these substances and
the spiritual experiences that they induce.
At the time of presenting Volume s 1 a nd 2 , a treatment that had already
gained international fame was the use of MDMA for post-traumatic stress
disorder (PTSD). Here in Chapter 3 Ben Sessa provides an overview of the
important role of MDMA in addressing trauma in “Therapeutic Applica-
tions of 3,4-methylenedioxymethamphetamine (MDMA).” He looks at the
extended evidence for the effectiveness of MDMA not only for PTSD, but
also for the potential treatment of addictions.
Clinical depression represents a growing burden for societies and is often
diffi cult to treat with traditional psychiatric approaches. British psychia-
trist James Rucker reviews the mechanisms, rationale, and latest clinical
advances in psilocybin-assisted advances in Chapter 4, “Psilocybin Ther-
apy for Major Depressive Disorder. Rucker reviews the clinical trials for
psilocybin treatment of depression underway and randomized controlled
trials in preparation for Phase 3 evaluations. This evidence, combined with
neuroimaging work, is revealing the neurological dynamics underlying the
subjective dynamics of psychedelic experience and how these understand-
ings may contribute to an appreciation of the therapeutic mechanism that
may address the emotional and existential predicament presented by the
syndrome of depression.
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Introduction to Advances in Psychedelic Medicine 5
Since the publication of Psychedelic Medicine: Volumes 1 and 2 we have
seen a global expansion of the off-license use of ketamine, as well as
clinical studies of its use for addressing treatment-resistant depression.
Here studies assessing clinical effi cacy and mechanisms of actions are
described in Chapter 5 by L. Alison McInnes and Marc Ettensohn in
“Ketamine Therapy for Treatment-Resistant Depression.
This potential of psychedelics to provide effective treatment of depres-
sion is also attested to in Chapter 6 by Dráulio Barros de Araújo, who reviews
“Evidence for the Therapeutic Effects of Ayahuasca. De Araújo points
to a phenomenon virtually unheard of in pharmaceutical treatments
signifi cant and persistent effects from a single dosage.
Psychedelic Treatment of Addictions
The psychedelic treatment of addictions is closely connected with the
very beginnings of psychedelic therapies from the 1950s onward. This
topic was explored extensively in Psychedelic Medicine: Volume 2 , where
six chapters addressed programs and research on the treatment of addic-
tions using peyote, LSD, ketamine, ayahuasca, and ibogaine. Since then
new research has evaluated the effi cacy of psychedelics in the treatment
of addictions. Chapter 7, “Psilocybin for the Treatment of Substance Use
Disorders” by Ishani Rao and Greg Lydall, reviews research on the effi -
cacy of psilocybin in treating nicotine and alcohol disorders, as well as
reviewing best practices and probable mechanisms of effi cacy.
Chapter 8 by José Carlos Bouso, Rafael G. dos Santos, and Jaime Hal-
lak reviews research addressing “Potential Applications of Cannabis and
Cannabinoids in the Treatment of Substance Use Disorder and in Harm
Reduction.” Studies show the potential of this popular and broadly useful
drug in reducing various aspects of addiction to more serious and debili-
tating substances.
The broader application of psychedelics in the treatment of addictions
is addressed by Peter Eischens and William Leigh Atherton in Chapter
9 on “Psychedelic Therapy as a Complementary Treatment Approach for
Alcohol Use Disorders.” Their chapter concentrates specifi cally on alco-
hol addiction, providing a review of the mechanisms generally involved
in psychedelic resolution of substance abuse, and a range of ways that
psychedelics may help reduce the burden of addictions.
Medical Hypotheses
The applications of psychedelics for physical medicine were suggested
in Psychedelic Medicine: Volume 1 where Andrew Sewell and John Halpern
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6 Advances in Psychedelic Medicine
presented evidence regarding the effectiveness of psychedelics in the treat-
ment of the notoriously treatment-resistant cluster headaches. Advances in
Psychedelic Medicine presents additional evidence of psychedelic treatment
of physical problems in Chapter 10 where Attila Szabo reviews “Effects
of Psychedelics on Infl ammation and Immunity.” Szabo suggests novel
therapeutic possibilities for various pathologies from chronic infl amma-
tion and autoimmunity to infectious diseases and cancer.
Evidence for “The Protective Role of Dimethyltryptamine against
Ischemia-Reperfusion Injury” is addressed in Chapter 11 by Ede Frecska,
Attila Kovacs, and Attila Szabo. This extends previous insights (Frecska,
Szabo, Winkelman, Luna, & McKenna, 2013) that the evolutionary sig-
nifi cance of DMT (and by extension other psychedelics) is not that they
produce hallucinations, but rather that they are involved in basic meta-
bolic processes. The apparent release of DMT in response to trauma (i.e.,
near-death experiences, shamanic visions) may refl ect its effects in mini-
mizing the effects of both trauma and the physiological trauma responses
on the body and cells.
Psychedelic Medicine: Volume 2 reprinted the groundbreaking paper in
Psychopharmacology by Roland Griffi ths and colleagues that presented
evidence suggesting that psilocybin had the potential to induce spirit-
ual experiences and lasting personality change. Here Petr Winkler and
Rita Ko cˇ árová review further evidence for psychedelics’ ability to create
personality change in Chapter 12, “Psychedelic Treatment of Disruptive
Personality Patterns. They further propose that psychedelics can help
people in general improve their overall mental health and behavior.
Therapeutic Guidelines and Training
Therapeutic guidelines for the safe and effective application of psych-
edelics were previously addressed in Psychedelic Medicine: Volume 1. In one
chapter, Torsten Passie provided an overview of contemporary psycholytic
therapy, while in another, Ede Frecska surveyed the therapeutic guidelines
and contraindications for psychedelic therapy. And in Psychedelic Medi-
cine: Volume 2 further guidelines—including those strategies learned from
non-Western, shamanic traditions—were explored in chapters on “The
Ten L essons of Psyche del ic Ps ychotherap y” (Ne al Gold smith), Sham anic
Guidelines for Psychedelic Medicine” (Michael Winkelman), “Common
Processes in Psychedelic-Induced Psychospiritual Change” (Sean House),
and “A Psychoanalytic Approach to Psychedelic Therapy” (Dan Merkur).
Here in Chapter 13, “Guidelines in Applying Psychedelic Therapies,
Friederike Meckel provides the wisdom of her personal experience
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Introduction to Advances in Psychedelic Medicine 7
derived from her years of work as an underground psychedelic therapist.
Friederike provides an expansion and deepening of understanding of
the conditions required for the most effective therapy with psychedelics,
informed by her years of work in psychedelic group therapy.
In light of the hopefully imminent licensing of MDMA and psilocybin,
we are going to need thousands of newly trained psychedelic therapists
to deliver the new treatments when they become legally available. There
is therefore a growing need to develop a standardized and state-of-the-art
educational program to provide a regulated population of psychedelic cli-
nicians for the future. This will be especially important in coming years
as the eyes of the regulatory authorities that control the formal licens-
ing of psychedelics will be fi rmly—and appropriately—fi xed on the fi eld.
The contents and processes of the training developments are explored in
Chapter 14 by Janis Phelps, “Training Psychedelic Therapists.”
The Social Context of Psychedelic Therapy and Research
While the scientifi c applications of psychedelics as medicines have
largely remained stymied in the political apparatus of governmental regu-
latory agencies, the engagement of the populace with diverse psychedelics
and for diverse reasons has continued. This popular use of psychedelics
in the nonclinical population has grown, typifi ed in concerts, raves, and
festivals around the world. It is important to address the risks of this
unregulated and unsupervised use of psychedelics, given that crises
may emerge from numerous factors—including the drug-induced emer-
gence of unrecognized trauma, disorientation, overdose, and fraudulent
misrepresentation of substances. These risks have been in addressed
in worldwide efforts to reduce harms, particularly through the develop-
ment of crisis intervention services in public venues and the promotion
of harm-reduction approaches. Here these social engagements designed
to mitigate risks in psychedelic self-treatment are explored by Maria
Carmo Carvalho and her co-authors through a review of the guide-
lines for such programmatic development in Chapter 15, ”Community-
Based Full-Spectrum Harm Reduction Approaches When Caring for
Psychoactive- and Psychedelic-Related Problems in a Transformational
Advances in Psychedelic Medicine presents the continuation of the citi-
zen scientist, exemplifi ed in the psychedelic treatment of cluster head-
aches that was discovered not by medical researchers, but by a suffering
patient population. The role of the citizen scientist in expanding the
knowledge and application of psychedelics is illustrated here in the realm
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8 Advances in Psychedelic Medicine
of microdosing, which is covered in Chapter 16 by James Fadiman and
Sophia Korb, who discuss “Microdosing Psychedelics.”
And nally, as we appear to be on the verge of a new era in which,
within the next few years, psychedelics could become licensed as legal
prescription medicines, we nish with Chapter 17 by Anne Wagner,
Michael Mithoefer and Rick Doblin on “Bringing Psychedelics and Entac-
togens into Mainstream Pharmaceuticals: A Focus on MDMA. There is
currently an emerging debate from some fringe elements of the psyche-
delic community proposing that formal recognition of psychedelics as
licensed medicines will lead to a “corporatized” exclusivity of their use.
However, the reality is that by gaining formal acceptance by regulatory
authorities, accessibility to these medicines will be increased, not reduced,
to the many millions who could benefi t from them. The complex process
of formal drug development and regulation necessarily involves working
with incumbent regulatory organizations and frameworks. In this chap-
ter Wagner, Mithoefer, and Doblin describe the legal and administrative
challenges faced in seeking approval for psychedelic drugs research and
the impediments faced in transforming the drugs’ status as maligned and
demonized public enemies into sanctioned, safe, and effective medicines
for the future.
Diversity and Equality Going Forward
The contributors to this volume include many of the leading fi gures in
the fi eld, clinicians and scientists who approach their work with diligent
study and a dispassionate eye for scientifi c rigor. The readers of Advances in
Psychedelic Medicine —whether they are researchers, therapists, students, or
the general public—will receive a thorough appraisal of recent advances in
the treatments with psychedelics. Refl ecting the perspectives of clinicians,
researchers, and program administrators in the eld, the book presents
the latest advances in establishing the research base to take psychedelic
compounds into the mainstream of medicine and addresses issues such as
clinical effi cacy, safety, state-of-the-art therapeutic approaches, and mech-
anisms of action.
There is also a broader role that psychedelics have to play in today’s
hugely secular, diverse, and expanded global culture. No matter how much
science studies psychedelics, the spiritual element of the psychedelic expe-
rience remains. There are few subjects that so dramatically and effectively
span the disparate worlds of art, science, religion, and culture better than
psychedelics. And appropriately, the social sciences (as well as popular cul-
ture) have responded with an outpouring of literature that examines the
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Introduction to Advances in Psychedelic Medicine 9
implications of psychedelics for understanding the origins of religion and
spirituality, cultures and civilizations, healing, personal development, art
and inspiration. Psychedelics involve a complex merging of postmodern
medicine and a revitalization of the central premodern medicines of the
planet that have recently reentered global consciousness. This reemergence
has stimulated the examination of the clinical applications of ayahuasca,
ibogaine, and psilocybin as today’s clinicians explore the continued rele-
vance of millennial-old medicines for contemporary healing. These natural
psychedelics are being used as tools to augment psychotherapy for a wide
range of conditions, including biological disorders.
The renaissance of psychedelic medicines continues to reverberate
within society. Advances in Psychedelic Medicine supports the general pub-
lic’s interest in the therapeutic applications for psychedelic compounds by
providing concise summaries of the evidence that these medicines repre-
sent an innovative and much needed new approach to treat resistant men-
tal disorders. The medical applications of these substances have always
had an important hidden public arena, an area of substantial research,
exploration, and application that has not waited for the medical sciences,
and especially the regulatory agencies, to catch up. The citizen scientist
functions in these informal medical communities that use these currently
illegal treatments to address a variety of signifi cant physiological, psycho-
logical, and social problems.
And nally, there are, of course, many other areas in respect to psyche-
delics that we have not had the time or space to cover in Advances in Psyche-
delic Medicine that nevertheless require urgent academic and sociocultural
attention, especially the profound lack of gender and ethnic diversity
within the psychedelic research community; the growing concerns about
unregulated, underground psychedelic therapists; the dark side of sexual
predation; the damage to indigenous communities through unsolicited
drug tourism; and the ongoing topic of tackling restrictive drug prohibi-
tion laws that hamper research and impede efforts to address the global
problem of drug misuse. Topics for another day, perhaps, but certainly
worthy of ongoing scrutiny. In the meantime, we sincerely hope you enjoy
learning from this book as much as we have in putting it together.
Frecska, E., Szabo, A., Winkelman, M., Luna, L., & McKenna, D. (2013). A pos-
sibly sigma-1 receptor mediated role of dimethyltryptamine in tissue
protection, regeneration, and immunity. Journal of Neural Transmission ,
120 (9),1295–1303.
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10 Advances in Psychedelic Medicine
Sessa, B. (2012/2017). The psychedelic renaissance: Reassessing the role of psychedelic
drugs in 21st century psychiatry and society (2nd ed.). London: Muswell Hill
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... Neuroinflammation after stroke is responsible for both infarct expansion as well as remodeling and repair (8,9). Modulation of this inflammation is currently a target for new therapies. ...
... Though it has been known for at least 40 years that DMT is an endogenously produced hallucinogen, its physiologic function remains elusive. The lack of consensus may be due in part to a paradigm in which the scientific community has assumed DMT can only be, or primarily acts as, a hallucinogen, which keeps research focus on its psychologic effects at 5-HTRs, rather than its non-hallucinogenic effects (9). Recent experiments have shown that an additional receptor, S1R, is critical in the immunomodulating response of DMT. ...
... Classical psychedelics have millennia of historical use, do not have significant risk of dependence, and are safe to use under close medical supervision (79,80). Though there should be caution in over-interpreting the relevance of the aforementioned animal studies' relevance to human pathological states, this historical data should serve in effect as phase 0 and phase I studies (9). However, presumably much of this historical data is based on intermittent, infrequent dosing, so trial safety data may need to be repeated with continuous, regular doses. ...
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Objective: Stroke and traumatic brain injury (TBI) are among the leading causes of disability. Even after engaging in rehabilitation, nearly half of patients with severe TBI requiring hospitalization are left with major disability. Despite decades of investigation, pharmacologic treatment of brain injury is still a field in its infancy. Recent clinical trials have begun into the use of psychedelic therapeutics for treatment of brain injury. This brief review aims to summarize the current state of the science's relevance to neurorehabilitation, and may act as a resource for those seeking to understand the precedence for these ongoing clinical trials. Methods: Narrative mini-review of studies published related to psychedelic therapeutics and brain injury. Results: Recent in vitro, in vivo , and case report studies suggest psychedelic pharmacotherapies may influence the future of brain injury treatment through modulation of neuroinflammation, hippocampal neurogenesis, neuroplasticity, and brain complexity. Conclusions: Historical data on the safety of some of these substances could serve in effect as phase 0 and phase I studies. Further phase II trials will illuminate how these drugs may treat brain injury, particularly TBI and reperfusion injury from stroke.
... One group of largely illegal substances used for selfmedicative purposes are classic psychedelics (Kopra et al., 2023). This is unsurprising given that classic psychedelics have been shown in a growing number of studies to be both safe and effective at treating various mental health conditions including anxiety, trauma, and treatmentresistant depression (for a series of reviews, see Winkelman and Sessa, 2019). In cross-sectional studies of the U.S. general population, lifetime classic psychedelic use (i.e. ...
Rising international migration, paired with increasing public support for far-right political parties, poses a growing challenge to the countries tasked with successfully integrating immigrants into their society. Further complicating this matter is the fact that the acculturation process which immigrants undergo to fully integrate into their host society can be long, difficult, and taxing to their mental health, physical health, and sense of belonging. A better understanding of how the unique burdens faced by immigrants might be alleviated or more easily processed is therefore vital for the success of both immigrants and their host countries. Drawing on initial findings suggesting that classic psychedelics can help individuals process incidents of discrimination, make healthier decisions, and experience deeper feelings of connectedness to others, this literature review presents a roadmap for determining what classic psychedelics may offer immigrants, a large and rapidly growing international minority group.
... Overall, art therapy is recognized as an intervention that enhances the mind-body connection and, in turn, reduces the levels of physical and psychological stressors (Elimimian et al., 2020;Malchiodi, 2003Malchiodi, , 2020Newland et al., 2020). Mind-body-related interventions have been described in a wide range of health-related psychology disciplines, such as sports psychology (Henning Schöttke & Giabbiconi, 2015;Schöttke et al., 2020), medical psychology, and spiritual psychology (Lusebrink, 2010;Silverstone, 2009;Winkelman & Sessa, 2019). Therapeutic interventions include a wide range of activities: eye movement and desensitization, biofeedback, breathing, relaxation, sensory-motor cascade, folks' rituals, hypnosis, and meditation practices. ...
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Introduction Creative art therapy is a psychotherapeutic approach used to enhance the mental health status of patients. Objectives This study aimed to evaluate the effect of creative art therapy on the levels of depression, anxiety, and stress in Jordanian patients following stroke. Methods One-group pretest–posttest design was used; it included four sessions of creative art therapy which were conducted as two sessions for two weeks. This study recruited 85 participants who were within three months poststroke diagnosis. The Depression, Anxiety, and Stress Scale was used to assess the levels of psychological reactions pre and post creative art therapy intervention. Results The data showed that there was a statistically significant improvement in the levels of depression ( t = 37.98; p < .001), anxiety ( t = 20.59, p < .001), and stress ( t = 35.52, p < .001) post-intervention. There was a statistically significant improvement in the study-related psychological aspects following creative art therapy. Conclusion The findings of this study suggest that creative art therapy is a valuable method to complement other types of treatments among patients with stroke, resulting in positive patient mental health outcomes. Creative art therapy could be used as a psychotherapeutic approach to manage mental health complexities among patients with stroke. Health policymakers are invited to use the findings of this study to establish tailored counselor services using this new psychotherapeutic approach.
... The iatrogenic inflammation induced by periodontal techniques such as scaling and root planning may also be reduced with CBD. Although the precise pathway of inflammation reduction caused by CBD is still unclear, it is demonstrated that CBD causes either modulation or impediment of cytokines [12]. ...
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In recent years, there has been a surge in the awareness regarding the phyto cannabinoid; cannabidiol. Between the time period from 1963 to 2000, only 460 publications can be found in a PubMed search while using cannabidiol as the keyword. The former pales in comparison to the record of 2769 publications found from 2008 to the present time. However, a limited amount of literature is available that discusses the therapeutic potential of cannabidiol, pertaining to the field of dentistry. In 1940, cannabidiol was isolated from cannabis for the first time, its structure being reported much later in 1963. Further research on Cannabis resulted in the declaration that “THC” is the active compound. Subsequent studies were then directed essentially based on the virtual exclusion of cannabidiol and other cannabinoids from cannabis. This was primarily due to the belief that the activity of cannabis was merely psychological activity. In retrospect, this seems unfortunate as many of the beneficial properties of cannabidiol which might have had a therapeutic benefit were overlooked. In the present review, attention will be focused on the therapeutic potential of Cannabidiol and the impact this may have on dentistry with the supplemental vision of encouraging further studies to reveal any other beneficial properties that may be present.
... Thus, the connection with "psychedelic-assisted psychotherapy", which today results in articles about ketamine being published in collections alongside articles focussing on "classic psychedelics" (e.g. (Grob and Grigsby, 2021;Winkelman and Sessa, 2019)) was made early on. Furthermore, in the 1980s and 1990s, the use of ketamine for treating alcoholism, heroin-dependence, and anxiety was studied in Russia by Krupitsky and colleagues (Krupitsky et al., 2002;Krupitsky et al., 2007;Krupitsky and Grinenko, 1997). ...
The so-called “psychedelic renaissance” has stimulated expanded interest in several classes of drugs that appear to possess transdiagnostic effects in the treatment of mental health disorders, specifically. N-methyl-d-aspartate receptor (NMDAR) antagonists are one such class with diverse therapeutic potential. NMDARs mediate excitatory postsynaptic signalling in the central nervous system (CNS) and are integral to normal neurobiological processes including neuronal development, synaptic transmission, and plasticity, and thus involved in learning and memory. However, NMDAR hyper-function is also implicated in acute CNS trauma, neuropsychiatric and neurodegenerative disorders, as well as chronic pain. The complex structure of NMDARs permits several locations for therapeutic inhibition, making these receptors a potential target for multiple drugs which modulate them in different ways. NMDAR antagonists, which may be competitive, non-competitive, or uncompetitive, either block glutamate from binding the receptor or modulate the response to glutamate binding. Despite longstanding concerns about side effects of NMDAR antagonists, recent research suggests that, when appropriately used, these agents have favourable safety profiles. Furthermore, their fast-acting mechanism of action, resulting in rapid effects compared to other therapeutic agents, makes them a promising class of drugs that may yield effective therapeutics for multiple CNS disorders.
... With the exception of a few naturally occurring substances (i.e., botulinum toxin), no commercially available compound has demonstrated comparable immunosuppressive potency [55] . Likewise, due to its potent immunosuppressive capacity, DMT was recently granted orphan drug designation by the FDA for the treatment of ischemia-reperfusion injury in solid organ transplant [56] and is garnering significant attention from pharma for other neuroinflammatory conditions [57,58] . ...
While psychedelic-assisted therapies are currently being studied for several indications in clinical trials, there is legal and ethical ambiguity for mental health professionals concerning these compounds. Seventy-six mental health professionals completed an online survey asking them to rank their interest in topics related to psychedelic therapy, research, legal obstacles, barriers to incorporating psychedelics in practice, and terminology related to the field. Results showed that providers want more clearly defined terminology and operating procedures concerning business matters such as malpractice and clinic guidelines, legal and ethical clarity on administering psychedelics in private practice and integration work, and further opportunities for psychedelic therapy training. The survey responses were reflected upon through the legal and ethical lens of the current psychedelic landscape.
... Visual phenomena are also often reported, ranging from colourful geometric patterns to vivid dream-like experiences, alongside transient dissociation, enhanced introspection and initial anxiety followed by euthymia (9,15,(18)(19)(20). Furthermore, ayahuasca's effects have been linked to transcendental and mystical experiences, such as being connected to spirit realms in traditional Amerindian perspectives, and divinity in religious contexts (21). Researchers attempt to measure these experiences using the Mystical Experience Questionnaire (22). ...
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Ayahuasca is a natural psychoactive brew, used in traditional ceremonies in the Amazon basin. Recent research has indicated that ayahuasca is pharmacologically safe and its use may be positively associated with improvements in psychiatric symptoms. The mechanistic effects of ayahuasca are yet to be fully established. In this prospective naturalistic study, 63 self-selected participants took part in ayahuasca ceremonies at a retreat centre in the Peruvian Amazon. Participants undertook the Beck Depression Inventory (BDI-II), State-Trait Anxiety Inventory (STAI), Self-compassion Scale (SCS), Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM), as well as secondary measures, pre- and post-retreat and at 6-months. Participants also provided saliva samples for pre/post epigenetic analysis. Overall, a statistically significant decrease in BDI-II (13.9 vs. 6.1, p < 0.001), STAI (44.4 vs. 34.3 p < 0.001) scores, and CORE-OM scores were observed (37.3 vs. 22.3 p < 0.001) at post-retreat, as well as a concurrent increase in SCS (3.1 vs. 3.6, p < 0.001). Psychometric improvements were sustained, and on some measures values further decreased at 6-month follow-up, suggesting a potential for lasting therapeutic effects. Changes in memory valence were linked to the observed psychometric improvements. Epigenetic findings were equivocal, but indicated that further research in candidate genes, such as sigma non-opioid intracellular receptor 1 (SIGMAR1), is warranted. This data adds to the literature supporting ayahuasca's possible positive impact on mental health when conducted in a ceremonial context. Further investigation into clinical samples, as well as greater analyses into the mechanistic action of ayahuasca is advised.
In this thesis, the author investigates the therapeutic potential of psychedelics through literature analysis. First, he places psychedelics in a historical context and presents the current legal regime. Through the presentation of the psychedelic experience through aspects of safety, physiological effects, neurobiological effects and psychological effects, the author answers the question of how, if at all, psychedelics work in combination with psychotherapy. In the discussion, the author notes that psychedelics: (a) create new connections between different centers in the brain; (b) release high-level beliefs of the default brain network, (c) reduce normal ego functions, (d) enhance feelings of connection with others, nature and self and lead from avoidance of emotions to acceptance; (e) affect the personality structure.
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Disease prevention is almost always done with a modern approach through medical science or other public health sciences. This approach is the primary reference in mitigating the spread of the disease. In fact, in Indonesian society, there are local wisdoms in the traditions of each ethnic group in tackling the spread of disease, for example, the Javanese tradition. Javanese culture has local wisdom in dealing with pandemics passed down from generation to generation. This study attempts to answer how the mitigation pattern in Javanese culture is. Anthropologically, pandemics can be studied under health anthropology on disease. By taking the case of the Javanese people in Indonesia, this article describes local ways of preventing and overcoming disease outbreaks or mitigating disease outbreaks. The data source of this article is produced from qualitative research through interview techniques, focus group discussions, online seminars, and the study of manuscripts from magazines published in Java. The results showed that local communities, in addition to knowing the causes of disease, also developed ways to prevent and eliminate diseases, and mitigate outbreaks and pandemics. Javanese people see the mitigation of diseases physically and psychically. Physical mitigation tends to be in line with modern medical methods and the application of new normal. The mitigation of psychics is done by using mantras and songs and developing Javanese attitude of “narima ing pandum” (take it as it comes).
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Psychedelic compounds are on the cusp of being approved by medical regulators for treatment‐resistant mental health disorders. Following promising clinical trials, and as rates of mental ill health rise globally, psychedelic medicine presents a new paradigm for treating depression, anxiety, addiction and post‐traumatic stress disorder. The novelty of psychedelic therapies, the cultural stigma they elicit, and the challenges of regulation and implementation urgently call for a sociological lens onto this emerging field of psychiatry. This article identifies key sociological issues related to the medicalisation of psychedelic‐assisted therapies. It begins with a brief overview of the field's history and current treatment approaches. We then identify and critically examine three areas of sociological interest: the of role advocacy in the advancement of scientific research and the destigmatisation of psychedelics; issues related to the medicalisation and pharmaceuticalisation; and integration into healthcare systems. The challenges and affordances of psychedelics to existing therapeutic models, regulation and monetisation are highlighted, and the socio‐political context of the pharmaceutical industry, research, investment and implementation is examined. Drawing on health science literature in this field, the article offers a sociological lens on clinical psychedelic medicine as an emerging and potentially paradigm shifting field of psychiatry and psychotherapy.
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N,N-dimethyltryptamine (DMT) is classified as a naturally occurring serotonergic hallucinogen of plant origin. It has also been found in animal tissues and regarded as an endogenous trace amine transmitter. The vast majority of research on DMT has targeted its psychotropic/psychedelic properties with less focus on its effects beyond the nervous system. The recent discovery that DMT is an endogenous ligand of the sigma-1 receptor may shed light on yet undiscovered physiological mechanisms of DMT activity and reveal some of its putative biological functions. A three-step active uptake process of DMT from peripheral sources to neurons underscores a presumed physiological significance of this endogenous hallucinogen. In this paper, we overview the literature on the effects of sigma-1 receptor ligands on cellular bioenergetics, the role of serotonin, and serotoninergic analogues in immunoregulation and the data regarding gene expression of the DMT synthesizing enzyme indolethylamine-N-methyltransferase in carcinogenesis. We conclude that the function of DMT may extend central nervous activity and involve a more universal role in cellular protective mechanisms. Suggestions are offered for future directions of indole alkaloid research in the general medical field. We provide converging evidence that while DMT is a substance which produces powerful psychedelic experiences, it is better understood not as a hallucinogenic drug of abuse, but rather an agent of significant adaptive mechanisms that can also serve as a promising tool in the development of future medical therapies.
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Validation of animal models of hallucinogenic drugs' subjective effects requires human data. Previous human studies used varied groups of subjects and assessment methods. Rating scales for hallucinogen effects emphasized psychodynamic principles or the drugs' dysphoric properties. We describe the subjective effects of graded doses of N,N-dimethyltryptamine (DMT), an endogenous hallucinogen and drug of abuse, in a group of experienced hallucinogen users. We also present preliminary data from a new rating scale for these effects. Twelve highly motivated volunteers received two doses (0.04 and 0.4 mg/kg) of intravenous (IV) dimethyltryptamine fumarate "nonblind," before entering a double-blind, saline placebo-controlled, randomized study using four doses of IV DMT. Subjects were carefully interviewed after resolution of drug effects, providing thorough and systematic descriptions of DMT's effects. They also were administered a new instrument, the Hallucinogen Rating Scale (HRS). The HRS was drafted from interviews obtained from an independent sample of 19 experienced DMT users, and modified during early stages of the study. Psychological effects of IV DMT began almost immediately after administration, peaked at 90 to 120 seconds, and were almost completely resolved by 30 minutes. This time course paralleled DMT blood levels previously described. Hallucinogenic effects were seen after 0.2 and 0.4 mg/kg of dimethyltryptamine fumarate, and included a rapidly moving, brightly colored visual display of images. Auditory effects were less common. "Loss of control," associated with a brief, but overwhelming "rush," led to a dissociated state, where euphoria alternated or coexisted with anxiety. These effects completely replaced subjects' previously ongoing mental experience and were more vivid and compelling than dreams or waking awareness. Lower doses, 0.1 and 0.05 mg/kg, were primarily affective and somaesthetic, while 0.1 mg/kg elicited the least desirable effects. Clustering of HRS items, using either a clinical, mental status method or principal components factor analysis provided better resolution of dose effects than did the biological variables described previously. These clinical and preliminary quantitative data provide bases for further psychopharmacologic characterization of DMT's properties in humans. They also may be used to compare the effects of other agents affecting relevant brain receptors in volunteer and psychiatric populations.
The Psychedelic Renaissance: Reassessing the Role of Psychedelic Drugs in 21st Century Psychiatry and Society By Ben Sessa. Muswell Hill Press. 2012. £16.95 (pb). 237 pp. ISBN: 9781908995009 The world of psychiatry is now ripe for a re-examination of psychedelic drugs, or so the psychiatrist and