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Psychedelics: Difference between revisions
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== Psychedelic Compounds == | == Psychedelic Compounds == | ||
[[File:Psychedelic types.png|alt=Much the same.|'''Figure 2'''. The “Classical” Psychedelics are mescaline, LSD, psilocybin, and DMT. Plus the deliriants and dissociatives.|thumb]] | [[File:Psychedelic types.png|alt=Much the same.|'''Figure 2'''. The “Classical” Psychedelics are mescaline, LSD, psilocybin, and DMT. Plus the deliriants and dissociatives.|thumb]] | ||
There are 5 classes of psychedelics based | There are 5 classes of psychedelics based on their effect and chemistry. | ||
'''Tryptamines''' | '''Tryptamines''' | ||
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* '''Cyclical thought patterns:''' | * '''Cyclical thought patterns:''' | ||
**'''Depression''' - multiple meta analyses results suggest that psychedelic-assisted therapy is effective with minimal adverse effects<ref>'''Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants'''. Nicole L. Galvão-Coelho, Psychopharmacology (Berl). 2021; 238(2): 341–354. Published online 2021 Jan 11. doi: 10.1007/s00213-020-05719-1. Accessed on 16th September 2022 via https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826317/pdf/213_2020_Article_5719.pdf</ref><ref>'''''A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy'''. Luoma, J. B., Chwyl, C., Bathje, G. J., Davis, A. K., & Lancelotta, R. (2020). Journal of Psychoactive Drugs, 1–11.'' doi:10.1080/02791072.2020.1769878. Accessed on 16th September 2022 via: https://pubmed.ncbi.nlm.nih.gov/32529966/ </ref>, relative to a comparable meta analysis of the effects of 21 traditional antidepressant drugs<ref>'''Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis.''' Andrea Cipriani, MD. Published in the Lancet. February 21, 2018 DOI:<nowiki>https://doi.org/10.1016/S0140-6736(17)32802-7</nowiki></ref>, relative to other treatments psychedelics lack the majority of serious adverse effects. | **'''Depression''' - multiple meta-analyses results suggest that psychedelic-assisted therapy is effective with minimal adverse effects<ref>'''Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants'''. Nicole L. Galvão-Coelho, Psychopharmacology (Berl). 2021; 238(2): 341–354. Published online 2021 Jan 11. doi: 10.1007/s00213-020-05719-1. Accessed on 16th September 2022 via https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7826317/pdf/213_2020_Article_5719.pdf</ref><ref>'''''A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy'''. Luoma, J. B., Chwyl, C., Bathje, G. J., Davis, A. K., & Lancelotta, R. (2020). Journal of Psychoactive Drugs, 1–11.'' doi:10.1080/02791072.2020.1769878. Accessed on 16th September 2022 via: https://pubmed.ncbi.nlm.nih.gov/32529966/ </ref>, relative to a comparable meta analysis of the effects of 21 traditional antidepressant drugs<ref>'''Comparative efficacy and acceptability of 21 antidepressant drugs for the acute treatment of adults with major depressive disorder: a systematic review and network meta-analysis.''' Andrea Cipriani, MD. Published in the Lancet. February 21, 2018 DOI:<nowiki>https://doi.org/10.1016/S0140-6736(17)32802-7</nowiki></ref>, relative to other treatments psychedelics lack the majority of serious adverse effects. | ||
**'''Obsessive compulsive disorder (OCD)''' | **'''Obsessive compulsive disorder (OCD)''' | ||
*'''Cyclical behavioural patterns:''' | *'''Cyclical behavioural patterns:''' | ||
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=== Medicinal Chemistry === | === Medicinal Chemistry === | ||
All psychedelics are chemically unique and | All psychedelics are chemically unique and can be categorised into four main types (see '''Figure 2'''). There are three main families of chemical compounds: [[tryptamines]], phenethylamines, or lysergamides and many tend to act via serotonin 2A receptor agonism which plays a key role in the regulation of cortical function. Serotonin antagonism has been proposed as the mechanism for the subjective and biological effects of classical psychedelics as these effects are blocked after administering 5HT2AR antagonists such as ketanserin<ref>'''The Fabric of Meaning and Subjective Effects in LSD-Induced States Depend on Serotonin 2A Receptor Activation.''' Preller KH, Herdener M, Pokorny T, Planzer A, Kraehenmann R, Stämpfli P, et al. Curr Biol. 2017 Feb;27(3):451–7. Accessed 14th February 2023 via: https://pubmed.ncbi.nlm.nih.gov/28132813/</ref><ref>'''Psychedelics Promote Structural and Functional Neural Plasticity.''' Ly C, Greb AC, Cameron LP, Wong JM, Barragan EV, Wilson PC, et al. Cell Rep. 2018 Jun 12;23(11):3170–82. Accessed on 14th February 2023 via: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082376/</ref>. | ||
== Who would be eligible for psychedelics from a doctor? == | == Who would be eligible for psychedelics from a doctor? == | ||
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To be able to obtain a psychedelic from a doctor all of the following criteria must be met: | To be able to obtain a psychedelic from a doctor all of the following criteria must be met: | ||
* '''Over 25''', this age is not written in stone and there will be some variability, however it is thought that psychedelics should not be taken until brain growth is completed which | * '''Over 25''', this age is not written in stone and there will be some variability, however, it is thought that psychedelics should not be taken until brain growth is completed which occurs around the mid 20's. | ||
* Diagnosed as having '''Treatment Resistant Depression,''' i.e. no adequate response to a course of appropriate antidepressant medication within a certain time. | * Diagnosed as having '''Treatment Resistant Depression,''' i.e. no adequate response to a course of appropriate antidepressant medication within a certain time. | ||
== Adverse effects == | == Adverse effects == | ||
Like all medicines, without proper guidance adverse effects can occur. As shown in '''Figure 3''', relative to other popular medicines psychedelics cause much less harm. However, there have been some idiosyncratic [[Adverse Psychedelic Effects|adverse psychedelic effects]]. | Like all medicines, without proper guidance, adverse effects can occur. As shown in '''Figure 3''', relative to other popular medicines psychedelics cause much less harm. However, there have been some idiosyncratic [[Adverse Psychedelic Effects|adverse psychedelic effects]]. | ||
==== Microdosing ==== | ==== Microdosing ==== | ||
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The medical definition of ''microdosing'' is a dose given which is ''sub therapeutic'', i.e. it is the dose doctors recognise as having no discernible effect. However, many claim, mainly via online survey studies, that very low doses of LSD, taken at 3–4-day intervals, improve mood and cognitive function<ref>'''Exploring the effect of microdosing psychedelics on creativity in an open-label natural setting.''' Prochazkova, L., Lippelt, D.P., Colzato, L.S. ''et al.'' ''Psychopharmacology'' 235, 3401–3413 (2018). <nowiki>https://doi.org/10.1007/s00213-018-5049-7</nowiki></ref>. | The medical definition of ''microdosing'' is a dose given which is ''sub therapeutic'', i.e. it is the dose doctors recognise as having no discernible effect. However, many claim, mainly via online survey studies, that very low doses of LSD, taken at 3–4-day intervals, improve mood and cognitive function<ref>'''Exploring the effect of microdosing psychedelics on creativity in an open-label natural setting.''' Prochazkova, L., Lippelt, D.P., Colzato, L.S. ''et al.'' ''Psychopharmacology'' 235, 3401–3413 (2018). <nowiki>https://doi.org/10.1007/s00213-018-5049-7</nowiki></ref>. | ||
In controlled studies, which in mental health are the gold standard, (see [[Referencing|critical appraisal]]) the placebo effect is excluded. In all of these studies microdosing has been shown to have no effect<ref>'''Repeated low doses of LSD in healthy adults: A placebo-controlled, dose–response study''' Harriet de Wit,Hanna M. Molla,Anya Bershad,Michael Bremmer,Royce Lee First published: 01 February 2022 <nowiki>https://doi.org/10.1111/adb.13143</nowiki>https://onlinelibrary.wiley.com/doi/abs/10.1111/adb.13143</ref> and even in some have shown negative effects such as neuroticism<ref>'''A Systematic Study of Microdosing'''. Richard J. Stevenson, Macquarie University, Sydney, Australia. 10.1371/journal.pone.0211023</ref>. It has been suggested that this is because the experience of the ''trip'' is more important than the underlying chemical-electrical mechanisms<ref>'''The Subjective Effects of Psychedelics Are Necessary for Their Enduring Therapeutic Effects''': David B. Yaden and Roland R. Griffiths* ACS Pharmacol. Transl. Sci. 2021, 4, 2, 568–572. Publication Date:December 10, 2020. <nowiki>https://doi.org/10.1021/acsptsci.0c00194</nowiki></ref> (see '''Figure 3''') . By propagating the myth that microdosing does have an effect | In controlled studies, which in mental health are the gold standard, (see [[Referencing|critical appraisal]]) the placebo effect is excluded. In all of these studies microdosing has been shown to have no effect<ref>'''Repeated low doses of LSD in healthy adults: A placebo-controlled, dose–response study''' Harriet de Wit,Hanna M. Molla,Anya Bershad,Michael Bremmer,Royce Lee First published: 01 February 2022 <nowiki>https://doi.org/10.1111/adb.13143</nowiki>https://onlinelibrary.wiley.com/doi/abs/10.1111/adb.13143</ref> and even in some have shown negative effects such as neuroticism<ref>'''A Systematic Study of Microdosing'''. Richard J. Stevenson, Macquarie University, Sydney, Australia. 10.1371/journal.pone.0211023</ref>. It has been suggested that this is because the experience of the ''trip'' is more important than the underlying chemical-electrical mechanisms<ref>'''The Subjective Effects of Psychedelics Are Necessary for Their Enduring Therapeutic Effects''': David B. Yaden and Roland R. Griffiths* ACS Pharmacol. Transl. Sci. 2021, 4, 2, 568–572. Publication Date:December 10, 2020. <nowiki>https://doi.org/10.1021/acsptsci.0c00194</nowiki></ref> (see '''Figure 3''') . By propagating the myth that microdosing does have an effect may cause people from not accessing the correct dose and getting the actual benefit from the medicine. | ||
== Oneirogens == | == Oneirogens == | ||
An [[Oneirogens|oneirogen]], is a substance or experience which enhances dream states, in effect this could be likened to an unconscious psychedelic | An [[Oneirogens|oneirogen]], is a substance or experience which enhances dream states, in effect, this could be likened to an unconscious psychedelic state.<hr> | ||
'''References'''<references /> | '''References'''<references /> | ||