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Psychedelics: Difference between revisions
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* Conceptual thinking | * Conceptual thinking | ||
* Thought loops | * Thought loops | ||
* Depersonalization | * [[Ego Death]] - Depersonalization | ||
===== Enhancements ===== | ===== Enhancements ===== | ||
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* Addiction suppression | * Addiction suppression | ||
* Personal bias suppression | * Personal [[Cognitive Biases|bias]] suppression | ||
== Long Term Effects == | == Long Term Effects == | ||
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Like all medicines, psychedelics are not without potential harm. However, relative to almost all other drugs (See '''Figure 3''') the risk associated with their use is minimal. In a clinical sense, under specific [[priming]], [[setting]] and [[integration]] there is abundant evidence for the safety and efficacy for their use in the treatment of conditions such as: | Like all medicines, psychedelics are not without potential harm. However, relative to almost all other drugs (See '''Figure 3''') the risk associated with their use is minimal. In a clinical sense, under specific [[priming]], [[setting]] and [[integration]] there is abundant evidence for the safety and efficacy for their use in the treatment of conditions such as: | ||
* '''Depression''' - multiple meta-analyses results suggest that psychedelic-assisted therapy reduces [[MADRS]] with minimal [[Adverse Psychedelic Effects|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>. | * '''[[Depression]]''' - multiple meta-analyses results suggest that psychedelic-assisted therapy reduces [[MADRS]] with minimal [[Adverse Psychedelic Effects|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>. | ||
* '''Obsessive compulsive disorder (OCD)''' | * '''Obsessive compulsive disorder (OCD)''' | ||
* '''Post Traumatic Stress Disorder (PTSD)''' | * '''Post Traumatic Stress Disorder (PTSD)''' | ||
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== Psychedelic Comparison == | == Psychedelic Comparison == | ||
The most commonly used psychedelics, [[Psilocybin]], DMT and LSD have a very similar effect<ref>'''Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being''': Associations With Patterns of Use, Reported Harms, and Transformative Mental States. Front. Psychiatry, 15 March 2022. Sec. Psychopharmacology. <nowiki>https://doi.org/10.3389/fpsyt.2022.831092</nowiki></ref><ref name=":0">'''Direct comparison of the acute effects of lysergic acid diethylamide and psilocybin in a double-blind placebo-controlled study in healthy subjects.''' Holze, F., Ley, L., Müller, F. ''et al.'' ''Neuropsychopharmacol.'' 47, 1180–1187 (2022). <nowiki>https://doi.org/10.1038/s41386-022-01297-2</nowiki></ref><ref>'''Double-blind comparison of the two hallucinogens psilocybin and dextromethorphan: similarities and differences in subjective experiences.''' Carbonaro TM, Johnson MW, Hurwitz E, Griffiths RR. Psychopharmacology (Berl). 2018 Feb;235(2):521-534. doi: 10.1007/s00213-017-4769-4. Epub 2017 Nov 7. PMID: 29116367; PMCID: PMC6645364.</ref><ref>'''Comparison of the Reactions Induced by Psilocybin and LSD-25 in Man'''. From the National Institute of Mental Health, Addiction Research Center, U. S. Public Health Service, Lexington, Kentucky by HARRIS ISBELL 1959</ref> whilst dissociative psychedelics like [[ketamine]] have a more of an [[Out of Body Experiences|Out of Body Experience]] effect. This is backed up by recent, real world evidence analysis of 2947 publicly available, [https://www.erowid.org/ erowid.org] trip reports which concluded: | The most commonly used psychedelics, [[Psilocybin]], [[DMT]] and [[LSD]] have a very similar effect<ref>'''Effects of Naturalistic Psychedelic Use on Depression, Anxiety, and Well-Being''': Associations With Patterns of Use, Reported Harms, and Transformative Mental States. Front. Psychiatry, 15 March 2022. Sec. Psychopharmacology. <nowiki>https://doi.org/10.3389/fpsyt.2022.831092</nowiki></ref><ref name=":0">'''Direct comparison of the acute effects of lysergic acid diethylamide and psilocybin in a double-blind placebo-controlled study in healthy subjects.''' Holze, F., Ley, L., Müller, F. ''et al.'' ''Neuropsychopharmacol.'' 47, 1180–1187 (2022). <nowiki>https://doi.org/10.1038/s41386-022-01297-2</nowiki></ref><ref>'''Double-blind comparison of the two hallucinogens psilocybin and dextromethorphan: similarities and differences in subjective experiences.''' Carbonaro TM, Johnson MW, Hurwitz E, Griffiths RR. Psychopharmacology (Berl). 2018 Feb;235(2):521-534. doi: 10.1007/s00213-017-4769-4. Epub 2017 Nov 7. PMID: 29116367; PMCID: PMC6645364.</ref><ref>'''Comparison of the Reactions Induced by Psilocybin and LSD-25 in Man'''. From the National Institute of Mental Health, Addiction Research Center, U. S. Public Health Service, Lexington, Kentucky by HARRIS ISBELL 1959</ref> whilst dissociative psychedelics like [[ketamine]] have a more of an [[Out of Body Experiences|Out of Body Experience]] effect. This is backed up by recent, real world evidence analysis of 2947 publicly available, [https://www.erowid.org/ erowid.org] trip reports which concluded: | ||
''"[[MDMA]] experience reports featured an emotionally intensifying profile accompanied by many cognitive process words and dynamic-personal language. In contrast, Ayahuasca and DMT experience reports involved relatively little emotional language, few cognitive process words, increased analytical thinking-associated language, and the most semantic similarity with psychedelic and mystical experience descriptions<ref>'''Analysis of recreational psychedelic substance use experiences classified by substance.''' Adrian Hase, Max Erdmann, Verena Limbach & Gregor Hasler Psychopharmacology volume 239, pages643–659 (2022) Altmetric Metrics https://link.springer.com/article/10.1007/s00213-022-06062-3</ref>. LSD, psilocybin mushroom, and ketamine reports showed only small differences on the emotion-, analytical thinking-, psychedelic, and mystical experience-related language outcomes. Further research has concluded: “Both doses of LSD and the high dose of psilocybin produced qualitatively and quantitatively very similar subjective effects, indicating that alterations of mind that are induced by LSD and psilocybin do not differ beyond the effect duration”<ref name=":0" />.'' | ''"[[MDMA]] experience reports featured an emotionally intensifying profile accompanied by many cognitive process words and dynamic-personal language. In contrast, Ayahuasca and DMT experience reports involved relatively little emotional language, few cognitive process words, increased analytical thinking-associated language, and the most semantic similarity with psychedelic and mystical experience descriptions<ref>'''Analysis of recreational psychedelic substance use experiences classified by substance.''' Adrian Hase, Max Erdmann, Verena Limbach & Gregor Hasler Psychopharmacology volume 239, pages643–659 (2022) Altmetric Metrics https://link.springer.com/article/10.1007/s00213-022-06062-3</ref>. LSD, psilocybin mushroom, and ketamine reports showed only small differences on the emotion-, analytical thinking-, psychedelic, and mystical experience-related language outcomes. Further research has concluded: “Both doses of LSD and the high dose of psilocybin produced qualitatively and quantitatively very similar subjective effects, indicating that alterations of mind that are induced by LSD and psilocybin do not differ beyond the effect duration”<ref name=":0" />.'' | ||
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''Dosage information frequently changes and is dependent on weight and prior medical condition. Before administering check all information with a suitably qualified professional.'' | ''Dosage information frequently changes and is dependent on weight and prior medical condition. Before administering check all information with a suitably qualified professional.'' | ||
A key effect of psychedelics is their ability to open a period of neuroplasticity where old habits can be erased and new habits formed. This period has been found to differ substantially between the various compounds (see '''Figure 5'''). | A key effect of psychedelics is their ability to open a period of [[neuroplasticity]] where old habits can be erased and new habits formed. This period has been found to differ substantially between the various compounds (see '''Figure 5'''). | ||
=== Medicinal Chemistry === | === Medicinal Chemistry === | ||
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=== Exclusions Criteria === | === Exclusions Criteria === | ||
There are a category of patients that have specific conditions or are taking specific medicines that should be [[Psychedelic Therapy Inclusion and Exclusion Criteria|excluded from psychedelic therapy]]. In general these patients have the following | There are a category of patients that have specific conditions or are taking specific medicines that should be [[Psychedelic Therapy Inclusion and Exclusion Criteria|excluded from psychedelic therapy]]. In general these patients have the following characteristics: | ||
* People taking '''olanzapine''' (an atypical antipsychotic) as there is some evidence to suggest it can [[Trip Terminator|''terminate'' a trip]]<ref>'''Olanzapine as the ideal “trip terminator”?''' Giuseppe Valeriani, Ornella Corazza, Francesco Saverio Bersani. First published: 28 July 2015 <nowiki>https://doi.org/10.1002/hup.2431</nowiki>. Accessed via: <nowiki>https://onlinelibrary.wiley.com/doi/10.1002/hup.2431</nowiki></ref>; | * People taking '''olanzapine''' (an atypical antipsychotic) as there is some evidence to suggest it can [[Trip Terminator|''terminate'' a trip]]<ref>'''Olanzapine as the ideal “trip terminator”?''' Giuseppe Valeriani, Ornella Corazza, Francesco Saverio Bersani. First published: 28 July 2015 <nowiki>https://doi.org/10.1002/hup.2431</nowiki>. Accessed via: <nowiki>https://onlinelibrary.wiley.com/doi/10.1002/hup.2431</nowiki></ref>; | ||