Depressive DisordersAnxiety DisordersTobacco/Nicotine Use Disorder (TUD)Substance Use Disorders (SUD)Headache Disorders (Cluster & Migraine)Palliative & End-of-Life DistressNeuroimaging & Brain MeasuresImmunology & InflammationChronic PainPsilocybinLSDDMTMescalineMDMA

Psychedelics

This paper is the most comprehensive review of psychedelics research up to 2016 by the eminent David E. Nichols.

Authors

  • David Nichols

Published

Pharmacological Reviews
meta Study

Abstract

Psychedelics (serotonergic hallucinogens) are powerful psychoactive substances that alter perception and mood and affect numerous cognitive processes. They are generally considered physiologically safe and do not lead to dependence or addiction. Their origin predates written history, and they were employed by early cultures in many sociocultural and ritual contexts. After the virtually contemporaneous discovery of (5R,8R)-(+)-lysergic acid-N,N-diethylamide (LSD)-25 and the identification of serotonin in the brain, early research focused intensively on the possibility that LSD and other psychedelics had a serotonergic basis for their action. Today there is a consensus that psychedelics are agonists or partial agonists at brain serotonin 5-hydroxytryptamine 2A receptors, with particular importance on those expressed on apical dendrites of neocortical pyramidal cells in layer V. Several useful rodent models have been developed over the years to help unravel the neurochemical correlates of serotonin 5-hydroxytryptamine 2A receptor activation in the brain, and a variety of imaging techniques have been employed to identify key brain areas that are directly affected by psychedelics. Recent and exciting developments in the field have occurred in clinical research, where several double-blind placebo-controlled phase 2 studies of psilocybin-assisted psychotherapy in patients with cancer-related psychosocial distress have demonstrated unprecedented positive relief of anxiety and depression. Two small pilot studies of psilocybin-assisted psychotherapy also have shown positive benefit in treating both alcohol and nicotine addiction. Recently, blood oxygen level-dependent functional magnetic resonance imaging and magnetoencephalography have been employed for in vivo brain imaging in humans after administration of a psychedelic, and results indicate that intravenously administered psilocybin and LSD produce decreases in oscillatory power in areas of the brain’s default mode network.

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Research Summary of 'Psychedelics'

Introduction

Serotonergic hallucinogens — commonly termed psychedelics — are powerful psychoactive substances whose use predates written history and which were employed across ancient cultures in sociocultural and ritual contexts. Following Albert Hofmann's accidental discovery of LSD in 1943 and the near-simultaneous identification of serotonin in the brain, a first era of intensive research produced more than a thousand clinical publications involving approximately 40,000 patients — before regulatory restrictions imposed by the Controlled Substances Act of 1970 brought clinical investigation to an abrupt halt. This comprehensive narrative review, authored by David Nichols and published in Pharmacological Reviews in 2016, aimed to synthesise the full breadth of the preclinical and clinical psychedelic literature: covering historical and anthropological context, pharmacological mechanisms of action at the serotonin 5-HT2A receptor, glutamatergic and GABAergic interactions, brain-regional neuroanatomy, validated animal models, safety and adverse effects, and the emerging clinical renaissance across therapeutic applications including depression, addiction, cluster headache, and immune modulation.

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Zeifman, R. J., Singhal, N., Breslow, L. et al. · ACS Pharmacology and Translational Science (2021)

The DMT and Psilocin Treatment Changes CD11b+ Activated Microglia Immunological Phenotype

Kozłowska, U., Klimczak, A., Wiatr, K. et al. · Biorxiv (2021)

Serotonin 2A Receptor (5-HT2AR) Activation by 25H-NBOMe Positional Isomers: In Vitro Functional Evaluation and Molecular Docking

Pottie, E., Kupriyanova, O. V., Brandt, A. L. et al. · ACS Pharmacology and Translational Science (2021)

19 cited
Trends in the Top-Cited Articles on Classic Psychedelics

Lawrence, D. W., Sharma, B., Griffiths, R. R. et al. · Journal of Psychoactive Drugs (2021)

Lasting effects of a single psilocybin dose on resting-state functional connectivity in healthy individuals

McCulloch, D. E-W., Madsen, M. K., Stenbæk, D. S. et al. · Journal of Psychopharmacology (2021)

Making “bad trips” good: How users of psychedelics narratively transform challenging trips into valuable experiences

Gashi, L., Sandberg, S., Pedersen, W. · International Journal of Drug Policy (2021)

Discriminative Stimulus Effects of Substituted Tryptamines in Rats

Gatch, M. B., Hoch, A., Carbonaro, T. M. · ACS Pharmacology and Translational Science (2020)

8 cited
Set and Setting: A Randomized Study of Different Musical Genres in Supporting Psychedelic Therapy

Strickland, J. C., Garcia-Romeu, A., Johnson, M. W. · ACS Pharmacology and Translational Science (2020)

Investigation of the Structure-Activity Relationships of Psilocybin Analogues

Klein, A. K., Chatha, M., Laskowski, L. J. et al. · ACS Pharmacology and Translational Science (2020)

The Subjective Effects of Psychedelics Are Necessary for Their Enduring Therapeutic Effects

Yaden, D. B., Griffiths, R. R. · ACS Pharmacology and Translational Science (2020)

Psychedelics as a Novel Approach to Treating Autoimmune Conditions

Thompson, C., Szabo, A. · Immunology Letters (2020)

Classic Psychedelics as a Psychotherapeutic Aid in the Treatment of Stimulant Use Disorder: a Case Report

Johnson, S., Black, Q. C. · International Journal of Mental Health and Addiction (2020)

1 cited
Direct Phosphorylation of Psilocin Enables Optimized cGMP Kilogram-Scale Manufacture of Psilocybin

Kargbo, R. B., Sherwood, A. R., Walker, A. et al. · ACS Omega (2020)

28 cited
Structure-Activity Relationship Analysis of Psychedelics in a Rat Model of Asthma Reveals the Anti-Inflammatory Pharmacophore

Flanagan, T. W., Billac, G. B., Landry, A. N. et al. · ACS Pharmacology and Translational Science (2020)

58 cited
Compassionate use of psychedelics

Greif, A., Šurkala, M. · Medicine Health Care and Philosophy (2020)

Chronic pain and psychedelics: a review and proposed mechanism of action

Castellanos, J. P., Woolley, C., Bruno, K. A. et al. · Regional Anesthesia and Pain Medicine (2020)

101 cited
LSD flattens the functional hierarchy of the human brain

Girn, M., Roseman, L., Bernhardt, B. et al. · Biorxiv (2020)

Isness: Using Multi-Person VR to Design Peak Mystical Type Experiences Comparable to Psychedelics

Glowacki, D. R., Wonnacott, M. D., Freire, R. et al. · Association for Computing Machinery (2020)

32 cited
Experience of Music Used With Psychedelic Therapy: A Rapid Review and Implications

O'callaghan, C., Hubik, D. J., Psychiatry, M. et al. · Journal of Music Therapy (2020)

Natural Psychoplastogens As Antidepressant Agents

Benko, J., Vranková, S. · Molecules (2020)

From Egoism to Ecoism: Psychedelics Increase Nature Relatedness in a State-Mediated and Context-Dependent Manner

Kettner, H., Gandy, S., Haijen, E. C. H. M. et al. · International Journal of Environmental Research and Public Health (2019)

131 cited
Acute effects of lysergic acid diethylamide (LSD) on resting brain function

Felix, M., Stefan, B. · Swiss Medical Weekly (2019)

Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function

Johnson, M. W., Hendricks, P. S., Barrett, F. S. et al. · Pharmacology and Therapeutics (2019)

A systematic study of microdosing psychedelics

Polito, V., Stevenson, R. J. · PLOS ONE (2019)

197 cited
143 cited
Psychedelics, meditation, and self-consciousness

Milliere, R., Carhart-Harris, R. L., Roseman, L. et al. · Frontiers in Psychology (2018)

DMT models the near-death experience

Timmermann, C., Roseman, L., Williams, L. et al. · Frontiers in Psychology (2018)

Psychedelics as anti-inflammatory agents

Flanagan, T. W., Nichols, C. D. · International Review of Psychiatry (2018)

Positive psychology in the investigation of psychedelics and entactogens: A critical review

Jungaberle, H., Thal, S., Zeuch, A. et al. · Neuropharmacology (2018)

Integrating Psychedelic Medicines and Psychiatry: Theory and Methods of a Model Clinic

Sloshower, J. A. · Plant Medicines Healing and Psychedelic Science (2018)

The Use of Salvia divinorum from a Mazatec Perspective

Maqueda, A. E. · Plant Medicines Healing and Psychedelic Science (2018)

Unifying theories of psychedelic drug effects

Swanson, L. R. · Frontiers in Pharmacology (2018)

Neuroendocrine Associations Underlying the Persistent Therapeutic Effects of Classic Serotonergic Psychedelics

Schindler, E. A. D., Wallace, R. M., Sloshower, J. A. et al. · Frontiers in Pharmacology (2018)

Serotonergic hallucinogens in the treatment of anxiety and depression in patients suffering from a life-threatening disease: A systematic review

Reiche, S., Hermle, L., Gutwinski, S. et al. · Progress in Neuro-Psychopharmacology and Biological Psychiatry (2018)

Quality of acute psychedelic experience predicts therapeutic efficacy of psilocybin for treatment-resistant depression

Roseman, L., Nutt, D. J., Carhart-Harris, R. L. · Frontiers in Pharmacology (2018)

68 cited
Psilocybin-Assisted Therapy: A Review of a Novel Treatment for Psychiatric Disorders

Thomas, K., Malcolm, B., Lastra, D. · Journal of Psychoactive Drugs (2017)

Psychedelics, personality and political perspectives

Nour, M. R., Evans, J., Carhart-Harris, R. L. · Journal of Psychoactive Drugs (2017)

164 cited
The fibrinolytic system: A new target for treatment of depression with psychedelics

Idell, R. D., Florova, G., Komissarov, A. A. et al. · Medical Hypotheses (2017)

Phenomenology, Structure, and Dynamic of Psychedelic States

Preller, K. H., Vollenweider, F. X. · Behavioral Neurobiology of Psychedelic Drugs (2016)

New World Tryptamine Hallucinogens and the Neuroscience of Ayahuasca

McKenna, D., Riba, J. · Current Topics in Behavioral Neurosciences (2016)

Serotonergic Hallucinogen-Induced Visual Perceptual Alterations

Kometer, M., Vollenweider, F. X. · Behavioral Neurobiology of Psychedelic Drugs (2016)

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