Psychedelics
This paper is the most comprehensive review of psychedelics research up to 2016 by the eminent David E. Nichols.
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.
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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Nichols, D. E. (2016). Psychedelics. Pharmacological Reviews, 68(2), 264-355. https://doi.org/10.1124/pr.115.011478
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