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Therapeutic use of serotoninergic hallucinogens: A review of the evidence and of the biological and psychological mechanisms

This review (2020) of the therapeutic potential of psychedelics (serotonergic hallucinogens) highlights the research that show both acute and long-term (subacute) positive effects after therapeutic psychedelic use.

Authors

  • Jamie Hallak
  • Rafael dos Santos

Published

Neuroscience and Biobehavioral Reviews
meta Study

Abstract

Serotoninergic hallucinogens include drugs such as lysergic acid diethylamide (LSD), dimethyltryptamine (DMT) and psilocybin. Recent trials with single/few doses of these compounds show that they induce rapid and sustained antidepressive, anxiolytic, and antiaddictive effects. These effects are also observed in religious groups using the DMT-containing brew ayahuasca. The agonist action of these substances on 5-HT2A receptors expressed in frontal and limbic areas increase glutamatergic transmission and neuroplasticity. These neurochemical effects are associated with acute alterations on self-perception and increases in introspection and positive mood, and with subacute and long-term decreases in psychiatric symptoms, increases in some personality traits such as openness, improvements in emotional processing, and increases in empathy. These are preliminary but promising results that should be further explored in controlled trials with larger sample sizes, especially considering that these compounds could be beneficial in the treatment of treatment-resistant psychiatric disorders.

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Research Summary of 'Therapeutic use of serotoninergic hallucinogens: A review of the evidence and of the biological and psychological mechanisms'

Introduction

Serotoninergic psychedelics (classical hallucinogens) include mescaline, DMT, psilocybin and LSD and act primarily as agonists at serotonin receptors, especially 5-HT2A. The Introduction frames these compounds as producing profound alterations in affect, perception and cognition that vary with dose, set (participant characteristics and preparation) and setting (support and context). The authors note a long history of ritual and therapeutic uses for naturally occurring tryptamines and phenethylamines, interrupted scientific interest in the late 1960s/early 1970s, and a resurgence of controlled human research from the 1990s onwards with a growing body of experimental and clinical studies reporting generally favourable safety profiles in carefully screened samples. Guimar and colleagues set out to synthesise existing reviews and primary studies on the therapeutic effects of serotoninergic hallucinogens for anxiety, mood and substance use disorders, with particular emphasis on clinical and preclinical work carried out by groups at the Universidade de São Paulo (USP) and the Universidade Federal do Rio Grande do Norte (UFRN) concerning ayahuasca/DMT. The paper also aims to discuss proposed biological and psychological mechanisms that might mediate therapeutic effects.

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