Current perspectives on psychedelic therapy: use of serotonergic hallucinogens in clinical interventions

Int Rev Psychiatry. 2018 Aug;30(4):291-316. doi: 10.1080/09540261.2018.1486289. Epub 2018 Nov 13.

Abstract

Humans have used serotonergic hallucinogens (i.e. psychedelics) for spiritual, ceremonial, and recreational purposes for thousands of years, but their administration as part of a structured therapeutic intervention is still a relatively novel practice within Western medical and psychological frameworks. In the mid-20th century, considerable advances were made in developing therapeutic approaches integrating administration of low (psycholytic) and high (psychedelic) doses of serotonergic hallucinogens for treatment of a variety of conditions, often incorporating psychoanalytic concepts prevalent at that time. This work contributed seminal insights regarding how these substances may be employed with efficacy and safety in targeted therapeutic interventions, including the importance of optimizing set (frame of mind) and setting (therapeutic environment). More recently, clinical and pharmacological research has revisited the effects and therapeutic potential of psychedelics utilizing a variety of approaches. The current article provides an overview of past and present models of psychedelic therapy, and discusses important considerations for future interventions incorporating the use of psychedelics in research and clinical practice.

Keywords: LSD; Psychedelic therapy; hallucinogens; psilocybin.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Biomedical Research*
  • Dose-Response Relationship, Drug
  • Hallucinogens / administration & dosage*
  • Hallucinogens / pharmacology
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Lysergic Acid Diethylamide / administration & dosage
  • Psilocybin / administration & dosage
  • Psychotherapy / history
  • Psychotherapy / methods*
  • Serotonin Antagonists / administration & dosage

Substances

  • Hallucinogens
  • Serotonin Antagonists
  • Psilocybin
  • Lysergic Acid Diethylamide