Psychedelic substances

Context: Psychedelic drugs are emerging in research as promising ways to treat treatment-resistant depression and post-traumatic stress disorder

What are Psychedelic substances

  • Psychedelics are a group of drugs that alter perception, mood, and thought processing while a person is still clearly conscious. 
  • Psychedelics are non-addictive, non-toxic and compared to illicit drugs, they are less harmful to the end user.
  • In India, the Narcotic Drugs and Psychotropic Substances Act 1985 prohibits (bans) the use of psychedelic substances.
    • Ketamine, a dissociative anaesthetic with psychedelic properties, is used under strict medical supervision, for anaesthesia and treatment-resistant depression.

How do the drugs work in the body?

  • Users of psychedelic substances report changes in perception, somatic experience, mood, thought-processing, and entheogenic experiences. 
  • Modern neuroimaging suggests that psychedelics are neither stimulants nor depressants of brain activity. Instead, they increase the cross-talk between different brain networks, and this correlates with the subjective effects of psychedelics.

Can psychedelics be used to treat neuropsychiatric disorders?

  • In November 2022, the results from a phase II psilocybin trial were published in the New England Journal of Medicine. The trial found that a single 25-mg dose of psilocybin reduced depression scores over three weeks in people with treatment-resistant depression.
  • In 2017, the U.S. Food and Drug Administration (FDA) designated the use of 3,4-methylenedioxymethamphetamine, also known as MDMA, to be the “breakthrough therapy” in the treatment of post-traumatic stress disorder (PTSD). 

Can such substances cause harm?

  • Death due to direct toxicity of LSD, psilocybin or mescaline has not been reported despite 50-plus years of recreational use. An overdose requires cardiac monitoring and supportive management in a low-stimulus and reassuring environment.
  • Synthetic psychedelics (such as 25I-NBOMe) have been associated with acute cardiac, central nervous system, and limb ischaemia, as well as serotonin syndrome. There have also been reports of death attributed directly to synthetic psychedelic use.

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