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Therapeutic Applications of Classic Hallucinogens

  • Chapter
Behavioral Neurobiology of Psychedelic Drugs

Part of the book series: Current Topics in Behavioral Neurosciences ((CTBN,volume 36))

Abstract

This chapter reviews what is known about the therapeutic uses of the serotonergic or classic hallucinogens, i.e., psychoactive drugs such as LSD and psilocybin that exert their effects primarily through agonist activity at serotonin 2A (5HT2A) receptors. Following a review of the history of human use and scientific study of these drugs, the data from clinical research are summarized, including extensive work on the use of classic hallucinogens in the treatment of alcoholism and other addictions, studies of the use of LSD and psilocybin to relieve distress concerning death, particularly in patients with advanced or terminal cancer, and more limited data concerning the use of classic hallucinogens to treat mood and anxiety disorders. A survey of possible mechanisms of clinically relevant effects is provided. The well-established safety of classic hallucinogens is reviewed. To provide a clinical perspective, case summaries are provided of two individuals who received treatment in recent controlled trials of psilocybin: one being treated for alcoholism, the other suffering from anxiety and depression related to fear of death due to a cancer diagnosis. Although promising early phase research conducted from the 1950s through the early 1970s was discontinued before firm conclusions could be reached concerning the efficacy of any of the classic hallucinogens for any clinical condition, the research that was conducted in that era strongly suggests that classic hallucinogens have clinically relevant effects, particularly in the case of LSD treatment of alcoholism. In the past decade, clinical trials have resumed investigating the effects of classic hallucinogens in the treatment of existential distress in the face of cancer, and in the treatment of addictions including alcoholism and nicotine addiction. The studies that have been completed to date are not sufficient to establish efficacy, but the outcomes have been very encouraging, and larger trials, up to and including phase 3, are now underway or being planned. Although research has elucidated many of the acute neurobiological and psychological effects of classic hallucinogens on humans, animals, and in vitro systems, the mechanisms of clinically relevant persisting effects remain poorly understood.

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Authors and Affiliations

  1. Department of Psychiatry, New York University Langone Medical Center, New York City, USA

    Michael P. Bogenschutz & Stephen Ross

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  1. Michael P. Bogenschutz
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Correspondence to Michael P. Bogenschutz .

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  1. Department of Psychiatry, University of California San Diego, La Jolla, CA, USA

    Adam L. Halberstadt

  2. Psychiatric University Hospital, Heffter Research Center Zurich, University of Zurich, Zurich, Switzerland

    Franz X. Vollenweider

  3. Division of Chemical Biology and Medicinal Chemistry, University of North Carolina, Chapel Hill, NC, USA

    David E. Nichols

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Bogenschutz, M.P., Ross, S. (2016). Therapeutic Applications of Classic Hallucinogens. In: Halberstadt, A.L., Vollenweider, F.X., Nichols, D.E. (eds) Behavioral Neurobiology of Psychedelic Drugs. Current Topics in Behavioral Neurosciences, vol 36. Springer, Berlin, Heidelberg. https://doi.org/10.1007/7854_2016_464

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