Psychedelic and Dissociative Drugs as Medicines

This post originally appeared on MedLine Plus.

Psychedelic-assisted therapy—or ketamine-assisted therapy, if that substance is used—is when the use of psychedelic or dissociative drugs is integrated with other treatments, mainly talk therapy. Though more research is needed, scientists theorize that these substances promote brain changes that have the potential to promote healthy thought patterns, potentially supporting the effectiveness of talk therapy.

For example, some of these substances have mood effects that may boost the success of talk therapy. They may promote trust, sociability, and openness to suggestion; lessen anxiety; and reduce a person’s worrying or self-talk. These effects may also help people to work through challenging emotions or experiences with their therapist. Changing the patterns of a person’s brain activity may also disrupt habitual and potentially negative paths of thought and behavior, helping people adopt new and more positive ways of thinking. For more information, see “How do psychedelic and dissociative drugs work in the brain?

A typical approach is to administer these drugs in one to three sessions, combined with counseling, in a relaxing setting designed to help the patient be receptive to new perceptions, thoughts, and feelings, including mystical-type experiences. However, only esketamine is FDA approved for therapeutic use to date.

How do “mystical experiences” affect psychedelic or dissociative drug outcomes?

Some people who use psychedelic or dissociative drugs report having a mystical experience, a change in perception that may include feeling a strong sense of awe and of unity with everything that exists. This new and potentially meaningful experience may inspire brain changes that may affect a person’s emotions, outlook and behavior.

Researchers are still unclear if it’s necessary to have a mystical experience—which also carries the risk of side-effects such as fear—for the drugs to work. Research in psilocybin-assisted therapy suggests that there is a correlation of mystical experience with positive outcomes for smoking, alcohol, end-of-life anxiety, and depression. But some laboratory research suggests that it is possible for psilocybin to have antidepressant effects without causing changes in consciousness or perception. Scientists are also researching substances that may be chemically similar to psychedelics that may have the same therapeutic benefits without these mind-altering effects.

This post originally appeared on MedLine Plus.

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