Psychiatry & the psychedelic drugs. Past, present & future

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Title: Psychiatry & the psychedelic drugs. Past, present & future
Author(s): Rucker, JJH
Iliff, J
Nutt, DJ
Item Type: Journal Article
Abstract: The classical psychedelic drugs, including psilocybin, lysergic acid diethylamide and mescaline, were used extensively in psychiatry before they were placed in Schedule I of the UN Convention on Drugs in 1967. Experimentation and clinical trials undertaken prior to legal sanction suggest that they are not helpful for those with established psychotic disorders and should be avoided in those liable to develop them. However, those with so-called 'psychoneurotic' disorders sometimes benefited considerably from their tendency to 'loosen' otherwise fixed, maladaptive patterns of cognition and behaviour, particularly when given in a supportive, therapeutic setting. Pre-prohibition studies in this area were sub-optimal, although a recent systematic review in unipolar mood disorder and a meta-analysis in alcoholism have both suggested efficacy. The incidence of serious adverse events appears to be low. Since 2006, there have been several pilot trials and randomised controlled trials using psychedelics (mostly psilocybin) in various non-psychotic psychiatric disorders. These have provided encouraging results that provide initial evidence of safety and efficacy, however the regulatory and legal hurdles to licensing psychedelics as medicines are formidable. This paper summarises clinical trials using psychedelics pre and post prohibition, discusses the methodological challenges of performing good quality trials in this area and considers a strategic approach to the legal and regulatory barriers to licensing psychedelics as a treatment in mainstream psychiatry.
Publication Date: 1-Nov-2018
Date of Acceptance: 22-Dec-2017
ISSN: 0028-3908
Publisher: Elsevier
Start Page: 200
End Page: 218
Journal / Book Title: Neuropharmacology
Volume: 142
Sponsor/Funder: Medical Research Council (MRC)
Imperial College Healthcare NHS Trust- BRC Funding
Funder's Grant Number: MR/J00460X/1
Copyright Statement: © 201 8 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (
Keywords: Clinical trials
Psychiatric disorders
Clinical trials
Psychiatric disorders
1109 Neurosciences
1115 Pharmacology And Pharmaceutical Sciences
1701 Psychology
Neurology & Neurosurgery
Publication Status: Published
Online Publication Date: 2017-12-25
Appears in Collections:Department of Medicine
Faculty of Medicine

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