Psychedelics in Psychiatry:

7 min readJan 12, 2024

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by Lauro Amezcua-Patino, MD, FAPA.

Psychedelics in Psychiatry:

Despite the setbacks, the 21st century has witnessed a revival of interest in psychedelics within psychiatry. Rigorous clinical trials have explored their potential in treating conditions like post-traumatic stress disorder (PTSD), depression, and addiction. Substances like MDMA (commonly known as ecstasy) and psilocybin have shown remarkable results in alleviating symptoms when used in controlled therapeutic settings.

The Mechanisms Behind Psychedelic Healing

Researchers have made significant strides in understanding how psychedelics work in the brain. These substances primarily affect serotonin receptors, altering neural pathways and fostering increased communication between different brain regions. This enhanced connectivity facilitates profound self-reflection and therapeutic insights, leading to positive mental health outcomes.

The therapeutic potential of psychedelics has piqued the interest of scientists and researchers worldwide, leading to a resurgence of studies aimed at understanding the mechanisms that underlie their healing properties. Modern neuroscience and imaging technologies have provided unprecedented insights into the ways psychedelics interact with the brain, shedding light on the complex mechanisms behind their profound impact on mental health and well-being.

Psychedelics primarily target serotonin receptors in the brain, specifically the 5-HT2A receptor. Serotonin, often called the “feel-good” neurotransmitter, regulates mood, emotions, and cognition. When psychedelics bind to these receptors, they alter the normal functioning of neural pathways, leading to changes in perception, thought patterns, and self-awareness. This disruption of typical neural communication can enhance the brain’s plasticity, allowing new connections and perspectives to form.

The Default Mode Network is a collection of brain regions associated with self-referential thoughts, mind-wandering, and the ego. Overactivity of the DMN is often linked to conditions like depression and anxiety. Psychedelics, particularly substances like psilocybin, have been shown to dampen the activity of the DMN. By quieting the DMN, psychedelics can facilitate a state of ego dissolution, where individuals experience a diminished sense of self. This dissolution can lead to a profound sense of interconnectedness and unity, fostering feelings of empathy and compassion.

Psychedelics have been found to increase connectivity between different regions of the brain that do not typically communicate with each other. This enhanced neural connectivity is associated with the intensity of psychedelic experiences and is believed to facilitate the integration of thoughts and emotions. This heightened connectivity can lead to novel insights and perspectives, allowing individuals to process past traumas and reframe negative thought patterns.

Under the influence of psychedelics, individuals often experience heightened emotional states. This emotional release can provide a cathartic experience, allowing individuals to confront and process deep-seated emotions, traumas, and unresolved issues. The safe and supportive environment in therapeutic settings encourages individuals to navigate these intense emotions, leading to emotional healing and resolution.

Neuroplasticity refers to the brain’s ability to reorganize itself, forming new neural connections throughout life. Psychedelics may enhance neuroplasticity by stimulating the growth of dendritic spines, the tiny protrusions on nerve cells where synaptic connections are formed. This increase in synaptic plasticity is thought to facilitate learning, memory, and adaptive responses to psychological stressors, contributing to long-term mental health benefits.

Understanding these mechanisms is crucial not only for unraveling the mysteries of psychedelics but also for harnessing their therapeutic potential. As research in this field continues to advance, the intricate interplay between psychedelics and the human brain offers promising avenues for the development of innovative and effective treatments for mental health disorders, ushering in a new era of psychiatric care that combines ancient wisdom with modern scientific understanding.

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by Lauro Amezcua-Patino, MD, FAPA.

Ethical Considerations and Future Prospects

As psychedelics regain credibility in psychiatric circles, ethical considerations surrounding their use are paramount. Ensuring patient safety, addressing potential risks, and developing guidelines for their administration are critical steps in integrating psychedelics into mainstream psychiatric treatments. The resurgence of interest in psychedelics within the field of psychiatry has brought forth a myriad of ethical considerations that demand careful attention. As these substances move closer to mainstream acceptance as therapeutic tools, several key ethical concerns and prospects emerge.

Ensuring informed consent is paramount in psychedelic research and therapy. Participants must be fully aware of the potential risks and benefits associated with psychedelic experiences. Given the profound alterations in consciousness, therapists must create a safe, supportive environment, emphasizing trust and openness. Rigorous screening processes and psychological assessments are necessary to identify individuals who are suitable candidates for psychedelic-assisted therapies, minimizing adverse reactions and ensuring participant safety.

Psychedelic experiences can be intense and transformative, often requiring careful integration into one’s life afterward. Ethical psychedelic therapy includes a robust system of aftercare, where therapists provide support and guidance as individuals process their experiences. Integration therapy assists participants in making sense of their journey, translating insights into real-life changes, and addressing any psychological challenges that may arise post-session.

It is crucial to recognize and address the cultural, racial, and socioeconomic disparities in access to psychedelic therapy. Historically, marginalized communities have faced disproportionate consequences in the war on drugs. Ethical psychedelic practices involve actively working to bridge these gaps, ensuring that these therapies are accessible and culturally sensitive. This includes diversifying the workforce in the field of psychedelic therapy and conducting research that represents diverse populations.

The stigma surrounding psychedelics remains a significant challenge. Ethical considerations extend to public education and awareness campaigns to dispel myths and provide accurate information about psychedelics. Destigmatization efforts are essential to fostering open dialogue, reducing fear, and encouraging evidence-based discussions about these substances’ potential benefits and risks.

The evolving landscape of psychedelic research necessitates clear and comprehensive regulatory frameworks. Ethical guidelines and legal standards must be established and adhered to, ensuring the responsible use of psychedelics in therapeutic settings. Ongoing dialogue between researchers, policymakers, and regulatory bodies is crucial to strike a balance between fostering innovation and ensuring public safety.

Looking forward, the prospects of psychedelics in psychiatry are promising. Research continues to explore their efficacy in treating various mental health conditions, including depression, anxiety, PTSD, and addiction. Additionally, investigations into the potential of psychedelics in enhancing creativity, spiritual experiences, and overall well-being are underway. Ethical exploration of these frontiers involves maintaining scientific rigor, respecting individual autonomy, and continuously evaluating the long-term effects of these therapies.

As with any medicine or controlled substance used in medicine, the ethical considerations surrounding psychedelics in psychiatry are multifaceted and require a holistic approach that encompasses scientific integrity, social responsibility, and cultural awareness. By addressing these ethical challenges, the field can move forward responsibly, ensuring that the therapeutic potential of psychedelics is harnessed in a manner that is safe, equitable, and transformative for individuals and society.

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by Lauro Amezcua-Patino, MD, FAPA.

Final Thoughts:

The future of psychedelics in psychiatry is promising, with ongoing research exploring their potential in diverse areas, including end-of-life anxiety, obsessive-compulsive disorder, and autism spectrum disorders. Collaborations between scientists, mental health professionals, and policymakers are essential to navigate these substances’ legal and ethical complexities.

Currently, my associates and I at Reverie Mind (www.reveriemind.com), a Ketamine Treatment Center in Chandler, Arizona, are studying the use of these substances conjointly with traditional therapies to help those suffering from treatment-resistant mental health conditions, including generalized anxiety disorder, depression, and trauma, including Post Traumatic Stress Disorder (PTSD). We are also studying the use of Suboxone, a combination of two drugs — buprenorphine and naloxone — that work chemically to decrease the severity of withdrawal symptoms and reduce a patient’s dependence on opioids in the long term.

At Reverie Mind, we are working with leading companies worldwide to research and further develop psychedelic and psychedelic-like treatments for various mental health indications. So far, I have seen some exceptional results with these non-traditional substances. Indeed, there is much data, both empirical and scientific, to mandate studies with cannabis, psilocybin, DMT, and other psychedelic drugs. Ketamine has been a very effective treatment for many when other drugs and therapies just have not worked.

The history of psychedelics in psychiatry is a testament to the ever-evolving relationship between science, culture, and mental health. From ancient rituals to modern therapeutic interventions, psychedelics have traversed a complex path, offering glimpses of hope and healing along the way. As society embraces evidence-based approaches, the integration of psychedelics into psychiatric practices may usher in a new era of mental health treatments guided by knowledge, compassion, and a profound respect for the intricate workings of the human mind.

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by Lauro Amezcua-Patino, MD, FAPA.

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Psychedelics in Psychiatry:

Psychedelics in Psychiatry:

Ethical Considerations and Future Prospects

Final Thoughts:

Written by Morgan Lucas KP