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Psychoactive substances for the treatment of neuropsychiatric disorders.

Zifan Zhen, Xueqiang Sun, Shiying Yuan, Jiancheng Zhang

Asian Journal of Psychiatry November 1, 2024 DOI: 10.1016/j.ajp.2024.104193 (opens in new tab)

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AI-extracted from the abstract
Characteristics Review Peer reviewed
Interventions Lysergic acid diethylamide Psilocybin MDMA Ketamine
Topics Ketamine MDMA
Keywords Neuropsychiatric disorders Psychedelics hallucinogens Entheogens Psychoactive drugs Behavioral therapy Psychological treatment Novel therapy Cutting-edge healthcare
Citations 8
Key findings Hallucinogens, MDMA, and ketamine show therapeutic potential for severe mental health disorders through distinct mechanisms, but require cautious clinical application.

Abstract

In the contemporary landscape of psychiatric medicine, critical advancements have been noted in the utilization of psychoactive substances such as hallucinogens, 3,4-methylenedioxymethamphetamine (MDMA), and ketamine for the treatment of severe mental health disorders. This review provides a detailed evaluation of these substances, focusing on their mechanisms of action and the profound clinical outcomes observed in controlled environments. Hallucinogens like lysergic acid diethylamide and psilocybin primarily target the 5-HT2A receptor agonist-2 (5-HT2AR), inducing substantial perceptual and cognitive shifts that facilitate deep psychological introspection and significant therapeutic advances, particularly in patients suffering from depression and anxiety disorders. MDMA, influencing multiple neurotransmitter systems including 5-Hydroxytryptamine (5-HT), dopamine, and norepinephrine, has been demonstrated to effectively alleviate symptoms of post-traumatic stress disorder, enhancing patients' emotional engagement and resilience during psychotherapy. Meanwhile, ketamine, a glutamate receptor antagonist, rapidly alleviates depressive symptoms, offering a lifeline for individuals with treatment-resistant depression through its fast-acting antidepressant properties. The integration of these substances into psychiatric practice has shown promising results, fundamentally changing the therapeutic landscape for patients unresponsive to traditional treatment modalities. However, the potent effects of these agents also necessitate a cautious approach in clinical application, ensuring careful dosage control, monitoring, and risk management to prevent potential abuse and mitigate adverse effects.

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