The potential of 5‐methoxy‐N,N‐dimethyltryptamine in the treatment of alcohol use disorder: A first look at therapeutic mechanisms of action
Addiction Biology April 1, 2024 DOI: 10.1111/adb.13386 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | 5-MeO-DMT Addiction DMT |
| Keywords | 5‐Methoxy‐N,N‐Dimethyltryptamine Classic psychedelics Psychedelics entheogens Hallucinogens Rehabilitation Recovery |
| Citations | 12 |
| Key findings | 5-MeO-DMT may treat alcohol use disorder through mystical experiences, ego-dissolution, increased psychological flexibility and mindfulness, modulation of neural oscillations, and neuroplastic and anti-inflammatory effects. |
Abstract
Abstract Alcohol use disorder (AUD) remains one of the most prevalent psychiatric disorders worldwide with high economic costs. Current treatment options show modest efficacy and relapse rates are high. Furthermore, there are increases in the treatment gap and few new medications have been approved in the past 20 years. Recently, psychedelic‐assisted therapy with psilocybin and lysergic acid diethylamide has garnered significant attention in the treatment of AUD. Yet, they require significant amounts of therapist input due to prolonged subjective effects (~4–12 h) leading to high costs and impeding implementation. Accordingly, there is an increasing interest in the rapid and short‐acting psychedelic 5‐methoxy‐ N,N ‐dimethyltryptamine (5‐MeO‐DMT). This paper offers a first look at potential therapeutic mechanisms for AUD by reviewing the current literature on 5‐MeO‐DMT. Primarily, 5‐MeO‐DMT is able to induce mystical experiences and ego‐dissolution together with increases in psychological flexibility and mindfulness. This could decrease AUD symptoms through the alleviation of psychiatric mood‐related comorbidities consistent with the negative reinforcement and self‐medication paradigms. In addition, preliminary evidence indicates that 5‐MeO‐DMT modulates neural oscillations that might subserve ego‐dissolution (increases in gamma ), psychological flexibility and mindfulness (increases in theta ), and the reorganization of executive control networks (increases in coherence across frequencies) that could improve emotion regulation and inhibition. Finally, animal studies show that 5‐MeO‐DMT is characterized by neuroplasticity, anti‐inflammation, 5‐HT 2A receptor agonism, and downregulation of metabotropic glutamate receptor 5 with clinical implications for AUD and psychiatric mood‐related comorbidities. The paper concludes with several recommendations for future research to establish the purported therapeutic mechanisms of action.
Comparable studies
Other narrative reviews on DMT, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Neuropharmacology of N,N-dimethyltryptamine | 2016 | Review | |
| N, N-Dimethyltryptamine (DMT), an Endogenous Hallucinogen: Past, Present, and Future Research to Determine Its Role and Function Humans and animals (general) | 2018 | Review | |
| Psychedelic 5-methoxy-N,N-dimethyltryptamine: metabolism, pharmacokinetics, drug interactions, and pharmacological actions. Humans (pharmacokinetics) | 2010 | Review | |
| Pharmahuasca: Human Pharmacology of Oral DMT Plus Harmine Human self-experimenters | 1999 | Review | n = 8 |
| The psychedelic model of schizophrenia: the case of N,N- dimethyltryptamine | 1976 | Review |
Citations in the library
Cited by 12
- Innovative Psychedelic Therapies: Harnessing 5-MeO-DMT and DMT for Mental Health Treatment. ACS Medicinal Chemistry Letters November 14, 2024
- 5‐Methoxy‐ N , N ‐dimethyltryptamine (5‐MeO‐DMT) for alcohol use disorder: An open‐label, phase 2, proof‐of‐concept, clinical trial Addiction December 10, 2025
- Therapeutic and Structural Dimensions in Psychiatric Prescribing: Bridging Psychedelics and Antidepressants. Harvard Review of Psychiatry
- Expanding the Therapeutic Horizons of Psilocybin in Mental Health ACS Medicinal Chemistry Letters October 15, 2024
- The way of O: phenomenology of psychedelic use and the path to ultimate reality Psychodynamic Practice June 24, 2024
and 7 more in the library
Cites 98
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- Psychedelics Promote Structural and Functional Neural Plasticity Cell Reports June 1, 2018
- Psychedelics and the essential importance of context. Journal of Psychopharmacology February 15, 2018
- Lysergic acid diethylamide (LSD) for alcoholism: meta-analysis of randomized controlled trials Journal of Psychopharmacology March 8, 2012
- The Subjective Effects of Psychedelics Are Necessary for Their Enduring Therapeutic Effects. ACS Pharmacology & Translational Science December 10, 2020
and 93 more in the library