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Beyond psychedelics: set and setting in general psychiatric practice.

Zofia Kozak, Christopher W. T. Miller

International Review of Psychiatry December 1, 2024 DOI: 10.1080/09540261.2024.2419662 (opens in new tab)

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AI-extracted from the abstract
Characteristics Theoretical or philosophical paper Peer reviewed
Topics Neuroplasticity
Keywords Psychotherapy Psychedelics Psychopharmacology Socioeconomic status
Citations 7
Key points Argues that integrating insights from psychedelic research, particularly 'set and setting', can improve depression treatment outcomes in traditional psychiatric settings by optimizing non-pharmacological factors such as high-quality psychotherapy.

Abstract

Psychedelic compounds continue gaining scientific and regulatory traction as potential new treatments for psychiatric disorders. While most psychiatrists will likely not work directly with these compounds, psychedelic research practices provide insights that may improve conventional psychiatric care. Through its emphasis on 'set and setting' (mindset and environment, respectively), psychedelic research highlights the importance of non-pharmacologic factors maximizing therapeutic outcomes. While psychedelics and serotonergic antidepressants are distinctly different in their subjective experience, new findings suggest mechanistic overlap between them. Both have been found to modulate neurotrophins, enhance neuroplasticity, and reopen critical periods of learning, molded by the environmental context in which they are administered. This paper will argue that by integrating insights from psychedelic research (particularly set and setting), depression treatment outcomes in traditional psychiatric settings can improve by optimizing non-pharmacological factors in treatment, including the provision of high-quality psychotherapy.

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