Using Psychedelics in Clinical Practice: Comparing Therapeutic Uses and Potential Harms.

Résumé

Psychedelics might be the oldest psychoactive agents known to be used for inducing religious or mystical experiences. Their strong psychoactive effect was discovered accidentally in 1943 after the synthesis of Lysergic acid diethylamide (LSD) in 1937. These drugs became a mainstream area of research following the synthesis of LSD; however, several political and social factors led to their ban in 1966, after which research on psychedelics remained limited. These drugs became a major topic of scientific and ethical debate in the 1990's and the recent times have seen a 'Psychedelic renaissance' where the therapeutic value of psychedelics is being reconsidered. This article reports the historical perspective of psychedelics, pharmacologic action by 5-HT receptor agonism, and psychological effects and compares the proposed therapeutic uses, including uses in depression, PTSD, anxiety- related disorders, drug and alcohol addiction, neurodegenerative diseases, and auto-immune diseases to potential harms including the development of tolerance, hallucinogen persisting perception disorder, and potential psychosis. An analysis of history, pharmacology, and comparison of benefits and harms lead to the conclusion that the potential therapeutic benefits significantly outweigh the potential harms; thus, further research and clinical trials need to be conducted across different countries and cultures for their legal approval in clinical use.