LSD and psilocybin for chronic nociplastic pain: A narrative review of the literature supporting the use of classic psychedelic agents in chronic pain.

Managing chronic nociplastic pain remains challenging because pain is multidimensional and current treatments often fall short. Classic psychedelics such as LSD and psilocybin, which act on the serotonin system, have a long history of use for chronic pain and mental health conditions. Recent research on psychedelics for major depressive disorder opens opportunities to apply these drugs to chronic pain management. This narrative review provides healthcare workers with a framework for understanding how these drugs act on chronic nociplastic pain pathways, along with a brief history of their use. The authors conducted a PubMed search using keywords including 'chronic pain,' 'psilocybin,' and 'lysergic acid diethylamide' without date limits, supplemented by Google Scholar searches and updates from leading pain journals.

Study at a glance

Abstract

Healthcare providers face the challenging task of managing patients who suffer from chronic nociplastic pain conditions. Pain is a multidimensional experience, and the current approach to managing people in chronic pain often fails to meet the needs of these patients. Novel ways of treating people who suffer from chronic nociplastic pain with classic psychedelic agents may offer a new lens through which to approach their pain. Lysergic acid diethylamide (LSD) and psilocybin are both serotonergic agents with a long history of use in treating people with chronic pain and mental health disorders. The new wave of research into psychedelics for major depressive disorder provides an opportunity to investigate and understand the potential for incorporating these drugs into chronic pain management pathways. This narrative review presents healthcare workers with a framework to understand the method of action of these drugs in chronic nociplastic pain pathways and a brief history into their use. We conducted an online search using Pubmed with keywords 'chronic pain' AND/OR 'psilocybin' AND/OR 'lysergic acid diethylamide' AND/OR 'psychedelics' with no date limit applied. We identified further articles that contained information on the neuroscience of psychedelics and the serotonergic system using Google Scholar. During the final stages of writing the article, the latest publications on psychedelics and chronic pain in leading pain journals were again included to update the information.