Current perspectives on psychedelic therapy: use of serotonergic hallucinogens in clinical interventions

Serotonergic hallucinogens (psychedelics) have been used for millennia, but their integration into Western therapeutic practice is relatively new. Mid-20th-century work developed therapeutic models using both low (psycholytic) and high (psychedelic) doses, often combined with psychoanalytic concepts, and established the importance of set (mindset) and setting (environment) for safe, effective use. Recent clinical and pharmacological research has revisited these substances' therapeutic potential. This article reviews past and present models of psychedelic therapy and discusses key considerations for future research and clinical applications.

Study at a glance

Abstract

Humans have used serotonergic hallucinogens (i.e. psychedelics) for spiritual, ceremonial, and recreational purposes for thousands of years, but their administration as part of a structured therapeutic intervention is still a relatively novel practice within Western medical and psychological frameworks. In the mid-20th century, considerable advances were made in developing therapeutic approaches integrating administration of low (psycholytic) and high (psychedelic) doses of serotonergic hallucinogens for treatment of a variety of conditions, often incorporating psychoanalytic concepts prevalent at that time. This work contributed seminal insights regarding how these substances may be employed with efficacy and safety in targeted therapeutic interventions, including the importance of optimizing set (frame of mind) and setting (therapeutic environment). More recently, clinical and pharmacological research has revisited the effects and therapeutic potential of psychedelics utilizing a variety of approaches. The current article provides an overview of past and present models of psychedelic therapy, and discusses important considerations for future interventions incorporating the use of psychedelics in research and clinical practice.