Contemplating versus having used psychedelics in bipolar disorder - What makes the difference?

People with bipolar disorder who have used classic psychedelics like psilocybin or LSD hold more positive attitudes toward these substances and score higher on openness to experience compared to those who are only considering use. The two groups do not differ in sociodemographic background or mental health status. Those who have used psychedelics endorse certain motives for use more strongly, while those contemplating use express greater concerns about potential negative effects. The findings suggest that prior psychedelic experience shapes perceptions and motivations, and highlight topics for discussion with individuals with bipolar disorder who may consider psychedelic use, including in clinical trials.

Study at a glance

Abstract

In recent years psychedelics have gained popularity and potential promise in the field of mental health, but for patients diagnosed with bipolar disorder (BD), fears of emerging manic or psychotic symptoms have caused investigators to exclude them from psychedelic research. In this observational study, we explore the motivations, expectations, and personality characteristics of individuals with BD who have either used (i.e., experimenters) a classic psychedelic (i.e., psilocybin, LSD) or were considering using (i.e., contemplators) in the near future. We compared so-called experimenters to contemplators across various sociodemographic, psychological, and mental health variables. The groups did not differ in socio-demographic variables or mental health, however, experimenters demonstrated more positive attitudes towards psychedelics and more 'openness to experience.' Furthermore, certain motives for use were more strongly endorsed while contemplators expressed concerns about potential negative effects and outcomes. These findings highlight that previous psychedelic experience is associated with more positive perceptions and motivations for use, which might have also been shaped by the actual experience. While we do not advocate for unsupervised use of psychedelics outside of a clinical setting, the study provides some information what areas need to be discussed with individuals with BD who contemplate using psychedelics, even in the context of a clinical trial.