Psychedelics in Psychiatry: New Treatment Paradigms or Addictive Treatment Strategies? A Narrative Review

Psychedelics, studied since the 1800s, are seeing renewed scientific interest after decades of prohibition. Research points to their therapeutic potential for treatment-resistant psychiatric disorders and their usefulness for studying brain networks and consciousness. This chapter reviews the history, traditional uses, mechanisms, and clinical evidence for ayahuasca, mescaline, psilocybin, ibogaine, and LSD. It also covers regulatory and ethical issues like informed consent and cultural respect, and discusses debates on ego dissolution and 'non-subjective psychedelics.' Psychedelics are described as 'molecules of complexity' that integrate biological, psychological, and social dimensions, suggesting a paradigm shift in psychiatry. However, the data remain preliminary and not unequivocal; excessive enthusiasm could expose people to more risks than benefits if research is not rigorous.

Study at a glance

Abstract

Scientific interest in psychedelics, documented since the nineteenth century, has recently resurged after decades of prohibition. Contemporary research highlights their therapeutic potential in treatment-resistant psychiatric disorders, alongside their heuristic value for studying brain networks and consciousness. This chapter reviews the historical trajectory, traditional uses, mechanisms of action, and clinical evidence regarding key substances used in traditional or shamanic medicine (ayahuasca, mescaline, psilocybin, and ibogaine) and the psychedelic symbol of the hippy revolution, LSD. It further examines regulatory challenges and ethical concerns, including informed consent, cultural respect, and professional boundaries. Phenomenological debates on ego dissolution and the emergence of “non-subjective psychedelics” are discussed. Overall, psychedelics appear as “molecules of complexity,” integrating biological, psychological, and social dimensions, and suggesting a paradigm shift in psychiatry. Despite these promising developments, that in the chapter are underlined, the conclusive discussion emphasized that the data are still preliminary and not unequivocal. This caveat has to be strongly underlined: an excess of enthusiasm may expose treated people to more risks than benefits if research is not rigorously conducted.