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Soto-Angona Ó, Fortea A, Fortea L, Martínez-Ramírez M, Santamarina E, López FJG, Knudsen GM, Ona G. Do classic psychedelics increase the risk of seizures? A scoping review. Eur Neuropsychopharmacol 2024; 85:35-42. [PMID: 38917636 DOI: 10.1016/j.euroneuro.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 04/27/2024] [Accepted: 05/01/2024] [Indexed: 06/27/2024]
Abstract
Seizures are a concerning adverse event frequently associated with the use of psychedelics, and hence, studies involving these substances tend to exclude patients with past history of epilepsy. This is especially relevant because epileptic seizures are markedly increased in the population suffering from mental disorders, and psychedelic assisted therapy is being researched as a promising treatment for several of them. To determine the extent of the current literature on the relationship between classic psychedelics and seizures, a scoping review was performed using the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews). The search was conducted in PubMed, Web of Science, Google scholar, LILACS and Scielo, and both animal and human models were included. A total of 16 publications on humans, and 11 on animals, were found. The results are heterogeneous, but globally suggest that psychedelics may not increase the risk of seizures in healthy individuals or animals in the absence of other drugs. However, concomitant use of other substances or drugs, such as kambo or lithium, could increase the risk of seizures. Additionally, these conclusions are drawn from data lacking sufficient external validity, so they should be interpreted with caution. Future paths for research and a summary on possible neurobiological underpinnings that might clarify the relationship between classical psychedelics and seizures are also provided.
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Affiliation(s)
- Óscar Soto-Angona
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Parc Sanitari Sant Joan de Déu, Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain
| | - Adriana Fortea
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Barcelona, Spain; Fundació Clínic per a la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Lydia Fortea
- Fundació Clínic per a la Recerca Biomèdica-Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain; Department of Medicine, University of Barcelona, Institute of Neuroscience, Barcelona, Spain
| | - María Martínez-Ramírez
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | - Estevo Santamarina
- Epilepsy Unit. Department of Neurology, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain
| | | | - Gite Moos Knudsen
- Neurobiology Research Unit, Rigshospitalet and Dept. Clinical Medicine, University of Copenhagen, Denmark
| | - Genís Ona
- Sociedad Española de Medicina Psicodélica (SEMPsi), Barcelona, Spain; Fundació Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain; Universitat Rovira i Virgili, Medical Anthropology Research Center (MARC), Department of Anthropology, Philosophy and Social Work, Tarragona, Catalonia, Spain.
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Williams M, Kingston Miller A, Lafrance A. Ayahuasca ceremony leaders' perspectives on special considerations for eating disorders. Eat Disord 2024; 32:120-139. [PMID: 37943076 DOI: 10.1080/10640266.2023.2271201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
Eating disorders (EDs) are difficult conditions to resolve, necessitating novel treatments. Ayahuasca, a psychedelic plant medicine originating in Indigenous Amazonian communities, is being investigated. Aspects of ceremonial ayahuasca use (purging, dietary restrictions) appear similar to ED behaviors, raising questions about ayahuasca's suitability as an intervention for individuals with EDs. This study explored the perspectives of ayahuasca ceremony leaders on these and other considerations for ceremonial ayahuasca drinking among individuals with EDs. A qualitative content analysis of interviews was undertaken with 15 ayahuasca ceremony leaders, the majority of whom were from the West/Global North. Screening for EDs, purging and dietary restrictions, potential risks and dangers, and complementarity with conventional ED treatment emerged as categories. The findings offer ideas, including careful screening and extra support, to promote safe and beneficial ceremony experiences for ceremony participants with EDs. More research is needed to clarify the impacts of ceremony-related purging and preparatory diets. To evolve conventional models of treatment, the ED field could consider Indigenous approaches to mental health whereby ayahuasca ceremony leaders and ED researchers and clinicians collaborate in a decolonizing, bidirectional bridging process between Western and Indigenous paradigms of healing.
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Affiliation(s)
- Meris Williams
- Independent Researcher, Vancouver, British Columbia, Canada
| | - Annie Kingston Miller
- School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada
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Evans J, Robinson OC, Argyri EK, Suseelan S, Murphy-Beiner A, McAlpine R, Luke D, Michelle K, Prideaux E. Extended difficulties following the use of psychedelic drugs: A mixed methods study. PLoS One 2023; 18:e0293349. [PMID: 37874826 PMCID: PMC10597511 DOI: 10.1371/journal.pone.0293349] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 10/11/2023] [Indexed: 10/26/2023] Open
Abstract
Long-term adverse experiences following psychedelic use can persist for weeks, months, or even years, and are relatively unexplored in psychedelic research. Our convergent mixed-method study gained quantitative and qualitative data from 608 participants who reported extended difficulties following psychedelic experiences. Data was gathered on the context of use, the nature and duration of the challenges they experienced (including a written description of these), plus a range of possible risk factors and perceived causes. The most common forms of extended difficulty were feelings of anxiety and fear, existential struggle, social disconnection, depersonalization and derealization. For approximately one-third of the participants, problems persisted for over a year, and for a sixth, they endured for more than three years. It was found that a shorter duration of difficulties was predicted by knowledge of dose, drug type and lower levels of difficulty reported during the psychoactive experience, while a narrower range of difficulties was predicted by taking the drug in a guided setting. Implications for psychedelic harm reduction are discussed.
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Affiliation(s)
- Jules Evans
- Centre for the History of Emotions, Queen Mary University, London, United Kingdom
| | - Oliver C. Robinson
- School of Human Sciences, University of Greenwich, London, United Kingdom
| | | | - Shayam Suseelan
- School of Human Sciences, University of Greenwich, London, United Kingdom
| | | | - Rosalind McAlpine
- Division of Psychology & Language Sciences, University of College London, London, United Kingdom
| | - David Luke
- School of Human Sciences, University of Greenwich, London, United Kingdom
| | - Katrina Michelle
- Department of Applied Psychology, New York University, New York, New York, United States of America
| | - Ed Prideaux
- Researcher, Perception Restoration Foundation, San Juan, Puerto Rico, United States of America
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Bouso JC, Révész D, Ona G, Rossi GN, Rocha JM, Dos Santos RG, Hallak JEC, Alcázar-Corcoles MÁ. Longitudinal and transcultural assessment of the relationship between hallucinogens, well-being, and post-traumatic growth during the COVID-19 pandemic. Sci Rep 2023; 13:14052. [PMID: 37696900 PMCID: PMC10495368 DOI: 10.1038/s41598-023-41199-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/23/2023] [Indexed: 09/13/2023] Open
Abstract
The COVID-19 pandemic has had a devastating impact on the health and wellbeing of the global population. This paper presents the results of a longitudinal transcultural study that was begun at the peak of the pandemic (in April, 2020). An online survey was used to collect data from English-, Spanish-, and Portuguese-speaking participants. The survey collected information about sociodemographics, lifestyle activities, COVID-19-related circumstances, and drug use (with an emphasis on hallucinogenic drugs), as well as involving psychometric questionnaires. Users of hallucinogenic drugs had higher psychological well-being and lower scores on psychopathology scales, both at baseline and during follow-ups. This difference was larger when users were distinguished by frequency of use, as regular users scored higher on psychological well-being and lower on psychopathology scales. Subjects with more psychological distress had lower scores for all scales of post-traumatic growth, but if they were regular hallucinogens users, they had higher scores for post-traumatic growth. When comparing the results between cultural contexts, heterogeneous results were obtained. There were more English-speaking regular users of hallucinogenic drugs. Further research should analyse the potential role of hallucinogens in large-scale catastrophes, with a special focus on post-traumatic growth.
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Affiliation(s)
- José Carlos Bouso
- ICEERS-International Center for Ethnobotanical Education, Research, and Service, C/ Sepúlveda, 65 Bajos 2, 08015, Barcelona, Catalunya, Spain.
- Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, Catalunya, Spain.
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
| | - Dóra Révész
- ICEERS-International Center for Ethnobotanical Education, Research, and Service, C/ Sepúlveda, 65 Bajos 2, 08015, Barcelona, Catalunya, Spain
| | - Genís Ona
- ICEERS-International Center for Ethnobotanical Education, Research, and Service, C/ Sepúlveda, 65 Bajos 2, 08015, Barcelona, Catalunya, Spain
- Medical Anthropology Research Center (MARC), Universitat Rovira i Virgili, Tarragona, Catalunya, Spain
| | - Giordano N Rossi
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Juliana M Rocha
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Rafael G Dos Santos
- ICEERS-International Center for Ethnobotanical Education, Research, and Service, C/ Sepúlveda, 65 Bajos 2, 08015, Barcelona, Catalunya, Spain
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology-Translational Medicine, São Paulo, Brazil
| | - Jaime E C Hallak
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
- National Institute of Science and Technology-Translational Medicine, São Paulo, Brazil
| | - Miguel Ángel Alcázar-Corcoles
- Department of Biological and Health Psychology, School of Psychology, Autonomous University of Madrid (UAM), Madrid, Spain
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Rodríguez-Cano BJ, Kohek M, Ona G, Alcázar-Córcoles MÁ, Dos Santos RG, Hallak JEC, Bouso JC. Underground ibogaine use for the treatment of substance use disorders: A qualitative analysis of subjective experiences. Drug Alcohol Rev 2023; 42:401-414. [PMID: 36456173 DOI: 10.1111/dar.13587] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 10/16/2022] [Accepted: 11/12/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION Ibogaine is one of the alkaloids naturally found in plants such as Tabernanthe iboga, which has been traditionally used by members of the Bwiti culture. Since the discovery of its anti-addictive properties by Howard S. Lotsof in 1962, ibogaine has been used experimentally to treat substance use disorders (SUD), especially those involving opioids. We aim to provide a detailed understanding of the underlying psychological aspects of underground ibogaine use for the treatment of SUD. METHODS Semi-structured interviews were carried out with 13 participants with SUD, which motivated their self-treatment with ibogaine. The data were analysed using the grounded theory approach and considered the context of the treatment, and the nature of the occurring hallucinogenic and cognitive phenomena during the treatment experience. RESULTS We identified several psychological effects that the study respondents experienced, which seem to play a substantial role in the therapeutic process concerning SUD. The evoking of interpersonal and transpersonal experiences, autobiographical memories, and preparation, integration and motivation for a lifestyle change are important components that participants reported during and after ibogaine intake. DISCUSSION AND CONCLUSION Ibogaine is increasingly being used for the treatment of SUD, due in part to the limited treatment options currently available. Its beneficial effects seem to be related not only to its complex pharmacology but also to the subjective experience that ibogaine induces. The main aspects of this experience are related to autobiographical memories and valuable personal insights, which together appear to help individuals cope with their SUD.
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Affiliation(s)
- Borja J Rodríguez-Cano
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
| | - Maja Kohek
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | - Genís Ona
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
| | | | - Rafael G Dos Santos
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
- Department of Neurosciences and Behavior, University of São Paulo, São Paulo, Brazil
- National Institute for Translational Medicine, Brazil
| | - Jaime E C Hallak
- Department of Neurosciences and Behavior, University of São Paulo, São Paulo, Brazil
- National Institute for Translational Medicine, Brazil
| | - José Carlos Bouso
- International Center for Ethnobotanical Education, Research and Service, Barcelona, Spain
- Medical Anthropology Research Center, Universitat Rovira i Virgili, Tarragona, Spain
- Department of Neurosciences and Behavior, University of São Paulo, São Paulo, Brazil
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Hallucinations and Hallucinogens: Psychopathology or Wisdom? Cult Med Psychiatry 2023; 47:576-604. [PMID: 36633720 PMCID: PMC9838303 DOI: 10.1007/s11013-022-09814-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/27/2022] [Indexed: 01/13/2023]
Abstract
Hallucinations are currently associated almost exclusively with psychopathological states. While it is evident that hallucinations can indicate psychopathology or neurological disorders, we should remember that hallucinations also commonly occur in people without any signs of psychopathology. A similar case occurs in the case of hallucinogenic drugs, which have been long associated with psychopathology and insanity. However, during the last decades a huge body of research has shown that certain kinds of hallucinations, exerted by hallucinogenic drugs, may serve to improve mental health. We propose that, in light of historical, epidemiological, and scientific research, hallucinations can be better characterized as a common phenomenon associated sometimes with psychopathology but also with functional and even beneficial outcomes. In the last sections of the manuscript, we extend our argument, suggesting that hallucinations can offer a via regia to knowledge of the mind and the world. This radical shift in the cultural interpretation of hallucinations could have several implications for fields such as drug policy, civil law, and psychiatry, as well as for the stigma associated with mental disorders.
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Ayahuasca's therapeutic potential: What we know - and what not. Eur Neuropsychopharmacol 2023; 66:45-61. [PMID: 36368095 DOI: 10.1016/j.euroneuro.2022.10.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Revised: 10/08/2022] [Accepted: 10/14/2022] [Indexed: 11/10/2022]
Abstract
The therapeutic potential of the psychedelic brew ayahuasca has been investigated in preclinical and clinical studies. Currently, the most consistent evidence refers to depression. However, various studies suggest that ayahuasca may comprise therapeutic benefits in other health conditions. This narrative review provides a comprehensive, up-to-date overview of ayahuasca's therapeutic effects in diverse clinical conditions in human (clinical, cross-sectional, observational, and qualitative) and preclinical (animal and in vitro) studies. In addition to summarizing and discussing the most commonly studied conditions, such as depression, anxiety, and substance use disorders (SUD), we also examine less frequently studied psychiatric, neurological, and physical conditions. Moreover, we discuss evidence from epidemiological studies on the impact of regular, long-term ayahuasca use on health and psychosocial outcomes. Overall, evidence for depression and SUD is more consistent, with numerous and diverse studies. However, a growing body of evidence suggests that other conditions equally relevant to public health might be promising targets for ayahuasca's therapeutic effects. This includes preliminary studies indicating potential for grief, eating disorders, posttraumatic stress disorder, personality disorders, Parkinson's and Alzheimer's disease, and severe physical illnesses (e.g., cancer, chronic conditions). Moreover, preliminary evidence in long-term ayahuasca users does not suggest detrimental effects but possible benefits for individual and collective health. In light of the emerging evidence of psychedelic drugs as therapeutic agents, it is essential to further investigate in rigorous designs the therapeutic potential of ayahuasca in conditions other than depression.
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Ona G, Kohek M, Bouso JC. The illusion of knowledge in the emerging field of psychedelic research. NEW IDEAS IN PSYCHOLOGY 2022. [DOI: 10.1016/j.newideapsych.2022.100967] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Bouso JC, Andión Ó, Sarris JJ, Scheidegger M, Tófoli LF, Opaleye ES, Schubert V, Perkins D. Adverse effects of ayahuasca: Results from the Global Ayahuasca Survey. PLOS GLOBAL PUBLIC HEALTH 2022; 2:e0000438. [PMID: 36962494 PMCID: PMC10021266 DOI: 10.1371/journal.pgph.0000438] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 10/07/2022] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Ayahuasca is a plant-based decoction native to Amazonia, where it has a long history of use in traditional medicine. Contemporary ritual use of ayahuasca has been expanding throughout the world for mental health purposes, and for spiritual and personal growth. Although researchers have been conducting clinical trials and observational studies reporting medical and psychological benefits, most of these do not report ayahuasca's immediate or medium-term adverse effects, so these are underrepresented in the literature. With the expansion of ayahuasca ceremonies from their traditional contexts to countries around the world, there is an important public health question regarding the risk/benefit balance of its use. METHODS We used data from an online Global Ayahuasca Survey (n = 10,836) collected between 2017 and 2019 involving participants from more than 50 countries. Principal component analysis was performed to assess group effects. Logistic regression analysis was performed to test for adverse effects associated with history of ayahuasca use, clinical, context of use and spiritual effect variables. RESULTS Acute physical health adverse effects (primarily vomiting) were reported by 69.9% of the sample, with 2.3% reporting the need for subsequent medical attention. Adverse mental health effects in the weeks or months following consumption were reported by 55.9% of the sample, however, around 88% considered such mental health effects as part of a positive process of growth or integration. Around 12% sought professional support for these effects. Physical adverse effects were related to older age at initial use of ayahuasca, having a physical health condition, higher lifetime and last year ayahuasca use, having a previous substance use disorder diagnosis, and taking ayahuasca in a non-supervised context. Mental health adverse effects were positively associated with anxiety disorders; physical health conditions; and the strength of the acute spiritual experience; and negatively associated with consumption in religious settings. CONCLUSIONS While there is a high rate of adverse physical effects and challenging psychological effects from using ayahuasca, they are not generally severe, and most ayahuasca ceremony attendees continue to attend ceremonies, suggesting they perceive the benefits as outweighing any adverse effects. Knowing what variables might predict eventual adverse effects may serve in screening of, or providing additional support for, vulnerable subjects. Improved understanding of the ayahuasca risk/benefit balance can also assist policy makers in decisions regarding potential regulation and public health responses.
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Affiliation(s)
- José Carlos Bouso
- International Center for Ethnobotanical Education, Research and Services (ICEERS), Barcelona, Spain
- Medical Anthropology Research Center, Department of Anthropology, Philosophy and Social Work, University of Rovira I Virgili, Tarragona, Spain
- Department of Neurosciences and Behavior, Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Óscar Andión
- Research Sherpas, Mieres (Olot), Sabadell, Spain
| | - Jerome J Sarris
- Psychae Institute, Melbourne, Australia
- NICM Health Research Institute, Western Sydney University, Westmead, Australia
- Florey Institute of Neuroscience and Mental Health, The Melbourne Clinic Professorial Unit, Department of Psychiatry, University of Melbourne, Melbourne, Australia
| | - Milan Scheidegger
- Department of Psychiatry, Psychotherapy, and Psychosomatics, University Hospital of Psychiatry Zurich, University of Zurich, Zurich, Switzerland
| | - Luís Fernando Tófoli
- Interdisciplinary Cooperation for Ayahuasca Research and Outreach (ICARO), School of Medical Sciences, University of Campinas, Campinas, Brazil
| | | | - Violeta Schubert
- School of Social and Political Science, University of Melbourne, Melbourne, Australia
| | - Daniel Perkins
- Psychae Institute, Melbourne, Australia
- School of Social and Political Science, University of Melbourne, Melbourne, Australia
- School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Centre for Mental Health, Swinburne University, Melbourne, Australia
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