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Published Date: 20 December 2024

Primum Non Nocere: The Onus to Characterize the Potential Harms of Psychedelic Treatment

Publication: American Journal of Psychiatry

Abstract

The last few years have seen exponential growth in interest, investment, advocacy, and research into psychedelics as therapeutics. This reflects an optimism about the potential promise of psychedelics as therapeutics. As with all therapeutic interventions, research is needed not only into their benefits but also potential risks. Indeed, when substances with therapeutic potential are scrutinized over time, especially in broad populations with psychiatric and medical comorbidities typically excluded from clinical trials, and applied in less well-regulated or controlled settings, a greater understanding of the cautions emerges. Here, we review the literature on the known and potential harms, including enduring perceptual disturbances; triggering or enhancing the risk for onset of mania or psychosis; overuse, misuse, and dependence; challenging experiences or “bad trips”; risks associated with increased neuroplastic potential; and acute and cumulative cardiovascular effects. Each of these issues is addressed in this review, along with the call for continued research, including recommendations for further research and monitoring.

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Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 47 - 53
PubMed: 39741443

History

Received: 13 November 2023
Revision received: 26 March 2024
Accepted: 9 April 2024
Published online: 20 December 2024
Published in print: January 01, 2025

Keywords

  1. psychedelics
  2. risks
  3. ethics
  4. adverse effects

Authors

Details

Sharmin Ghaznavi, M.D., Ph.D. [email protected]
Department of Psychiatry, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Ghaznavi, King, Rosenbaum); Department of Cardiology, Massachusetts General Hospital, Boston (Ruskin); Department of Psychiatry and Neurology, Chemical Neurobiology Laboratory, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Haggerty); Havard Medical School, Boston (Ghaznavi, Ruskin, Haggerty, King, Rosenbaum).
Jeremy N. Ruskin, M.D.
Department of Psychiatry, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Ghaznavi, King, Rosenbaum); Department of Cardiology, Massachusetts General Hospital, Boston (Ruskin); Department of Psychiatry and Neurology, Chemical Neurobiology Laboratory, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Haggerty); Havard Medical School, Boston (Ghaznavi, Ruskin, Haggerty, King, Rosenbaum).
Stephen J. Haggerty, Ph.D.
Department of Psychiatry, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Ghaznavi, King, Rosenbaum); Department of Cardiology, Massachusetts General Hospital, Boston (Ruskin); Department of Psychiatry and Neurology, Chemical Neurobiology Laboratory, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Haggerty); Havard Medical School, Boston (Ghaznavi, Ruskin, Haggerty, King, Rosenbaum).
Franklin King IV, M.D.
Department of Psychiatry, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Ghaznavi, King, Rosenbaum); Department of Cardiology, Massachusetts General Hospital, Boston (Ruskin); Department of Psychiatry and Neurology, Chemical Neurobiology Laboratory, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Haggerty); Havard Medical School, Boston (Ghaznavi, Ruskin, Haggerty, King, Rosenbaum).
Jerrold F. Rosenbaum, M.D.
Department of Psychiatry, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Ghaznavi, King, Rosenbaum); Department of Cardiology, Massachusetts General Hospital, Boston (Ruskin); Department of Psychiatry and Neurology, Chemical Neurobiology Laboratory, Center for the Neuroscience of Psychedelics, Massachusetts General Hospital, Boston (Haggerty); Havard Medical School, Boston (Ghaznavi, Ruskin, Haggerty, King, Rosenbaum).

Notes

Send correspondence to Dr. Ghaznavi ([email protected]).

Competing Interests

Dr. Ghaznavi owns stock in Atai Life Sciences. Dr. Haggerty is on the scientific advisory boards of 4M Therapeutics, Alzheimer’s Drug Discovery Foundation, Entheos Labs, Frequency Therapeutics, Ilios Therapeutics, the Kissick Family Foundation FTD Grant Program, Psy Therapeutics, Souvien Theraputics, and Sensorium Therapeutics; he has received consulting fees from Juvenescence Life, and Biohaven Pharmaceuticals RBNC; he has also received research funding from Atai Life Sciences, COMPASS Pathways, Entheos Labs, JW Pharmaceuticals, Lexicon Pharmaceuticals, Stealth Biotherapeutics, and Vesigen Therapeutics. Dr. King owns stock in Apex Labs, COMPASS Pathways, and Cybin; he is on the scientific advisory board of Apex Labs; and has received consulting fees from Cybin. Dr. Rosenbaum owns stock in Atai Life Sciences, Cerebral Inc., Entheos Labs, Psy Therapeutics, Sensorium Therapeutics, TaraMind, and Terran Biosciences; he is a member of the board of directors for Cerebral Inc., Entheos Labs, Psy Therapeutics, and Sensorium Therapeutics; he is an advisor for TaraMind. Dr. Ruskin owns stock in Ablacor, Celero, Element Science, Infobionic, LuxMed, and NewPace; he has received consulting fees and is a member of the scientific advisory board for Acesion Pharma, Advanced Medical Education, InCarda, Janssen, Sanofi, and Vertex; he holds a patent from Celero Systems.

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