Brazilian Psychedelic Science and the Frontiers of PsychiatryThe use of psychedelic substances has intrigued, benefited, and challenged humanity for millennia. These substances, found regularly in nature, are known to induce non-ordinary states of consciousness. They provide heightened sensory, emotional and cognitive experiences, which include augmented visual imagery, changes in thought, mood, and awareness, perception of space-time and reality and, in many cases, profound insights, and mystical experiences. Throughout history, many indigenous populations around the world developed the use of these substances, especially as a vital component of healing. From the Amazon, for example, Ayahuasca emerged, a drink made from the combination of two plants, used ancestrally by shamans to promote physical and psychological healing. Likewise, indigenous populations in North America, such as the Navajo, retain the ancestral use of the peyote cactus as sacred medicine, while indigenous populations such as the Mazatecs of Mexico used psilocybin-containing mushrooms in their healing rituals1.
During the 1950s to 1970s, there was intense biomedical research activity on psychedelics. However, despite this rich history, the 20th century brought with it a more skeptical and repressive perspective regarding the use of psychedelics. About 50 years ago, these substances were banned internationally under the false claims that they had a high potential for abuse, lack therapeutic value and were unsafe for use, even under medical supervision. This decision was not based on scientific evidence, but rather on ideological motivations that prohibited the therapeutic use of psychedelic substances2.
In the last two decades, however, there has been a vigorous resurgence of biomedical research on psychedelics. Several studies have revealed low potential for abuse, and a considerable therapeutic potential, particularly for mood disorders. In this scenario, Brazil has emerged as one of the global leaders in the psychedelic renaissance, positioning itself as the third country in the world in producing high-quality research on the topic, behind the United States and the United Kingdom.
Results from a phase II clinical trial have shown rapid and long-lasting antidepressant effects after a single intervention with ayahuasca in patients with treatment-resistant depression3. Phase III studies with MDMA4 and psilocybin5 are ongoing, and recently the Australian government recognized the therapeutic value of these substances in the treatment of depression and Post-Traumatic Stress Disorder. In the United States, the state of Oregon and the city of Denver have also approved the decriminalization of certain psychedelics.
In light of these developments, Brazilian psychiatry is at a crucial point to integrate the scientific and clinical aspects of psychedelics comprehensively. Considering our powerful anthropological, cultural and scientific heritage on psychedelics, coupled with their potential to revolutionize the treatment of mental disorders, Brazil has the opportunity and responsibility to lead the vanguard of this exciting medical frontier.
REFERENCES
- 1 Labate BC, Goulart SL. O uso de plantas psicoativas nas Américas. Gramma Editora; 2019 Nov 27.
- 2 Grinspoon L, Bakalar JB. Psychedelic drugs reconsidered. New York: Basic Books; 1979 Jan.
- 3 Palhano-Fontes F, Barreto D, Onias H, Andrade KC, Novaes MM, Pessoa JA, Mota-Rolim SA, Osório FL, Sanches R, Dos Santos RG, Tófoli LF. Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial. Psychological medicine. 2019 Mar;49(4):655-63.
- 4 Mitchell JM, Ot'alora G M, van der Kolk B, Shannon S, Bogenschutz M, Gelfand Y, Paleos C, Nicholas CR, Quevedo S, Balliett B, Hamilton S. MDMA-assisted therapy for moderate to severe PTSD: a randomized, placebo-controlled phase 3 trial. Nature Medicine. 2023 Sep 14:1-8.
- 5 Goodwin GM, Aaronson ST, Alvarez O, Arden PC, Baker A, Bennett JC, Bird C, Blom RE, Brennan C, Brusch D, Burke L. Single-dose psilocybin for a treatment-resistant episode of major depression. New England Journal of Medicine. 2022 Nov 3;387(18):1637-48.
