Psychedelic Medicines and Drugs: A Comprehensive Guide
As interest in psychedelic-assisted therapies grows, understanding these substances' histories, effects, and potential therapeutic benefits becomes essential for anyone seeking alternative treatments for complex conditions such as PTSD, depression, and anxiety.
Psychedelics, historically used for spiritual and therapeutic purposes, are gaining renewed interest in the scientific community due to their unique ability to profoundly alter perception, mood, and cognitive processes. These comparative tables list the most common psychedelics, including ketamine, MDMA, psilocybin, ayahuasca, LSD, mescaline, and DMT, examining their mechanisms of action, therapeutic uses, and the legal landscape governing their clinical use.
Explore Psychedelic Medicines and Therapies:
Classification
Substance | Purpose |
Ketamine | Dissociative anesthetic |
MDMA | Empathogen-entactogen |
Psilocybin | Serotonergic psychedelic |
Ayahuasca | Psychedelic brew containing DMT |
LSD (Lysergic Acid Diethylamide) | Serotonergic psychedelic |
Mescaline | Phenethylamine psychedelic |
DMT (Dimethyltryptamine) | Tryptamine psychedelic |
Chemical Structure
Substance | Chemical Structure |
Ketamine | C13H16ClNO |
MDMA | C11H15NO2 |
Psilocybin | C12H17N2O4P |
Ayahuasca | Primary active ingredient is DMT (C12H16N2) |
LSD | C20H25N3O |
Mescaline | C11H17NO3 |
DMT | C12H16N2 |
History of Use
Substance | History of Use |
Ketamine | Developed in the 1960s for anesthesia; more recently used to treat depression. |
MDMA | Synthesized in 1912; used as a psychotherapeutic tool in the 1970s; became popular as a recreational drug in the 1980s. |
Psilocybin | Used traditionally in religious and spiritual contexts; studied scientifically in the 1960s. |
Ayahuasca | Used for centuries in South American shamanic practices. |
LSD | Synthesized in 1938 and popularized in the 1960s counterculture. |
Mescaline | Used traditionally by Native Americans for spiritual and religious purposes. |
DMT | Used traditionally in various indigenous Amazonian rituals; found naturally in several plant species. |
Subjective Effects
Substance | Subjective Effects |
Ketamine | Dissociation from reality, altered perception, and tranquility under clinical settings. |
MDMA | Increased empathy, emotional warmth, and euphoria. |
Psilocybin | Altered visual and auditory perceptions, sense of connectedness, mystical experiences. |
Ayahuasca | Intense visual hallucinations, emotional revelations. |
LSD | Distortions in sensory perception, profound psychological insights, altered sense of time. |
Mescaline | Visual hallucinations, altered consciousness, euphoria, and profound introspection. |
DMT | Short-acting but intense visual and auditory hallucinations, profound emotional shifts. |
Mechanism of Action
Substance | Mechanism of Action |
Ketamine | Blocks NMDA receptors in the brain, affecting glutamate, a neurotransmitter. |
MDMA | Increases the release of serotonin, dopamine, and norepinephrine. |
Psilocybin | Agonist at serotonin receptors, particularly in the prefrontal cortex. |
Ayahuasca | Contains DMT, which acts as a serotonin receptor agonist. |
LSD | Serotonin receptor agonist, particularly affecting the 5-HT2A receptor. |
Mescaline | Acts primarily on serotonin receptors. |
DMT | Binds to serotonin receptors, similar to other psychedelics. |
Therapeutic Uses
Substance | Therapeutic Uses |
Ketamine | Treatment-resistant depression, acute management of pain. |
MDMA | PTSD, potentially anxiety and other mood disorders. |
Psilocybin | Treatment-resistant depression, end-of-life anxiety, addiction. |
Ayahuasca | Studied for depression and addiction. |
LSD | Experimental treatments for anxiety, depression, and PTSD. |
Mescaline | Investigated for therapeutic potential in treating addiction and facilitating psychological exploration. |
DMT | Currently under research for various psychiatric conditions. |
Regulatory Status
Substance | Regulatory Status |
Ketamine | FDA-approved for anesthesia; used off-label for depression. |
MDMA | Schedule I in the USA; undergoing clinical trials for PTSD. |
Psilocybin | Schedule I in the USA; granted Breakthrough Therapy designation by the FDA for depression. |
Ayahuasca | Not regulated as a medicine; illegal in many countries. |
LSD | Schedule I in the USA. |
Mescaline | Controlled substance in many countries, with no mainstream medical use approved. |
DMT | Schedule I in the USA. |
Side Effects (Clinical Setting)
Substance | Side Effects (Clinical Setting) |
Ketamine | Nausea, dizziness, dissociation, elevation in blood pressure. |
MDMA | Nausea, mild anxiety, jaw clenching, transient increase in heart rate. |
Psilocybin | Mild anxiety, headache, altered sensory perception. |
Ayahuasca | Nausea, vomiting (commonly referred to as "purging"), intense emotional upheaval. |
LSD | Minimal physiological toxicity; potential for flashbacks. |
Mescaline | Typically mild, including headache and nausea. |
DMT | Minimal when used in controlled settings; primarily psychological effects like altered sensory perception and emotional intensity. |
Side Effects (Casual / Abuse)
Substance | Side Effects (Casual / Abuse) |
Ketamine | Potential for abuse, long-term cognitive deficits, bladder issues. |
MDMA | Dehydration, hyperthermia, potential neurotoxicity, dependency. |
Psilocybin | Psychological distress, potential for triggering psychiatric conditions. |
Ayahuasca | Psychological distress, potential exacerbation of mental health issues. |
LSD | Hallucinogen persisting perception disorder, paranoia, disorientation. |
Mescaline | Can cause significant psychological distress and potential for panic. |
DMT | Potential for frightening hallucinations, overwhelming fear, and confusion. |
Find Out More
Outside of clinical research settings, ketamine remains the sole FDA-approved psychedelic therapy. Ketamine, and particularly ketamine infusion therapy, remains the most studied psychedelic medication and therapy.
Read our introduction to Psychedelic Medicine.
Find out more about ketamine infusion therapy and ketamine-assisted therapy.
To understand more about the benefits of an anesthesiology-led practice, click here.
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