The world of psychiatry is now ripe for a re-examination of psychedelic drugs, or so the psychiatrist and psychedelic enthusiast Dr Sessa passionately proclaims. These endlessly fascinating compounds were shelved following the excesses of the late 1960s, as a consequence of the misplaced concerns of the powers that be. There had been feverish speculation up to then about the ability of these drugs to expand consciousness and engender life-changing, mystical experiences, explaining the fear provoked in the establishment who perceived that they would be hijacked by the counterculture for the purposes of inciting revolution. Unfortunately, owing to the legal restrictions imposed on psychedelics, all scientific work that had been continuing apace subsequently and abruptly ceased. Studies that were being performed to determine their utility and elucidate their mechanisms of action were cut short. These included studies that had been established to illuminate the biological constructs underlying the psychotic process and those conducted to prove the efficacy of psychedelic drugs as adjuncts to psychotherapy. It was strongly acknowledged in those circles that drugs such as lysergic acid diethylamide (LSD), psilocybin and 3,4-methylenedioxy-N-methylamphetamine (MDMA) had the ability to enable repressed and traumatic material to come to the surface and be discussed freely, thereby facilitating its resolution.
This enforced hiatus had, regrettably, taken psychedelics off the radar for a protracted period, but they are now making a resurgence and clinical researchers are once again beginning tentatively to experiment with these substances. Dr Sessa has provided a synopsis of the history of psychedelics and painted a captivating picture of the social environment in which they originated. He also details a comprehensive account of the pharmacology of each substance in turn and delineates the current state of play in terms of contemporary studies. The subject of psychedelic drugs was never alluded to in psychiatric training, hence I was intrigued about what might be considered a controversial topic in some quarters. I found the chapter describing the key personnel in the psychedelic literature illuminating, as it read like a Who's Who guide to the psychedelic world, and I was enthused by the listing of those seminal texts which are considered indispensible for the burgeoning researcher keen to develop an interest in such matters.
What certainly comes across in the book is Dr Sessa's patent frustration with the current crop of psychotropics that we have available in our armamentarium and the attendant lack of desired effect in those who are severely incapacitated by their problems. You can sense his desperation which is underpinned by a deep-seated desire to be afforded a better position from which to help his patients with potentially more efficacious treatments. What is also clear is his fondness for all things psychedelic and his inimitable and unique style, which is peppered throughout with cultural references and his own colloquialisms, and is rarely anything but compelling.
With the first clinical trials for generations about to commence in the foreseeable future in the UK, this is a very exciting time indeed. The recent programme ‘Drugs Live’ on British television, where MDMA was administered to willing participants who then underwent fMRI, and the interest generated is testament to the appeal of these much-maligned substances. It now seems opportune to revisit their potential uses. Researchers such as Professor Nutt at Imperial College London are leading the way in this area, beginning to dismantle the stigma with which psychedelic drugs have been unfairly tarnished. We shall wait with hopeful expectancy to see whether the forthcoming trials will show that drugs such as MDMA and psilocybin can ameliorate the conditions of post-traumatic stress disorder and severe depression, respectively, conditions which by and large are proving increasingly refractory to most treatments. This book serves as a timely reminder of the usefulness that psychedelics can bring to bear on the world of psychiatry and maybe this might be a trip, pardon the pun, worth embarking on.
eLetters
No eLetters have been published for this article.