Novel use of psychedelics for heart disease and mental health: treatment and ethics

There is an increasing interest from medical and psychiatric fields in psychedelic drug properties to treat mental and physical illness. Most recently, Simonsson et al (2021) has explored the associations between lifetime classic psychedelic use and cardiometabolic diseases. Heart disease and diabetes are currently leading contributors to the global burden of disease, and a leading cause of death in the Western world. The researchers acknowledged that pharmacological treatment, intensive lifestyle modification or both can delay or reverse the development of cardiometabolic diseases, but noted that no study has so far investigated the long-term cardiometabolic effects of classic psychedelics. If found to be beneficial, they suggest that psychedelics could be used as a possible pharmacological treatment and as part of a programme to facilitate healthy lifestyle changes.

‘Classic psychedelics’ mainly refer to psychoactive substances known to act as agonists primarily at serotonin 2A receptors, which are often categorised into three classes: tryptamines, lysergamides, and phenethylamines. Most notably, tryptamines include N,N-dimethyltryptamine (DMT), the DMT-containing admixture ayahuasca, and psilocybin. Lysergic acid diethylamide (LSD) comprises the lysergamide class. Phenethylamines include mescaline and the mescaline-containing cacti peyote and San Pedro. Simonsson et al (2021) described the evidence to date, suggesting that classic psychedelics have a good risk profile and can be effective in the treatment of various mental health conditions. However, recent research indicates that classic psychedelics could show a beneficial effect for a range of physical conditions as well, such as heart disease and diabetes.