Adapting psychedelic medicine for headache and chronic pain disorders

Aug 31, 2023Expert review of neurotherapeutics

Using psychedelic medicine to treat headaches and long-term pain

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Abstract

Psychedelics may have therapeutic effects on headache disorders and chronic pain, as evidenced by early clinical trials and case reports.

The first two clinical trials of psilocybin show potential in treating headache disorders.
Recent case reports indicate self-administration of psilocybin mushrooms by chronic pain patients.
Challenges exist in applying psychedelics for headache and chronic pain, particularly regarding dosage and therapeutic models.
Flexibility in treatment protocols may be necessary to explore various factors influencing the effectiveness of psychedelics.

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INTRODUCTION: While the majority of current research and development surrounds depression, demoralization, and substance use disorders, there are numerous reports of psychedelics having beneficial effects in other branches of medicine, including for headache disorders and chronic pain.

AREAS COVERED: This perspective reviews conventional forms of treatment for headache and other chronic pain disorders and describes historical, recent, and ongoing investigations of the therapeutic effects of psychedelics in these disorders. The first two clinical trials of psilocybin in headache disorders and recent case reports of psilocybin mushroom self-administration in chronic pain patients are described. This perspective highlights several factors related to the application of psychedelics in chronic pain disorders, comparing this with the standard psychedelic-assisted psychotherapy model of treatment.

EXPERT OPINION: When faced with a more constricted view of psychedelic medicine that features larger doses, underscores subjective effects in the mediation of therapeutic outcomes, and requires adjunctive psychotherapy to ensure safety and efficacy, the application of psychedelics in headache and chronic pain disorders may face challenges. It will be important to allow for flexibility and adaptation in protocols to evaluate different treatment paradigms, mechanisms of action, and the range of pharmacologic and extra-pharmacologic factors that affect psychedelic treatment outcomes.

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Adapting psychedelic medicine for headache and chronic pain disorders

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