Psychedelics (serotonergic hallucinogens)
are powerful psychoactive substances that alter perception and mood and affect numerous cognitive processes. They are generally considered physiologically
safe and do not lead to dependence or addiction. Their origin predates written history, and they were employed by early cultures in many sociocultural and
ritual contexts. After the virtually contemporaneous discovery of (5R,8R)-(+)-lysergic acid-N,N-diethylamide
(LSD)-25 and the identification of serotonin in the brain, early research focused intensively on the possibility that LSD and other psychedelics had a serotonergic basis for their action. Today there is a consensus that psychedelics are agonists or partial
agonists at brain serotonin 5-hydroxytryptamine 2A receptors, with particular importance on those expressed
on apical dendrites of neocortical pyramidal cells in layer
V.Severaluseful rodentmodelshave been developed over the years to help unravel the neurochemical correlates of serotonin 5-hydroxytryptamine 2A receptor activation in
the brain, and a variety of imaging techniques have been employed to identify key brain areas that are directly affected by psychedelics. Recent and exciting
developments in the field have occurred in clinical research, where several double-blind placebo-controlled phase 2 studies of psilocybin-assisted psychotherapy in
patients with cancer-related psychosocial distress have demonstrated unprecedented positive relief of anxiety and depression. Two small pilot studies of psilocybinassisted
psychotherapy also have shown positive benefit in treating both alcohol and nicotine addiction. Recently,
blood oxygen level–dependent functional magnetic resonance imaging and magnetoencephalography have
been employed for in vivo brain imaging in humans after administration of a psychedelic, and results indicate that intravenously administered psilocybin and LSD produce decreases in oscillatory power in areas of the brain’s default mode network.