Table 1.
Studies Examining the Role of Psychedelics for the Management of Chronic Pain Conditions
| Author (Year) | Study Type | Groups Studied and Intervention | Results | Conclusions |
|---|---|---|---|---|
| Kuromaru et al (1967)19 | Case series | 8 patients with PLP were given 1–3 doses of 50 micrograms of LSD. | No quantitative analysis was performed, but 7 out of 8 patients had resolution of some PLPS. | LSD aids in the abatement of PLPS. |
| Fanciullacci et al (1974)18 | Open-label study | 5 patients with PLP (3 hospitalized and 4 outpatient) were treated with a placebo daily for a week, followed by 25 micrograms daily of LSD for a week, then 50 micrograms for two weeks, and finally followed with placebo for four weeks. | No quantitative analysis was performed, but 5 out of the 7 patients had pain relief with a reduction in analgesic intake. | LSD reduces pain in PLP and reduction analgesic intake. |
| Ramachandran et al (2018)17 | Case Report | Single patient with PLP following an amputation was successfully treated with mirror-visual-feedback. | Pain relief was achieved to a similar extent when comparing it to the phantom limb massage When psilocybin was administered in conjunction with MVF, the pain relief was amplified resulting in momentary, total pain relief; furthermore, there was a decrease in paroxysmal episodes. | The addition of psychedelics as adjuncts has the potential to dramatically improve the efficacy of current pain treatments. |
| Sewell et al (2006)20 | Comparative study | 53 patients who had consumed psilocybin and/or LSD treat their cluster headache were interviewed. | 22 of 26 psilocybin users reported that it aborted attacks, while 25 of 48 psilocybin users and 7 of 8 LSD users reported cluster period termination. Of the psilocybin and LSD users, 18 of 19 and 4 of 5, respectively, reported remission period extension. | First paper to demonstrate the use of sub-hallucinogenic doses, for the treatment of psychedelics for cluster headaches. |
| Karst et al (2010)16 | Open, non-randomized case series | 5 patients with cluster headache were administered oral 30 micrograms/kg/day 2-bromo-LSD, for a dose every 5 days for a total of 3 doses. | One patient had resolution of her cluster headaches for > 6 months; two had significant reduction in attack frequency, remission for 1 month, and converted to episodic cluster headache; one patient had a significant reduction in attack frequency, but remission lasted < 1 month and she stopped taking acute headache management medications. Finally, the last patient had a profound reduction in pain unfortunately did not experience pain reduction but experienced a reduction in attack intensity. | Non-hallucinogenic, 2-bromo-LSD may have potential in treating cluster headaches. |
| Schindler et al (2015)15 | Online survey | Survey was performed on 496 participants from the Clusterbuster.org website inquiring about the efficacy of indoleamine hallucinogens, and comparing them to standard of treatment. | IH were similar in efficacy if not better, and participants deemed IH able to abort a cluster headache and result in higher rates of remission from chronic cluster headaches. | IH are perceived to aid in aborting cluster headaches. |
| Schindler et al (2022)12 | Randomized double-blind, placebo-controlled study | A total of 30 participants were randomized to receive either psilocybin (n = 16, 0.143 mg psilocybin/kg body weight) or placebo (n = 14) in 3 separate doses 5 days apart. | The change in cluster attack frequency was 3.2 (95% confidence interval [CI] −8.3 to 1.9) attacks/week with psilocybin compared to 0.03 attacks/week with the placebo (95% CI −2.6 to 2.6). | Psilocybin administration had no serious adverse or unexpected effects and was well tolerated. |
| Glynos et al (2023)10,11 | Cross-sectional survey | A total of 354 patients with fibromyalgia were anonymously surveyed online to assess the understanding and perception of psychedelics and the interest in the use of psychedelics for fibromyalgia. | Only 29.9% of participants had reported use of a psychedelic with 59.4%, 36.8%, and < 3% having a neutral, positive, or negative perception, respectively, on the impact of health and pain. Twelve participants report intentional use for treating chronic pain with 11 noting improvement in pain symptoms. | Participants believed that psychedelics could hold promise for their pain and would be willing to participate in a clinical trial to assess this. |
| Lyes et al (2023)10 | Case series | Three patients microdosed with psilocybin-containing mushrooms. The patients with chronic pain/neurological disorders were a 37-year-old male with spinal cord injury resulting in neuropathic pain, 69-year-old female with complex regional pain syndrome, and 40-year-old female with lumbar radiculopathy/neuropathic pain. Patient initiated dosing regimens varied from consuming 250, 500, or 750–1000 mg of psilocybin-containing mushrooms daily. to 1000 mg mushroom chocolate bar every 2 months. | Patients experienced up 80–100% pain relief lasting anywhere from 3–4 hours to 2–4 weeks. | This case series details the experience of these patients including the side effect and high percentage of pain relief though conclusions are limited. |
Abbreviations: IH, indoleamine hallucinogens; LSD, lysergic acid diethylamide; MVF, mirror-visual-feedback; PLP, phantom limb pain; PLPS, phantom limb pain syndrome.