Abstract The visionary beverage known as ayawaska ( yage, oni , caapi , camaranti , etc.) among the Indigenous Nations of the Amazon has, over the past century, generated increasing academic interest and popular fascination, leading to a boom in psychedelic tourism and “neo-shamanism”. This article attempts to account for the uses of ayawaska within the contemporary cultural context of the Shipibo-Konibo Indigenous Nation (Ucayali, Peru) including influences associated with Western neo-shamanic or spiritual tourism. Our interpretation draws on testimonies collected over 15 years of fieldwork among the Shipibo-Konibo, alongside excerpts from ancestral narratives, medicinal songs, and various ethnographic sources. We argue that the Indigenous use of ayawaska cannot be considered apart from the complex cultural framework—linguistic, cosmogonic, and spiritual—in which it occurs, despite the dominance of Western approaches and their presumptive monopoly on onto-epistemic understandings. While this article does not seek to discredit insights emerging from Western psychology and biomedical engagements with psychedelics, it calls attention to the ethnographic thinness and conceptual impositions often found in such approaches—impositions that risk reducing Indigenous ontologies to psychological projections, and in doing so, obscure the sovereign integrity of Amazonian worlds. In contrast, this work centers the voices of Shipibo visionary healers ( Onanyabo ), articulating their visions of legitimate use and the ecological and philosophical resonances of their healing practices—resonances that may enter into careful and reciprocal dialogue with Western onto-ethico-epistemologies, but not be subsumed by them.

Abstract Background and Aims Parkinson's disease (PD) significantly impairs quality of life, and current treatments do not halt dopaminergic neurodegeneration. Evidence suggests that ibogaine, a naturally occurring indole alkaloid, may stimulate glial cell line-derived neurotrophic factor (GDNF) expression and affect dopamine transporter (DAT) function. This case study reports the effects of low-dose ibogaine hydrochloride on PD symptoms. Methods A 52-year-old female PD patient, decreasingly responsive to conventional therapy, underwent an 80-day treatment with gradually titrated daily doses of ibogaine hydrochloride (max 75 mg/day). Standardized assessments were conducted pre- and post-treatment using validated PD-specific clinical instruments; Unified Parkinson's Disease Rating Scale (UPDRS), Parkinson's Disease Questionnaire-39 (PDQ-39), Parkinson's Disease Sleep Scale (PDSS-2), Parkinson's Disease Fatigue Scale-16 (PFS-16) and the Beck Depression Inventory-II (BDI-II), alongside a qualitative interview. Results Substantial improvements were observed in four of five assessment domains: motor symptoms (UPDRS), quality of life (PDQ-39), fatigue (PFS-16), and depression (BDI-II). Sleep quality (PDSS-2) declined, potentially due to ibogaine's stimulant properties. The patient reported reduced freezing of gait episodes, enhanced mobility, energy and mood, as well as an overall increased optimism. No adverse events were recorded. Conclusion This is the first known case study to use validated instruments to document symptomatic improvements in a PD patient following low-dose ibogaine treatment. While preliminary, these findings support the hypothesis that ibogaine may alleviate PD symptoms through neurotrophic, pharmacochaperone, and DAT-modulating mechanisms. Larger controlled trials are needed to evaluate its efficacy and clarify its mechanisms of action in PD.

Abstract BackgroundThere is a need to systemically diversify psychedelic clinical trials, considering the growing interest in in the therapeutic potential of psychedelics within Black, Indigenous, and Peoples of Color (BIPOC) and queer communities. Doing so contributes to a more inclusive foundation of evidence-based research and addresses ethical considerations surrounding anticipated demand for these treatments following regulatory approval. Cultural attunement may be key to facilitating effective research and ensuring equitable treatment.AimsHere, we introduce a primer for culturally attuned psychedelic clinical trials. We narratively review prevalent psychological and pragmatic barriers to diversity – as part of set and setting – in modern psychedelic trials. We also propose potential strategies for the culturally attuned recruitment, assessment, and retention of diverse participants.MethodsThis primer narratively synthesizes existing literature on barriers and potential strategies for culturally attuned psychedelic trials. Here, the scope is on classic psychedelics and other drugs with consciousness-altering effects (3,4-methylenedioxy-methamphetamine [MDMA], ketamine). The term ‘diversity’ focuses on BIPOC and sexual- and gender-diverse populations, primarily in the US.ResultsPsychological and pragmatic barriers include stigma, medical mistrust, history of psychedelic-assisted conversion therapy, income disparities, schedule inflexibilities, and transportation inaccessibility. Culturally attuned recruitment, assessment, and retention strategies include queering/diversifying the study team, debinarizing the therapist dyad, developing culturally attuned flyers, community outreach, using culturally attuned language, improving transportation-related access, diversifying room setup, and using culturally attuned assessments.ConclusionsPsychedelic research groups are encouraged to adapt and enact these recommendations in their clinical trials, to improve accessibility to innovative mental health treatments for diverse populations.

Abstract This commentary explores public priorities in psychedelic research, drawing insights from extensive conversations between the author and the general public during lectures and seminars across the UK. Two primary themes emerged from this exchange: areas where further research is desired and concerns about the current direction of psychedelic research. Key topics of interest include psychedelics' effects on neurodivergent individuals, ageing, pain management, cognitive enhancement, psychosis, and interactions with the female menstrual cycle. Areas of concern pertain to the involvement of pharmaceutical companies in psychedelics research, the potential medicalisation of psychedelics, and the growing interest in psychedelic tourism. The commentary emphasises the need for a constant dialogue between scientists and the public, critical engagement with research and the integration of diverse perspectives in order to foster a broader understanding of psychedelics and their potential applications in this rapidly evolving field.

Abstract Psychedelic-assisted therapy (PAT) is currently undergoing a resurgence of clinical interest for several mental health ailments. We propose that philosophers can play a significant role in PAT in both the preparation and integration phases of PAT. Philosophers can aid in the former phase by offering philosophical preparatory insights and in the latter phase by providing the conceptual language to articulate the complex philosophical aspects of a psychedelic experience.

Abstract As reliable facilitators of characteristically unique altered states of consciousness that are notoriously difficult to comprehend, psychedelics naturally attract a multidisciplinary scope for their research, with direct relevance to neuroscience, pharmacology, psychology, as well as philosophy of mind, metaphysics, and epistemology — disciplines united by the common inquiry into the nature of conscious experience. Accordingly, the central focus of this paper concerns the metaphysical debate between internalism and externalism about whether psychedelic phenomenology — in particular, its ‘breakthrough’ level — could be said to directly ontologically depend on external factors, as well as the interpretive implications arising from each of those positions. The main contributions of the author of this paper include the provision of a coherent account of the essential phenomenal characteristics of psychedelic experiences, the integration of relatively fragmented philosophical debates on psychedelic phenomenology into the traditional internalist-externalist framework in metaphysics, as well as the exploration of the extent to which the externalist position on psychedelic phenomenology — traditionally associated with non-naturalism — is compatible with naturalistic explanatory frameworks. In Part 1, psychedelic phenomenology will be outlined first, after which the central inquiries of this paper will be contextualised and qualified. In Part 2, the internalist position on psychedelic phenomenology — both its strong and weak versions — will be discussed. In Part 3, the externalist position will be explored, which will be followed by a final evalutation between the three positions presented in this paper. The paper will conclude in favour of the weak internalist position, and that whilst the externalist position remains significantly more speculative than both the strong and the weak internalist positions, the externalist position cannot be rejected altogether until further progress in consciousness research is made.

Abstract Background and aimsScientific interest in the therapeutic potential of psychedelics has been experiencing significant growth. Understanding the perceptions of psychedelic assisted psychotherapy (PAP) among health professional, patients, and the public is essential to guide future research objectives, trial protocols, and identify any barriers to future implementation.MethodsA comprehensive search of the databases (Medline, EMBASE, PSYCHinfo, SCOPUS, and Web of Science) was conducted on the 29th of November, 2022. This review included cross-sectional, longitudinal, and quasi-experimental studies published in peer-reviewed journals exploring perceptions of PAP among the three stakeholder groups. Studies were limited to English-language and the years 2012–2022. The protocol and review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines.ResultsThe sample consisted of 29 studies, including n = 17 health professional, n = 6 patients, and n = 6 public. Broadly, knowledge of PAP was low among all three stakeholder groups. There was mixed to positive belief in the therapeutic potential of psychedelics, with male gender, younger age, and personal psychedelic experience/knowledge being key predictors of more favourable views. The majority of findings reported strong endorsement of further research. Consistent themes were identified surrounding concerns about legal status, funding, access, side-effects, and implementation.ConclusionThe evaluated research indicates a need for further research that will provide clarity about safety and elucidate how PAP may be implemented in public health settings. Further education of health professionals and the public should be a priority.

Abstract Background and aimsEmerging research indicates that psychedelics may have therapeutic potential by fostering meaningful experiences that act as “inflection points” in people's narratives of personal development. However, psychedelic research has largely failed to address pertinent developmental considerations. We investigated whether attachment-related variables were associated with psychedelic experiences and whether psychedelic experiences moderated expected links between perceived attachment history and current adult attachment orientations.MethodsWe administered an online survey to an international Jewish sample (N = 185) with psychedelic experience. The survey included measures about recollection of attachment interactions with parents (perceived attachment history), adult attachment orientations (anxiety, avoidance), and psychedelic phenomenology (mystical experiences, challenging experiences, emotional breakthrough, ego dissolution, sensed presence) associated with respondents' most memorable psychedelic experiences.ResultsPerceptions of an insecure attachment history were positively linked to all measures of psychedelic phenomenology (r's = 0.19–32, p's mostly < 0.01). In contrast, adult attachment orientations were unrelated to psychedelic phenomenology. Also, psychedelic phenomenology mostly did not moderate the links observed between perceptions of an insecure attachment history and adult attachment orientations.ConclusionsOur findings suggest that perceptions of early attachment experiences may be relevant to psychedelic phenomenology. However, subjective experiences associated with naturalistic psychedelic use do not typically attenuate links between a perceived insecure attachment history and attachment insecurity at present.

Aixalà, M. (2022). Psychedelic integration: Psychotherapy for non-ordinary states of consciousness. Synergetic Press. ISBN 9780907791393 (paperback) 9780907791584 (ebook).