Chronic pain and psychedelics: a review and proposed mechanism of action
Autor: | Chris Woolley, Fadel Zeidan, Kelly Bruno, Timothy Furnish, Joel P. Castellanos, Adam L. Halberstadt |
---|---|
Rok vydání: | 2020 |
Předmět: |
Pain medicine
Analgesic 03 medical and health sciences 0302 clinical medicine medicine Humans Pain Management Analgesics Mechanism (biology) business.industry Cluster headache Chronic pain General Medicine medicine.disease 030227 psychiatry Analgesics Opioid Anesthesiology and Pain Medicine Nociception Mechanism of action Hallucinogens Chronic Pain medicine.symptom Cancer pain business Neuroscience 030217 neurology & neurosurgery |
Zdroj: | Regional Anesthesia & Pain Medicine. 45:486-494 |
ISSN: | 1532-8651 1098-7339 |
Popis: | The development of chronic pain is a complex mechanism that is still not fully understood. Multiple somatic and visceral afferent pain signals, when experienced over time, cause a strengthening of certain neural circuitry through peripheral and central sensitization, resulting in the physical and emotional perceptual chronic pain experience. The mind-altering qualities of psychedelics have been attributed, through serotonin 2A (5-HT2A) receptor agonism, to ‘reset’ areas of functional connectivity (FC) in the brain that play prominent roles in many central neuropathic states. Psychedelic substances have a generally favorable safety profile, especially when compared with opioid analgesics. Clinical evidence to date for their use for chronic pain is limited; however, several studies and reports over the past 50 years have shown potential analgesic benefit in cancer pain, phantom limb pain and cluster headache. While the mechanisms by which the classic psychedelics may provide analgesia are not clear, several possibilities exist given the similarity between 5-HT2A activation pathways of psychedelics and the nociceptive modulation pathways in humans. Additionally, the alterations in FC seen with psychedelic use suggest a way that these agents could help reverse the changes in neural connections seen in chronic pain states. Given the current state of the opioid epidemic and limited efficacy of non-opioid analgesics, it is time to consider further research on psychedelics as analgesics in order to improve the lives of patients with chronic pain conditions. |
Databáze: | OpenAIRE |
Externí odkaz: |