Natural Psychedelics _ ________________________________________________________________________
Summary Although there have been many promising anecdotal reports suggesting that ayahuasca may be beneficial in patients with treatment-resistant mental health disorders, there is not enough clinical research to support its use for any purpose. Additionally, ayahuasca should be used with caution in patients with certain underlying conditions and medication regimens.
Interactions Hawaiian baby woodrose has serotonergic effects and should be used with caution in patients taking other serotonergic agents. It may increase the risk of serotonin syndrome. Summary There is no known medical use for Hawaiian baby woodrose; its primary use has been for recreational purposes, as a “natural” source of an LSD-like chemical. Because its use is associated with many adverse effects, some serious in nature, it should not be recommended for any purpose. IBOGA (IBOGAINE) Iboga ( Tabernanthe iboga ) is a shrub that grows wild in certain parts of Africa. Its root bark is used in some ceremonial practices for its hallucinogenic and stimulant properties. The root bark contains the psychoactive chemical ibogaine. It also contains a number of other constituents that are thought to contribute to hallucinogenic effects, including ibogaline, ibogamine, and tabernanthine [44; 45; 46; 47]. Although iboga has a long history of traditional use, any modern research for therapeutic purposes has used purified ibogaine only. It is not clear how much ibogaine is naturally found in iboga, or how the processing of iboga may alter the total ibogaine content. Ibogaine is classified as a Schedule I controlled substance by the DEA [121]. Mechanism of Action Pure ibogaine has been shown to exert serotonergic effects, act as an agonist at kappa-opioid receptors, and act as an antagonist at N -methyl-D-aspartate (NMDA) receptors. Noribogaine, a metabolite of ibogaine, seems to have overlapping, and possibly stronger, affinities for these same receptors. Noribogaine has also demonstrated activity at the mu-opioid receptor [48; 49]. Clinical Effects There is interest in the use of iboga for various purposes, including depression, fatigue, and sexual arousal. However, all available clinical reports are specific to ibogaine, are anecdotal or observational in nature, and evaluate patients with substance use disorders. Multiple case series in patients with opioid use disorder suggest that ibogaine may offer some benefit for the acute relief of opioid withdrawal symptoms. These reports also suggest that some patients may experience long-term relief of withdrawal symptoms for up to 14 weeks. The doses used in these studies ranged from a single dose of 12–25 mg/kg to 25–55 mg/kg provided over multiple doses within 24 to 96 hours [49; 50; 51; 52].
HAWAIIAN BABY WOODROSE (LYSERGIC ACID AMIDE)
Hawaiian baby woodrose ( Argyreia nervosa ), also referred to as elephant creeper, is a flowering vine that grows in Florida, California, and Hawaii. The seeds of this plant are sometimes touted online as “natural LSD” due to the presence of a chemical called lysergic acid amide (LSA), which is structurally similar to LSD. This plant and others containing LSA have been used in shamanistic rituals in South America [111]. The seeds of the plant have been shown to contain LSA in concentrations up to 83%. However, the alkaloid content of the seeds varies significantly from batch to batch. When used recreationally, the seeds may be eaten whole, crushed, or soaked in water [38; 112]. Despite the presence of a known psychoactive chemical, this plant and its seed remain legal for sale in the United States. Mechanism of Action LSA has effects at the dopamine D2 receptor. It also seems to be a partial agonist or antagonist at adrenergic and serotonergic receptors, including serotonin 2A. The hallucinogenic effects that occur with LSA are thought to be similar to those seen with LSD [39; 40]. However, LSD is a synthetic chemical that does not occur in nature. LSA in doses of 2–5 mg is considered enough to cause hallucinations. In pharmacokinetic studies, LSA has become detectable in the blood within 30 to 40 minutes of ingestion and levels continue to increase for approximately 90 minutes. Psychedelic effects are reported to last approximately four to eight hours [41; 42; 43]. Clinical Effects Hawaiian baby woodrose continues to be used primarily as a recreational drug and has not garnered attention as a potential therapeutic agent. There is currently no clinical research evaluating its use for any medical purpose. Safety Hawaiian baby woodrose has been associated with many side effects, including nausea and vomiting, fatigue, dizziness, mydriasis, and sweating, as well as elevations in blood pressure and heart rate. In addition to hallucinations, it has also been reported to cause blurred vision and altered visual perception. Multiple reports also suggest that consuming the seeds of this plant can cause suicidal ideations, paranoia, weakness, and vertigo [38; 41; 42; 43].
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