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      Moral Psychopharmacology Needs Moral Inquiry: The Case of Psychedelics

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          Abstract

          The revival of psychedelic research coincided and more recently conjoined with psychopharmacological research on how drugs affect moral judgments and behaviors. This article makes the case for a moral psychopharmacology of psychedelics that examines whether psychedelics serve as non-specific amplifiers that enable subjects to (re-)connect with their values, or whether they promote specific moral-political orientations such as liberal and anti-authoritarian views, as recent psychopharmacological studies suggest. This question gains urgency from the fact that the return of psychedelics from counterculture and underground laboratories to mainstream science and society has been accompanied by a diversification of their users and uses. We propose bringing the pharmacological and neuroscientific literature into a conversation with historical and anthropological scholarship documenting the full spectrum of moral and political views associated with the uses of psychedelics. This paper sheds new light on the cultural plasticity of drug action and has implications for the design of psychedelic pharmacopsychotherapies. It also raises the question of whether other classes of psychoactive drugs have an equally rich moral and political life.

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          Most cited references58

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          Trial of Psilocybin versus Escitalopram for Depression

          Psilocybin may have antidepressant properties, but direct comparisons between psilocybin and established treatments for depression are lacking.
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            Oxytocin increases trust in humans.

            Trust pervades human societies. Trust is indispensable in friendship, love, families and organizations, and plays a key role in economic exchange and politics. In the absence of trust among trading partners, market transactions break down. In the absence of trust in a country's institutions and leaders, political legitimacy breaks down. Much recent evidence indicates that trust contributes to economic, political and social success. Little is known, however, about the biological basis of trust among humans. Here we show that intranasal administration of oxytocin, a neuropeptide that plays a key role in social attachment and affiliation in non-human mammals, causes a substantial increase in trust among humans, thereby greatly increasing the benefits from social interactions. We also show that the effect of oxytocin on trust is not due to a general increase in the readiness to bear risks. On the contrary, oxytocin specifically affects an individual's willingness to accept social risks arising through interpersonal interactions. These results concur with animal research suggesting an essential role for oxytocin as a biological basis of prosocial approach behaviour.
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              Psychedelics and the essential importance of context

              Psychedelic drugs are making waves as modern trials support their therapeutic potential and various media continue to pique public interest. In this opinion piece, we draw attention to a long-recognised component of the psychedelic treatment model, namely ‘set’ and ‘setting’ – subsumed here under the umbrella term ‘context’. We highlight: (a) the pharmacological mechanisms of classic psychedelics (5-HT2A receptor agonism and associated plasticity) that we believe render their effects exceptionally sensitive to context, (b) a study design for testing assumptions regarding positive interactions between psychedelics and context, and (c) new findings from our group regarding contextual determinants of the quality of a psychedelic experience and how acute experience predicts subsequent long-term mental health outcomes. We hope that this article can: (a) inform on good practice in psychedelic research, (b) provide a roadmap for optimising treatment models, and (c) help tackle unhelpful stigma still surrounding these compounds, while developing an evidence base for long-held assumptions about the critical importance of context in relation to psychedelic use that can help minimise harms and maximise potential benefits.
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                Author and article information

                Contributors
                Journal
                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                1664-0640
                02 August 2021
                2021
                : 12
                : 680064
                Affiliations
                [1] 1Department of Anthropology, The New School for Social Research , New York, NY, United States
                [2] 2Department of History, University of Saskatchewan , Saskatoon, SK, Canada
                [3] 3Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich , Zurich, Switzerland
                [4] 4Charité – Universitätsmedizin Berlin, Department of Psychiatry and Psychotherapy , Berlin, Germany
                Author notes

                Edited by: Michael James Winkelman, Arizona State University, United States

                Reviewed by: Fabrizio Schifano, University of Hertfordshire, United Kingdom; Brian D. Earp, University of Oxford, United Kingdom; Ido Hartogsohn, Bar-Ilan University, Israel

                *Correspondence: Dimitris Repantis dimitris.repantis@ 123456charite.de

                This article was submitted to Psychopharmacology, a section of the journal Frontiers in Psychiatry

                Article
                10.3389/fpsyt.2021.680064
                8365088
                34408677
                9060e71a-bdb4-4221-9e7b-35781dbe9410
                Copyright © 2021 Langlitz, Dyck, Scheidegger and Repantis.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 31 March 2021
                : 09 June 2021
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 58, Pages: 6, Words: 4731
                Categories
                Psychiatry
                Perspective

                Clinical Psychology & Psychiatry
                psychedelics,hallucinogens,morality and values,extrapharmacological variables,anthropology,ethnography,history,psychotherapy

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