What good are psychedelic humanities?

The revival of psychedelic research has been dominated by the biomedical sciences. Yet it raises questions that cannot be answered by laboratory experiments and clinical trials alone. Among these are questions pertaining to the conceptual and practical frameworks that render experimental and clinical findings meaningful. Psychedelic humanities clarify the historical presuppositions, philosophical blind spots, and political stakes of different approaches to psychedelics. In this emergent field, many scholars evaluate such alternatives epistemologically, ethically, or politically. However, they could just as well refrain from offering normative orientation and instead increase the complexity of the observed phenomena by opening other possible perspectives, leaving it to their readers to reduce the resulting complexity in novel ways. This enables clinical psychiatrists, laboratory scientists, and other practitioners to use (or abuse) psychedelic humanities scholarship for their own purposes. The article concludes with a note on the institutionalization of such collaboration at The New School's Psychedelic Humanities Lab.

Moral Psychopharmacology Needs Moral Inquiry: The Case of Psychedelics.

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.

Opaque models: Using drugs and dreams to explore the neurobiological basis of mental phenomena.

On the basis of four historical and ethnographic case studies of modeling in neuroscience laboratories, this chapter introduces a distinction between transparent and opaque models. A transparent model is a simplified representation of a real world phenomenon. If it is not patently clear, it is at least much better comprehended than its objects of representation. An opaque model, by contrast, looks at one only partially understood phenomenon to stand in for another partially understood phenomenon. Here, the model is often just as complex as its target. Examples of such opaque models discussed in this chapter are the use of hallucinogen intoxication in humans and animals as well as the dreaming brain as models of psychosis as well as the dreaming brain as a model of consciousness in general. Several functions of opaque models are discussed, ranging from the generation of funding to the formulation of new research questions. While science studies scholars have often emphasized the epistemic fertility of failures of representation, the opacity of hallucinogen intoxications and dreams seems to have diminished the potential to produce positive knowledge from the representational relationship between the supposed models and their targets. Bidirectional comparisons between inebriation, dreaming, and psychosis, however, proved to be generative on the level of basic science. Moreover, the opaque models discussed in this chapter implicated cosmologies that steered research endeavors into certain directions rather than others.

The persistence of the subjective in neuropsychopharmacology: observations of contemporary hallucinogen research.

The elimination of subjectivity through brain research and the replacement of so-called "folk psychology" by a neuroscientifically enlightened worldview and self-conception has been both hoped for and feared. But this cultural revolution is still pending. Based on nine months of fieldwork on the revival of hallucinogen research since the "Decade of the Brain," this paper examines how subjective experience appears as epistemic object and practical problem in a psychopharmacological laboratory. In the quest for neural correlates of (drug-induced altered states of) consciousness, introspective accounts of test subjects play a crucial role in neuroimaging studies. Firsthand knowledge of the drugs' flamboyant effects provides researchers with a personal knowledge not communicated in scientific publications, but key to the conduct of their experiments. In many cases, the "psychedelic experience" draws scientists into the field and continues to inspire their self-image and way of life. By exploring these domains the paper points to a persistence of the subjective in contemporary neuropsychopharmacology.

Pharmacovigilance and post-black market surveillance.

Pharmacovigilance can be defined as a set of practices aiming at the detection, understanding and assessment of risks related to the use of drugs in a population, and the prevention of consequential adverse effects. In a narrower sense, the term refers exclusively to postmarket surveillance. This paper briefly outlines how pharmacovigilance has come to play a central role in the regulation of novel pharmaceuticals. However, the focus of the text is on mechanisms emerging in an experimental drug scene that aim at dealing with the risks posed by 'designer drugs' newly introduced to the black market. This discussion of pharmacovigilance and 'post-black market surveillance' is situated in the broader context of the more recent dissemination of vigilance as a key element of government in a world too complex for legal and disciplinary measures alone.

Is dose escalation of antidepressants a rational strategy after a medium-dose treatment has failed? A systematic review.

BACKGROUND: Maximizing the dose of antidepressants is widely recommended in cases of non-response to medium-dose treatment. However, scientific evidence supporting high-dose treatment is scarce. Systematic studies comparing dose escalation with alternative strategies for refractory depression (i. e. augmentation or change of compound) are lacking. The aim of this publication is to review available direct and indirect evidence concerning dose increase of antidepressants after a medium-dose trial has failed. METHOD: We performed a systematic literature search of Medline (1966-2003) and reviewed studies and publication references for available evidence. DATA SOURCES AND STUDY SELECTION: Studies of the following types were included: 1) dose increase studies in treatment refractory patients, 2) comparative dose studies, 3) therapeutic drug monitoring studies. RESULTS: Available data suggest differential efficacy of various pharmacological classes at more than medium-dosage. Direct evidence shows no increase of efficacy with high-dose selective serotonin reuptake inhibitor (SSRI) treatment; however, indirect evidence suggests enhanced therapeutic efficacy with high-dose tricyclic antidepressants. Few clinical data show ultra-high-dose treatment with the irreversible monoamine-oxidase-(MAO-) inhibitor tranylcypromine to be effective for refractory depression. Data concerning other selective compounds are insufficient to allow any definitive conclusion on the benefit of high-dose treatment. CONCLUSIONS: Based on available data highdose antidepressant treatment of patients refractory to medium-dose treatment is recommended for tricyclic compounds but not for SSRI. Some data suggest beneficial efficacy of ultra-high doses of the irreversible MAOI tranylcypromine. Research on other substance groups is limited and inconclusive. Prospective studies comparing dose escalation with alternative strategies for treatment of non-responding patients are needed.