Психоделики и шизофрения: мифы, риски, факты | Владимир Алипов

The talk begins by addressing the historical label of 'psychotomimetics' applied to psychedelics, amphetamines, opiates, and alcohol — a term implying these substances produce a state equivalent to schizophrenic psychosis. Alipov clarifies that psychosis from psychedelics does occur but is a side effect rather than a primary effect, and that most psychedelics do not cause thinking disorders or trigger lasting mental illness in the general population. He cites accumulated retrospective data showing no clear causal link between psychedelic use and the development of mental disorders. On the contrary, he notes that psychedelic users tend to report lower stress and anxiety, and there is weak preliminary evidence suggesting reduced suicide risk.

Alipov then shifts to examining a specific vulnerable subgroup: people with a hereditary predisposition to schizophrenia. He references a 2022 or 2023 study indicating that if a person experiences psychosis on any substance — including LSD — they face a 40–60% risk of later being diagnosed with schizophrenia. He offers two interpretations: either the substance damages something in the psyche, or — his preferred view — the person already had an underlying predisposition, and the psychedelic acted as a triggering blow, likened to a 'double hit' on an already fragile system.

He singles out LSD as the most concerning psychedelic in this context due to its affinity not only for serotonin receptors (like other classic psychedelics) but also for dopamine receptors. Since dopamine dysregulation is central to schizophrenic psychosis — treatable with dopamine-blocking neuroleptics like haloperidol — this makes LSD pharmacologically more relevant to schizophrenia risk. Animal studies in rats and mice have shown that chronic high-dose LSD use can disrupt the dopamine system, affecting motivation and motor activity, though much remains unclear.

Finally, Alipov attributes the scarcity of reliable data to the political climate of the 1960s–70s in the US, when psychedelics were associated with the hippie movement and anti-Vietnam War activism. Conservative government sentiment led to a blanket ban on these substances, which simultaneously halted all scientific research and data collection. He concludes that based on current available evidence, psychedelics appear significantly safer than antidepressants in terms of serious complications, but acknowledges that the data gap makes definitive conclusions premature.