Therapy Atlas

The core model of modern psychedelic medicine. The therapy follows a three-phase approach: (1) Preparation — building therapeutic alliance, psychoeducation, intention-setting over 2-3 sessions. (2) Medicine session — a full psychedelic experience lasting 6-8 hours with 2 therapists present, in an aesthetically designed room with music, eyeshades, and supportive, non-directive guidance. (3) Integration — processing the experience over 2-4 follow-up sessions, connecting insights to daily life. This model is based on the hypothesis that psychedelics open a temporary window of enhanced neural plasticity in which therapeutic change is facilitated.

A European therapy model historically developed in Switzerland, the Netherlands, and Germany. Unlike PAP, psycholytic therapy uses low to moderate doses (e.g., 100-200ug LSD or 10-15mg psilocybin) across multiple sessions (typically 6-12 over several months). The lower dose allows verbal communication during the session, enabling conventional psychotherapeutic techniques to be combined with psychedelically-enhanced insights. The therapeutic process is more gradual and less focused on single 'breakthrough' experiences. In Switzerland, this method has been available since 2014 under controlled exemption from the FOPH.

The most widely used and evidence-based psychedelic therapy form. Racemic ketamine (0.5mg/kg IV over 40 minutes) or esketamine (Spravato, intranasal) is administered in a clinical setting under medical supervision. The mechanism of action differs fundamentally from classical psychedelics: NMDA receptor antagonism triggers a glutamate surge, AMPA receptor potentiation, and increased BDNF expression, which stimulates rapid synaptogenesis in the prefrontal cortex and hippocampus. The antidepressant effect occurs within hours — compared to weeks with SSRIs. Standard treatment involves 6 induction infusions over 2-3 weeks followed by maintenance therapy. Side effects (dissociation, nausea, blood pressure elevation) are transient and resolve within 1-2 hours.

Specifically developed for the treatment of PTSD. MDMA (3,4-methylenedioxymethamphetamine) acts as an empathogen/entactogen, producing a state of increased emotional openness, reduced fear response, and enhanced trust. This allows trauma patients to engage with traumatic material without the usual overwhelming anxiety and avoidance reaction. The MAPS protocol uses a male-female therapist pair approach across 3 medicine sessions (80-120mg MDMA + optional 40-60mg supplement dose) with 3 integration sessions between each. MDMA does not produce a classical psychedelic experience (no visual hallucinations) but rather enhances emotional processing and interpersonal connection. Phase 3 trials (MAPP1/MAPP2) showed a 71% response rate, and 67% of participants no longer met PTSD diagnostic criteria at 18 months.

Microdosing refers to the regular intake of sub-perceptual doses of psychedelics — typically 1/10 to 1/20 of a full dose (e.g., 0.1-0.3g dried psilocybin mushrooms or 5-20ug LSD). Two main protocols: (1) Fadiman Protocol — 1 day dose, 2 days off, over 4-8 weeks. (2) Stamets Stack — 4 days dose (combined with lion's mane and niacin), 3 days off, over 4 weeks. The evidence is mixed: self-reports consistently show improvements in mood, creativity, and focus, while blinded placebo-controlled studies have so far found no significant difference from placebo. This suggests a possible strong placebo/expectancy effect. Long-term safety data is lacking; theoretical concerns about chronic 5-HT2B agonism and cardiac valve changes exist but are unproven at microdose levels.

Indigenous healing traditions with psychoactive plants have a millennia-long history. Ayahuasca ceremonies (South America) use a DMT-containing brew with MAO inhibition from Banisteriopsis caapi. Iboga ceremonies (Central Africa, Bwiti tradition) use Tabernanthe iboga root bark. 5-MeO-DMT ceremonies use the secretion of the Bufo alvarius toad. Modern Western adaptations ('neo-shamanic ceremonies') often combine traditional elements with Western therapeutic frameworks. Clinical evidence is limited to observational studies and case series, but shows promising signals for depression treatment (ayahuasca) and addiction treatment (ibogaine). Important safety concerns: ayahuasca has strict medication interactions (MAOIs), ibogaine carries life-threatening cardiac risks, and ceremony quality varies widely depending on the facilitator.