Medical Literature Regarding Psychedelics, Pregnancy, and Breastfeeding with Ben Malcolm, PharmD

In this episode of the Psychedelic Medicine Podcast, Ben Malcolm, PharmD joins to discuss the research surrounding the intersection of psychedelics with pregnancy and nursing. Dr. Malcolm is a psychopharmacology consultant, psychedelic educator, founder of Spirit Pharmacist, LLC and a board member of the Psychedelic Medicine Association. Dr. Malcolm recently wrote an overview article on the existing research into psychedelics, pregnancy and breastfeeding.

In this conversation, Dr. Malcolm shares the current state of research that he explored in his article, highlighting the few points where data does exist while emphasizing that there are still major unknowns. Overall, Dr. Malcolm describes how most are very conservative when it comes to psychedelic use while nursing or pregnant, though pregnancy seems to present more concerns than nursing.

Dr. Malcolm also discusses ketamine and the interesting findings in patients who were given this substance as an anesthetic for cesarean sections. In conclusion, Dr. Malcolm suggests moving beyond a black and white perspective on this topic, emphasizing that there are also opportunity costs to not pursuing healing. However, in this area especially, more research is needed before clear guidelines can be developed. 

In this episode:

• The lack of treatment options for postpartum depression
• Why it is likely for a fetus or infant to be exposed to psychedelics if a mother ingests them while pregnant or nursing
• Psychedelics and the developing brain
• Ritual use of ayahuasca and mushrooms among pregnant women in traditional ceremonial contexts
• The research into negative impacts of ecstasy use during pregnancy and the variables that confound the results
• The unknowns about microdosing while nursing
• The research into whether LSD is a teratogen
• The effects of psychedelics on hormones
• Pregnancy as an aspect of set and setting

Quotes:

"Psychoactive drugs or psychotropic drugs typically end up in breastmilk more than other types of substances because they are usually more fat-soluble. Usually to get into brain tissue they have to be a little more fat-soluble than drugs that act in the periphery." [10:15]

"In the nursing period I think that there's more potential to use psychedelics safely and without really taking much risk as far as exposing the [child], whereas in pregnancy, yeah, you just don't really have that choice—the fetus is going to be exposed." [24:42]

Links:

Dr. Malcolm's recent article: "Psychedelics, Pregnancy, and Breastfeeding"

Spirit Pharmacist website

Spirit Pharmacist on Facebook

Spirit Pharmacist on Instagram

Spirit Pharmacist on YouTube

Psychedelic Medicine Association

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