A Shared Vision: Can Psychedelics Illuminate the Hallucinations of Lewy Body Disease?

With Lewy body diseases (LBDs), including Parkinson's disease and dementia with Lewy bodies, the world can be a scary and bewildering place. The most challenging symptom is perhaps seeing things that aren't there, or having complex visual hallucinations. These episodes cause significant distress for both patients and families. But what if the answer to understanding these hallucinations is in an entirely different field of neuroscience: the research into traditional psychedelics?

A Surprising Connection

On initial impression, a neurodegenerative disorder and the effects of a psychedelic drug would seem vastly different. However, a fascinating new field of research is exploring their convergence. A comprehensive 2025 review in Schizophrenia Bulletin by an international team of researchers sets its sights on an unexpected convergence: visual hallucinations induced by serotonergic psychedelics (SPs) like psilocybin and LSD are very similar to those seen in LBDs [1].

This is not coincidental. The research suggests that both types of hallucinations are linked to the brain serotonin system, specifically the serotonin 2A (5-HT2A) receptor. This shared neural pathway has led scientists to speculate whether psychedelics could be an incredibly useful tool for research. By analyzing reversible, short-term hallucinations induced by SPs under rigorously controlled lab conditions, scientists can gain insight into the more persistent and disorienting hallucinations characteristic of LBDs.

The Burden of Hallucinations in LBDs

Visual hallucinations are not just an interesting symptom; they are a substantial source of distress and a potent predictor of a poorer disease course. They are associated with increased caregiver distress, increased rates of institutionalization, and decreased quality of life [1]. Current treatments are limited and often accompanied by significant side effects. For instance, older antipsychotics are potentially harmful to individuals with LBDs, occasionally exacerbating movement disorders or leading to serious side effects [2].

While some drugs, including cholinesterase inhibitors, yield some improvement for hallucinations in some patients, there is a pressing need for more effective and safer medications [3]. That is where the psychedelic model comes so useful. It offers a way of studying the biology of such hallucinations without compromising vulnerable patients.

Psychedelics as a Research Model

The intention is not to treat LBD patients with psychedelics but, rather, leverage their use as a model in healthy subjects to understand hallucinogenesis mechanisms. The review in 2025 outlines that SP- and LBD-induced hallucinations both involve cortical functional changes that suggest a blend of sensory deterioration and cortical excitation [1]. In effect, the visual processing areas of the brain may get overactive and less controlled by sensation, and thereby have hallucinations of seeing things that are not actually there.

Through high-tech neuroimaging to observe the brain on psychedelics, scientists are able to map the specific circuits and chemical changes that create these visions. This might bring about a variety of breakthroughs. First, it can help in the development of biomarkers—neutral measures that potentially can detect individuals at risk of developing hallucinations. Second, it can provide a model to test new treatments intended to modulate the 5-HT2A receptor or other signaling pathways [4, 5].

A New Frontier in Neurodegenerative Research

This new approach is a paradigm shift to how we study neurodegenerative diseases. This ends the divide between psychedelic science and neurology, opening a new era of discovery. By studying the shared vision between these two disparate conditions, researchers hope to illuminate the dark corners of LBDs and bring new hope to patients and families afflicted with these debilitating illnesses.

The journey is ahead, but the potential is vast. The strange, ephemeral world of psychedelic experience may be the key to overcoming one of the most stubborn symptoms of Lewy body disease, turning a shared dream into a path to healing.

References

1.Heller, N. H., et al. (2025). Visual hallucinations in serotonergic psychedelics and Lewy body diseases. Schizophrenia Bulletin, 51(Suppl 3), S273-S291. https://doi.org/10.1093/schbul/sbaf068

2.Boot, B. P. (2015). Comprehensive treatment of dementia with Lewy bodies. Alzheimer's Research & Therapy, 7(1), 45. https://link.springer.com/article/10.1186/s13195-015-0128-z

3.Hershey, L. A., & Coleman-Jackson, R. (2019). Pharmacological management of dementia with Lewy bodies. Drugs & Aging, 36(4), 309-319. https://link.springer.com/article/10.1007/s40266-018-00636-7

4.Saeger, H. N., & Olson, D. E. (2022). Psychedelic-inspired approaches for treating neurodegenerative disorders. Journal of Neurochemistry, 180(1), 121-136. https://onlinelibrary.wiley.com/doi/abs/10.1111/jnc.15544

5.Kozlowska, U., et al. (2022). From psychiatry to neurology: Psychedelics as prospective therapeutics for neurodegenerative disorders. Journal of Neurochemistry, 180(1), 137-154. https://onlinelibrary.wiley.com/doi/abs/10.1111/jnc.15509

Disclaimer: Psychedelic Assisted Psychotherapy has not been approved by any regulatory agencies in the United States, and the safety and efficacy are still not formally established at the time of this writing.