Alcohol use disorder (AUD) is a widespread, multifaceted disorder involving overproduction of pro-inflammatory cytokines, oxidative liver injury, and dysfunction of the brain’s dopaminergic reward circuits. Korean red ginseng (KRG), an herbal supplement derived from Panax ginseng, has demonstrated qualities potentially useful to the treatment of AUD, including antioxidative, anti-inflammatory, neuroprotective, and anxiolytic effects. This review examines active constituents of KRG, their pharmacological actions, and evidence supporting KRG’s therapeutic potential in the context of AUD, while also assessing its safety profile, adverse effects, and potential drug interactions. KRG’s main bioactive constituents, ginsenosides, appear to have roles in modulating alcohol-metabolizing enzymes, ethanol-activated inflammatory cytokine cascades, and neurological systems disrupted by AUD, including GABAergic and dopaminergic pathways. Evidence from animal models and limited small-scale human trials suggests KRG may alleviate symptoms of alcohol withdrawal, enhance cognitive performance, and attenuate anxiety through these pathways. While generally safe for consumption, several case reports and animal studies have indicated KRG’s potential to pose a variety of risks in vulnerable populations at high, prolonged doses, including hepatotoxicity, cardiovascular changes, mood disturbances, and hormonal effects. Furthermore, KRG’s neuromodulating role and influence on cytochrome P450 enzymes make it liable to interact with several medications, including warfarin, midazolam, selegiline, and serotonergic agents. Overall, KRG shows promise as a complementary supplement in managing aspects of AUD, though current evidence is limited by low sample sizes, inconsistent reports regarding nuances of ginsenosides’ mechanisms, and a low number of human trials. Further human-focused research is needed to elucidate its safety, efficacy, and mechanism.

Mescaline, the primary bioactive alkaloid found in Peyote and San Pedro cactus, has been used in traditional medicine for centuries and is now attracting renewed interest for clinical applications. The purpose of this systematic review was to search the literature for studies reporting the use of mescaline to address the gap in our understanding of mescaline use and its impact. References were exported from PubMed, Scopus, Embase, and Cochrane. Included studies contained patient data pertaining to mescaline, primary sources for beliefs on the use of mescaline as traditional medicine, and a range of psychiatric conditions. Excluded studies included unpublished studies, animal studies, and studies without English full-texts available. Of 2770 imported references, 66 met the inclusion criteria, with only 10 being found suitable for analysis. Studies reported therapeutic effects such as improvements in depression scales, well-being, nicotine dependence, alcohol use, and obsessions. Bayesian analysis found that certain effects were frequently reported, such as hypertension, headache, nausea, and vomiting. The existing literature on mescaline is limited and of highly variable quality, preventing definitive conclusions regarding the prevalence of psychological and somatic effects from mescaline and mescaline-containing ethnobotanicals. Additional research is needed to determine the safety profile of mescaline. Given the prevalence of Peyote use in the Native American Church, the collaboration of the Native American Church and regional hospitals/poison centers is recommended to create a registry to allow for standardized and clinically applicable data collection on the effects of mescaline in prevalent populations.