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Psychedelic therapy

Psychedelic therapy (or psychedelic-assisted therapy) refers to the proposed use of psychedelic drugs, such as psilocybin, MDMA,[note 1] LSD, and ayahuasca, to treat mental disorders.[2][3] As of 2021, psychedelic drugs are controlled substances in most countries and psychedelic therapy is not legally available outside clinical trials, with some exceptions.[3][4]

The procedure for psychedelic therapy differs from that of therapies using conventional psychiatric medications. While conventional medications are usually taken without supervision at least once daily, in contemporary psychedelic therapy the drug is administered in a single session (or sometimes up to three sessions) in a therapeutic context.[5] The therapeutic team prepares the patient for the experience beforehand and helps them integrate insights from the drug experience afterwards.[6][7] After ingesting the drug, the patient normally wears eyeshades and listens to music to facilitate focus on the psychedelic experience, with the therapeutic team interrupting only to provide reassurance if adverse effects such as anxiety or disorientation arise.[6][7]

As of 2022, the body of high-quality evidence on psychedelic therapy remains relatively small and more, larger studies are needed to reliably show the effectiveness and safety of psychedelic therapy's various forms and applications.[8][9][2] On the basis of favorable early results, ongoing research is examining proposed psychedelic therapies for conditions including major depressive disorder,[8][10] anxiety and depression linked to terminal illness,[8][11] and post-traumatic stress disorder.[9][12] The United States Food and Drug Administration has granted "breakthrough therapy" status, which expedites the assessment of promising drug therapies for potential approval,[note 2] to psychedelic therapies using psilocybin (for treatment-resistant depression and major depressive disorder)[3] and MDMA (for post-traumatic stress disorder).[14]

  1. ^ Nutt D (2019). "Psychedelic drugs-a new era in psychiatry?". Dialogues in Clinical Neuroscience. 21 (2): 139–147. doi:10.31887/DCNS.2019.21.2/dnutt. PMC 6787540. PMID 31636488.
  2. ^ a b Reiff CM, Richman EE, Nemeroff CB, Carpenter LL, Widge AS, Rodriguez CI, et al. (May 2020). "Psychedelics and Psychedelic-Assisted Psychotherapy". The American Journal of Psychiatry. 177 (5): 391–410. doi:10.1176/appi.ajp.2019.19010035. PMID 32098487. S2CID 211524704.
  3. ^ a b c Marks M, Cohen IG (October 2021). "Psychedelic therapy: a roadmap for wider acceptance and utilization". Nature Medicine. 27 (10): 1669–1671. doi:10.1038/s41591-021-01530-3. PMID 34608331. S2CID 238355863.
  4. ^ Pilecki B, Luoma JB, Bathje GJ, Rhea J, Narloch VF (April 2021). "Ethical and legal issues in psychedelic harm reduction and integration therapy". Harm Reduction Journal. 18 (1): 40. doi:10.1186/s12954-021-00489-1. PMC 8028769. PMID 33827588.
  5. ^ Nutt D, Erritzoe D, Carhart-Harris R (April 2020). "Psychedelic Psychiatry's Brave New World". Cell. 181 (1): 24–28. doi:10.1016/j.cell.2020.03.020. PMID 32243793. S2CID 214753833.
  6. ^ a b Johnson M, Richards W, Griffiths R (August 2008). "Human hallucinogen research: guidelines for safety". Journal of Psychopharmacology. 22 (6): 603–620. doi:10.1177/0269881108093587. PMC 3056407. PMID 18593734.
  7. ^ a b Garcia-Romeu A, Richards WA (August 2018). "Current perspectives on psychedelic therapy: use of serotonergic hallucinogens in clinical interventions". International Review of Psychiatry. 30 (4): 291–316. doi:10.1080/09540261.2018.1486289. PMID 30422079. S2CID 53291327.
  8. ^ a b c Bender D, Hellerstein DJ (January 2022). "Assessing the risk-benefit profile of classical psychedelics: a clinical review of second-wave psychedelic research". Psychopharmacology. 239 (6): 1907–1932. doi:10.1007/s00213-021-06049-6. PMID 35022823. S2CID 245906937.
  9. ^ a b Smith KW, Sicignano DJ, Hernandez AV, White CM (April 2022). "MDMA-Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta-Analysis". Journal of Clinical Pharmacology. 62 (4): 463–471. doi:10.1002/jcph.1995. PMID 34708874. S2CID 240072663.
  10. ^ Romeo B, Karila L, Martelli C, Benyamina A (October 2020). "Efficacy of psychedelic treatments on depressive symptoms: A meta-analysis". Journal of Psychopharmacology. 34 (10): 1079–1085. doi:10.1177/0269881120919957. PMID 32448048. S2CID 218873949.
  11. ^ Schimmel N, Breeksema JJ, Smith-Apeldoorn SY, Veraart J, van den Brink W, Schoevers RA (January 2022). "Psychedelics for the treatment of depression, anxiety, and existential distress in patients with a terminal illness: a systematic review". Psychopharmacology. 239 (1): 15–33. doi:10.1007/s00213-021-06027-y. PMID 34812901. S2CID 244490236.
  12. ^ Hoskins MD, Sinnerton R, Nakamura A, Underwood JF, Slater A, Lewis C, et al. (January 2021). "Pharmacological-assisted Psychotherapy for Post-Traumatic Stress Disorder: a systematic review and meta-analysis". European Journal of Psychotraumatology. 12 (1): 1853379. doi:10.1080/20008198.2020.1853379. PMC 7874936. PMID 33680344.
  13. ^ "Breakthrough Therapy". United States Food and Drug Administration. 1 April 2018. Archived from the original on 1 March 2022. Retrieved 27 March 2022.
  14. ^ Vermetten E, Yehuda R (January 2020). "MDMA-assisted psychotherapy for posttraumatic stress disorder: A promising novel approach to treatment". Neuropsychopharmacology. 45 (1): 231–232. doi:10.1038/s41386-019-0482-9. PMC 6879520. PMID 31455855.


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