Interest in psychedelic therapies for adults is growing, with substances like MDMA for PTSD, psilocybin for treatment-resistant depression, and LSD for generalized anxiety disorder showing promise. However, research on these therapies in children and adolescents is limited, with no recent trials. Adolescents may still experiment with these substances recreationally or therapeutically as accessibility increases, raising significant concerns due to their vulnerability. The authors advocate for structured, safe, and well-controlled exploration of psychedelic therapies in adolescents.
For treatment-resistant depression (TRD), a panel of 10 psychiatrists reached strong consensus on recommending augmentation with second-generation antipsychotics, transcranial magnetic stimulation, and ketamine/esketamine as next-step treatments after three failed antidepressant trials. Treatment preferences shifted to include nonaugmentative antidepressants and electroconvulsive therapy depending on patient characteristics such as metabolic disease and age. The findings underscore the importance of tailoring TRD treatment strategies to individual patient factors beyond conventional guideline tiers.
A commentary responds to an earlier article advocating for clinical trials of psychedelic-assisted therapy in adolescents aged 16 to 17. The authors agree that rigorous studies of compounds like psilocybin, LSD, and MDMA in this age group are warranted, as adolescents are likely already using these substances therapeutically. They offer additional considerations to foster further dialogue and advocacy in the field.