A scoping review of nine studies identified interventions for treating acute suicidality in emergency departments (EDs) that were tested between 2013 and 2023. Four studies tested a single dose of ketamine, three tested brief psychosocial interventions (two with follow-up care), and two tested motivational interviewing. The interventions with the strongest evidence and best fit for the ED environment were ketamine and Crisis Response Planning (CRP). However, the included studies had small sample sizes (average 57 participants), and there is currently insufficient evidence to conclude that these interventions are effective and well-suited for routine ED use. Further research is needed.
A critical review of six randomized controlled trials of MDMA-assisted therapy for PTSD finds that five show evidence of safety and efficacy. However, the review identifies serious methodological problems: lack of a suitable comparison condition, poor blinding, rigid trial designs, high treatment costs, and no head-to-head comparisons with established PTSD therapies. The sponsoring organization behind all trials may introduce bias. While the results are encouraging, there is not yet enough evidence to recommend widespread adoption of MDMA-assisted therapy over current validated treatments.
A systematic review of 25 studies found that psilocybin-assisted psychotherapy (PAP) produces a large reduction in anxiety symptoms within groups (Hedge's g = 0.96) and a small reduction compared to control groups (Hedge's g = 0.48). However, the studies varied widely in psychotherapy format, dosing, session structure, and outcome timing, and high heterogeneity persisted even after accounting for these differences. The authors conclude that PAP shows promise for treating anxiety across different diagnoses but caution that variability in study quality, design, sample representativeness, and high heterogeneity limit confidence in the findings. More rigorous trials with diverse populations are needed.