Trauma contributes to many psychiatric conditions beyond PTSD, with major depressive disorder (MDD) being the most common. About half of PTSD cases also have MDD, and their overlapping symptoms and neurobiology raise questions about whether they are distinct disorders or a single trauma-related phenotype. Traditional treatments have had mixed success. Drug-assisted psychotherapy, combining medication with therapy, is emerging as a novel approach. Psilocybin- and MDMA-assisted psychotherapy have received FDA 'breakthrough therapy' designation for resistant MDD and PTSD, respectively. This review examines the rationale for using these substances to treat trauma-related MDD and PTSD.
Functional neurological disorder (FND) causes seizures and movement disorders, is debilitating, and often has a poor prognosis. Brain imaging suggests FND involves multiple networks, and mechanisms like dissociation and abnormal motor agency may play a role. Psychedelics disrupt brain networks and are being tested for neuropsychiatric disorders. This open-label neuroimaging study will give 25 mg oral psilocybin with psychological support to 24 people with chronic FND. Resting-state and task-based fMRI, plus measures of interoception, somatisation, and dissociation, will be collected before and after psilocybin, with three-month follow-up. The study aims to probe FND mechanisms and assess safety and feasibility of psychedelic administration in this population.