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Critical appraisal of evidence supporting prescription of psychedelics from clinic websites in Ontario, Canada

Kyurim Kim, Abban Yusuf, Abhimanyu Sud, Nav Persaud, Abirami Kirubarajan, Monique Moller, Taryn Lloyd, Braden O'Neill

PLoS One October 24, 2024 DOI: 10.1371/journal.pone.0309911 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Cross-sectional analysis of clinic websites Peer reviewed
Sample size 10
Population Psychedelic clinic websites in Ontario, Canada
Topics Psychedelic-assisted therapy
Keywords Mental health treatment Clinical research Medical ethics Depression treatment
Citations 1
Key findings Psychedelic clinics in Ontario promote psychedelics for a wide range of medical conditions using primarily low to moderate quality evidence, with limited information on potential adverse effects.

Abstract

Psychedelics, including ketamine, 3,4-Methyl enedioxy methamphetamine (MDMA), and psilocybin, have gained attention for their potential therapeutic role in mental health treatment. While recreational use is prohibited in Canada, medicinal exemptions can be granted. There are several psychedelic clinics in Ontario, Canada, promoting the use of psychedelics for a variety of medical indications. Our objective was to identify the indications for which psychedelics are being prescribed in Ontario clinics and assess the quality of evidence used to support these claims. Internet searches were conducted using Google and Bing to identify psychedelic clinics in Ontario. Inclusion criteria was as follow: clinics were physically located in Ontario, had a functioning website link, and demonstrated involvement of a licensed physician or nurse practitioner. Identified clinics were evaluated for their claims of effectiveness, the quality of evidence used to support these claims, and statements on psychedelic-related harms. The cited studies were appraised for quality using Oxford Centre for Evidence-Based Medicine Levels of Evidence, “level 5” being the lowest quality and “level 1” being the highest quality. Out of 200 search results, 10 psychedelic clinic websites met our inclusion criteria. These clinics advertised psychedelics for 47 medical conditions, most commonly for depression. Only 2 out of 10 clinics described potential risks associated with psychedelic use. There were 29 studies cited by these websites, majority coming from “level 4” evidence consisting of case-series and case-control studies. Overall, the cited evidence quality was low to moderate. Psychedelic clinics in Ontario promote a wide range of medical indications for psychedelics using primarily low to moderate “level 4” evidence. There is limited information shared on the potential adverse effects of psychedelics. Our study emphasizes the importance of using transparent and high-quality evidence by clinics and clinicians to ensure safe and effective use of psychedelics in mental health treatments.

Comparable studies

Other cross-sectional and survey studies on psychedelic-assisted therapy, most cited first.

Study Year Design Participants
Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. International sample of people who reported having used a psychedelic 2020 Cross-sectional survey n = 985
Psychedelic Treatment for Trauma-Related Psychological and Cognitive Impairment Among US Special Operations Forces Veterans U.S. Special Operations Forces Veterans who completed a psychedelic clinical program in... 2020 Survey n = 51
Population Survey Data Informing the Therapeutic Potential of Classic and Novel Phenethylamine, Tryptamine, and Lysergamide Psychedelics Respondents from the National Survey on Drug Use and Health, 2008–2017, weighted to... 2020 Cross-sectional survey n = 260,964,827
Examination of the Phenomenology of the Ibogaine Treatment Experience: Role of Altered States of Consciousness and Psychedelic Experiences. Individuals who used ibogaine in the past 2017 Retrospective survey n = 27
American Psychiatrists' Opinions About Classic Hallucinogens and Their Potential Therapeutic Applications: A 7-Year Follow-Up Survey. American Psychiatric Association members (resident-fellows and attending psychiatrists) 2024 Survey n = 131

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