[Psychedelic and dissociative agents in psychiatry: challenges in the treatment].
Johannes Jungwirth, Francesco Bavato, Boris B. Quednow
Der Nervenarzt September 1, 2024 DOI: 10.1007/s00115-024-01727-0 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Ketamine Psychedelic-assisted therapy |
| Keywords | Mental health treatment Clinical safety Addictive potential Side effects Study quality Treatment risks Ketamine therapy Medical research |
| Citations | 6 |
| Key findings | The review highlights that while psychedelic and dissociative agents are considered safe, careful consideration of treatment risks and methodological weaknesses in existing studies is essential to avoid detrimental effects from excessive expectations. |
Abstract
With the discovery of the antidepressive effects of ketamine and the increasing withdrawal of the pharmaceutical industry from the development of new psychotropic drugs, the psychiatric research into the clinical application of hallucinogens in psychiatry has literally blossomed in the last two decades. Promising results for various treatment approaches with psychedelic agents, such lysergic acid diethylamide (LSD) and psilocybin, and dissociative agents, such as ketamine and esketamine, have raised great hopes among researchers, clinicians and patients in recent years, so that there was already talk of a new era in psychiatry. As one of the first of these substances, in December 2019 intranasal esketamine was approved in the USA and the EU for the treatment of treatment-resistant depression and Switzerland followed in 2020. Recently, psilocybin was approved in Australia, Canada and Switzerland for compassionate use in exceptional cases for the treatment of depression, while large approval studies with various psychedelic agents are currently ongoing worldwide. The medical application of psychedelic agents and ketamine/esketamine is considered to be safe; however, as with all new forms of treatment it is of crucial importance that, in addition to the hopes, the specific challenges of these new treatment approaches must also be carefully considered and assessed. Excessive expectations and an insufficient risk-benefit estimation are detrimental to the patients and the reputation of the treating physician. Although a possible paradigm shift in the care of mental health is already being discussed, this review article consciously concentrates on the possible risks of treatment and the methodological weaknesses of the studies carried out so far.
Comparable studies
Other narrative reviews on ketamine and psychedelic-assisted therapy, most cited first.
Citations in the library
Cited by 2
- [Intravenous Subnarcotic Ketamine Infusions for Treatment-Resistant Depression: Historical Development, Comparison with Esketamine Nasalspray, and Prospects]. Fortschritte der Neurologie · Psychiatrie June 8, 2026
- The therapeutic potential of ayahuasca in depression, generalized anxiety, and substance use disorders: modulation of the depressive burden in a longitudinal study. Frontiers in Psychiatry 2026
Cites 60
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- Ketamine use: a review Addiction July 21, 2011
- Side-effects associated with ketamine use in depression: a systematic review. The Lancet Psychiatry 2018
- Psychedelics promote neuroplasticity through the activation of intracellular 5-HT2A receptors Science February 16, 2023
- Efficacy and safety of psilocybin-assisted treatment for major depressive disorder: Prospective 12-month follow-up Journal of Psychopharmacology February 1, 2022
and 55 more in the library