Therapeutic Potential of Psychedelics in Treatment of Psychiatric Disorders, Part 2
Avinash Hosanagar, Joseph Cusimano, Rajiv Radhakrishnan
The Journal of Clinical Psychiatry February 23, 2021 DOI: 10.4088/jcp.20ac13787 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Randomized Double-blind Open-label Peer reviewed |
|---|---|
| Topics | Anxiety Depression LSD MDMA Psilocybin |
| Keywords | Hallucinogen Randomized controlled trial Mood Clinical psychology |
| Citations | 1 |
| Key findings | High-dose psilocybin produced large decreases in depression and anxiety, increased quality of life, and decreased death anxiety in patients with advanced cancer, with about 80% sustaining the response at 6-month follow-up. |
Abstract
P sychedelics have recently gained attention as compounds with therapeutic potential in the treatment of psychiatric disorders.The US Food and Drug Administration (FDA) has granted Breakthrough Therapy Designations for (±)-3,4-methylenedioxymethamphetamine (MDMA) as an adjunct to psychotherapy in severe posttraumatic stress disorder (PTSD) (in 2017) and for the adjunctive use of psilocybin with psychotherapy in both treatment-resistant depression (TRD) (in 2018) and major depressive disorder (MDD) (in 2019).Additionally, a number of clinical trials with psychedelics are ongoing for other indications such as eating disorders, cognitive impairment, and substance use disorders (SUD).This article is the second in a 2-part series 1 on the psychopharmacology and therapeutic effects of psychedelics, and it provides a review of the evidence for use of psychedelics, with a focus on psilocybin, lysergic acid diethylamide (LSD), MDMA, and ayahuasca. PsilocybinThe efficacy of psilocybin has been examined in open-label studies of treatment-resistant obsessive-compulsive disorder, TRD, and SUD such as alcohol and tobacco use disorders with promising results. 2 Randomized controlled trials (RCTs) of psilocybin are limited to the treatment of depression and anxiety in advanced cancer.In a double-blind crossover design RCT, 12 patients with advanced cancer received a single dose of psilocybin (0.2 mg/kg) and niacin (placebo) in 2 experimental sessions.Psilocybin resulted in a nonsignificant trend toward improvements in mood from the first session to 6-month follow-up. 3 A larger crossover design RCT that included patients with advanced cancer (n = 51), randomized to receive high-dose psilocybin (22 mg or 30 mg/70 kg) and low-dose psilocybin (1 mg or 3 mg/70 kg) in 2 experimental sessions, found that high-dose psilocybin produced large decreases in clinicianand self-rated measures of depression and anxiety, increased quality of life, and decreased death-anxiety.This response was sustained at 6-month follow-up in about 80% of participants when the