Psychedelic-assisted psychotherapy for depression: How dire is the need? How could we do it?
Mitch Earleywine, Joseph A. de Leo
Journal of Psychedelic Studies June 1, 2020 DOI: 10.1556/2054.2020.00134 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Anxiety Depression Psychedelic-assisted therapy |
| Keywords | Feeling Psychotherapist Depression economics Antidepressant Clinical psychology Clinical trial |
| Citations | 12 |
| Key findings | Antidepressants alone help only one in four patients, psychotherapies outperform drugs, and combining both helps only 65% of clients; psychedelics may improve depression through similar and novel mechanisms, warranting guided psychedelic-assisted clinical trials. |
Abstract
Abstract Despite the popular support for psychedelics as aids for depression, academics and the public frequently overestimate the efficacy of available medications and psychotherapies. Metaanalyses reveal that antidepressant medications alone help only one in four patients and rarely surpass credible placebos. Their effects, though statistically significant, might not impress depressed patients themselves. Psychotherapies create better outcomes than antidepressant drugs alone; combining the two provides measurable advantages. Nevertheless, the best combinations help only 65% of the clients who complete treatment. The drugs create side-effects and withdrawal surprisingly more severe than professional guidelines imply, too. Psychedelics appear to improve depression through some of the same mechanisms as psychotherapy, as well as some novel ones, suggesting that the combination could work very well. In addition, subjective experiences during the psychedelic sessions covary with improvement. Guiding clients to focus on these targeted thoughts and feelings could improve outcome. These data underscore the serious need for clinical trials of psychedelic-assisted, empirically supported treatment for depression with guided experiences during the psychedelic session. These trials would require important components to maximize their impact, including meaningful preparatory sessions designed to enhance motivation and explain empirically supported approaches, guided administration sessions that focus on oceanic boundlessness, integration sessions that support progress, and follow-up sessions consistent with established research. This combination involves markedly more than a simple pairing of medication and talk therapy, but proper application could have an unparalleled impact on public health.
Comparable studies
Other narrative reviews on psychedelic-assisted therapy, most cited first.
Citations in the library
Cited by 11
- Cannabis-induced oceanic boundlessness Journal of Psychopharmacology March 28, 2021
- How Important Is a Guide Who Has Taken Psilocybin in Psilocybin-Assisted Therapy for Depression? Journal of Psychoactive Drugs March 23, 2022
- Expectancies for Cannabis-Induced Emotional Breakthrough, Mystical Experiences and Changes in Dysfunctional Attitudes: Perceptions of the Potential for Cannabis-Assisted Psychotherapy for Depression Cannabis July 11, 2022
- Mystical experiences without mysticism: An argument for mystical fictionalism in psychedelics Journal of Psychedelic Studies June 8, 2022
- Cognitive Behavioral Therapy, Ketamine, and Combination Treatment for Depression: Impressions of Credibility in Participants with Self-Reported Depressive Symptoms Journal of Psychoactive Drugs April 20, 2021
and 6 more in the library
Cites 9
- Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology November 8, 2017
- The Standardized Psychometric Assessment of Altered States of Consciousness (ASCs) in Humans Pharmacopsychiatry July 1, 1998
- Psychological flexibility mediates the relations between acute psychedelic effects and subjective decreases in depression and anxiety. Journal of Contextual Behavioral Science 2020
- The antipodes Of the mind November 7, 2002
- Ayahuasca’s ‘afterglow’: improved mindfulness and cognitive flexibility in ayahuasca drinkers Psychopharmacology January 11, 2020
and 4 more in the library