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Psychedelic Psychiatry and the Consult-Liaison Psychiatrist: A Primer

Brian S. Barnett, George Greer

Journal of the Academy of Consultation-Liaison Psychiatry January 21, 2021 DOI: 10.1016/j.jaclp.2020.12.011 (opens in new tab)

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Study at a glance

AI-extracted from the abstract
Characteristics Review Peer reviewed
Topics LSD MDMA Psilocybin
Keywords Hallucinogen Counterculture Psychotherapist
Citations 13
Key findings Psychedelic-assisted therapies may have treatment potential for mental illness and addiction if administered thoughtfully and cautiously by trained professionals in medical settings.

Abstract

BackgroundPsychedelic compounds such as lysergic acid diethylamide (LSD), psilocybin, and 3,4-Methylenedioxymethamphetamine (MDMA) share a long and complex history with psychiatry. A half century ago, psychedelics were widely employed by psychiatrists in investigational and clinical settings, with studies demonstrating promising findings for their use in the treatment of mental illness and substance use disorders. However, concerns were also raised about their abuse potential and other adverse effects. Owing to these worries and psychedelics' association with the counterculture movement, psychedelics were largely outlawed in the United States in 1970, bringing research on their therapeutic potential to a halt. However, in recent years, a resurgence of psychedelic research has revealed compelling, though early, evidence for the use of psychedelic-assisted therapy in treating alcohol use disorder, nicotine use disorder, posttraumatic stress disorder, and depression.ObjectiveHere we provide an overview of psychiatry's complicated relationship with psychedelics, while reviewing contemporary findings on psychedelic-assisted therapy, safety of psychedelic-assisted therapy, and risks of nonmedical use. We also make the case that psychiatry should consider preparing now for the possibility of Food and Drug Administration approval of psychedelic-assisted therapies in the near future. We conclude by discussing how growing societal interest in psychedelics could impact the work of consult-liaison psychiatrists, while also exploring how consult-liaison psychiatrists might contribute to future delivery of psychedelic treatments.MethodsWe reviewed literature on psychedelic-assisted therapies and adverse events resulting from nonmedical psychedelic use.ResultsWe found a small, but rapidly growing literature indicating that psychedelic-assisted therapies may have treatment potential for mental illness and addiction. Our search also revealed a variety of rare adverse events stemming from nonmedical psychedelic use.ConclusionsDespite past concerns about psychedelics, current data indicate psychedelic-assisted therapy may potentially reduce suffering owing to mental illness and addiction if administered thoughtfully and cautiously by trained professionals in medical settings.

Comparable studies

Other narrative reviews on LSD, most cited first.

Study Year Design Participants
Study of a New Schizophrenomimetic Drug—Sernyl 1959 Review
Classic psychedelics: An integrative review of epidemiology, therapeutics, mystical experience, and brain network function. General population 2019 Integrative review
The Pharmacology of Lysergic Acid Diethylamide: A Review 2008 Review
Serotonin research: contributions to understanding psychoses 2008 Review
ADVERSE REACTIONS TO PSYCHEDELIC DRUGS. A REVIEW OF THE LITERATURE 1984 Review

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LSD MDMA Psilocybin Addiction Depression Psychedelic-assisted therapy