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Therapeutic potential of serotoninergic psychedelic substances in the treatment of Obsessive Compulsive Disorder

Jaime Rodrigues, O. Nombora, Luiz Vicente Ribeiro

European Psychiatry June 1, 2022 DOI: 10.1192/j.eurpsy.2022.1659 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Non-systematic review Peer reviewed
Topics LSD Psilocybin Serotonin
Keywords Obsessive compulsive Tolerability Hallucinogen Therapeutic approach Psychotherapist Pharmacology Adverse effect Disease Receptor
Citations 1
Key findings Serotoninergic psychoactive substances, particularly psilocybin and LSD, show clinically meaningful acute reduction of OCD symptoms and possible longer-lasting benefits, with relatively good tolerability.

Abstract

Introduction: Obsessive Compulsive Disorder (OCD) is a psychiatric disorder associated with suffering and disability. The serotoninergic system is implicated in the neurobiological processes of OCD and serotonin reuptake inhibitors (SRIs) are the first-line treatment. However, clinical improvement after starting SRIs can take long and patients may not fully recover. Meanwhile, recent data suggests that activation of 5-HT receptors may exert a therapeutic action in obsessional symptoms. Some psychedelics are strong 5-HT2 receptor agonists and there is a growing research interest as they can be a promising therapeutic approach to OCD.

Objectives: We aim to provide an overview on the current evidence on the therapeutic potential of serotoninergic psychoactive substances in the treatment of OCD.

Methods: Non-systematic review. Literature search in the PubMed database using the terms psychedelics and obsessive-compulsive disorder.

Results: Although research is currently limited to a few small studies, the ones conducted so far showed clinically meaningful acute reduction of OCD symptoms after treatment with serotoninergic psychoactive drugs, as well as possible longer-lasting benefits, particularly with psilocybin and lysergic acid diethylamide (LSD). Furthermore, substance-assisted psychotherapy with psychedelics has been showing promising results, being suitable for OCD treatment. It is important to add that, to date, studies have indicated relatively good tolerability to these drugs.

Conclusions: These promising early findings highlight the role of psychedelics in OCD treatment and the need for further research into efficacy, therapeutic mechanisms and safety, in order to determine whether these drugs may be worthy options for OCD treatment in the future. Disclosure No significant relationships.

Comparable studies

Other systematic reviews and meta-analyses on serotonin, most cited first.

Study Year Design Participants
Therapeutic effects of classic serotonergic psychedelics: A systematic review of modern‐era clinical studies Patients with cancer- or illness-related anxiety and depression, major depressive... 2020 Systematic review n = 188
Efficacy, tolerability, and safety of serotonergic psychedelics for the management of mood, anxiety, and substance-use disorders: a systematic review of systematic reviews Patients with mood, anxiety, or substance-use disorders, including cancer patients and... 2018 Systematic review of systematic reviews
Adverse events in clinical treatments with serotonergic psychedelics and MDMA: A mixed-methods systematic review Patients in clinical trials with MDMA or serotonergic psychedelics 2022 Systematic review n = 598
Classic serotonergic psychedelics for mood and depressive symptoms: a meta-analysis of mood disorder patients and healthy participants Healthy volunteers and patients with mood disorders 2021 Meta-analysis n = 257
Serotonergic psychedelics and personality: A systematic review of contemporary research 2018 Systematic review

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