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Analysis explores potential psychedelic treatments of mental illness

Treating mental illnesses with psychedelic medicine may be a re-emerging therapeutic field, according to an analysis published in the Canadian Medical Association Journal.

Kenneth W. Tupper, PhD, of the University of British Columbia, and colleagues reviewed emerging research considering potential benefits and harms of using psychedelic agents as adjuncts to psychotherapy or counseling for mental illnesses. Specifically, the researchers assessed the use of classic psychedelics (eg, lysergic acid diethylamide (LSD), psilocybin dimethyltryptamine (DMT) and mescaline) and entactogens (eg, methylenedioxymethamphetamine [MDMA]) for treating addiction, anxiety and PTSD.

“The findings presented in this analysis are preliminary, and most are results from small-scale pilot studies with relatively few participants. Further study is warranted before any unambiguous clinical utility may be confirmed, but the new generation of investigators is attempting to overcome some of the methodological weaknesses of earlier research on these substances,” Tupper and colleagues wrote.

A small randomized controlled trial conducted in Switzerland in 2014 suggested LSD-assisted psychotherapy may reduce anxiety associated with terminal illness. Twelve study participants with life-threatening illnesses received treatment involved drug-free psychotherapy supplemented with two LSD-assisted sessions 2 to 3 weeks apart. At the 2-month follow-up, the State-Trait Anxiety Inventory indicated insignificant reductions in trait anxiety but significant reductions in state anxiety. Further, follow-up 1 year after treatment showed sustained therapeutic benefit with no acute or chronic drug-related severe adverse events.

In the 1950s and 1960s, researchers studied psychedelic-assisted therapy for treatment of addictions, according to Tupper and colleagues. A meta-analysis that recently revisited these findings found significant benefits. Ten study participants with alcohol dependence received pre- and postpsychosocial support over 12 weeks, with one or two open-label interventions with psilocybin at weeks 4 and 8. Self-reported mean drinking days decreased by more than half of baseline measures, according to researchers.

Results from a pilot randomized controlled trial of MDMA-assisted psychotherapy for treatment of chronic treatment-resistant PTSD in the United States showed significant and sustained reduction in PTSD symptoms, with some participants no longer meeting DSM-IV criteria for PTSD.

Psychedelic treatment for mental illnesses comes with risks, according to Tupper and colleagues, as psychedelic drugs are known to evoke psychotic breaks. Further, Hallucinogen Persisting Perception Disorder (HPPD), also known as more uncommon and clinically severe “flashbacks,” is another known risk. Though, these are relatively uncommon among the general population, according to researchers.

“Currently, international drug control scheduling classifications and popular misconceptions about the relative risks and harms of psychedelic drugs make research involving humans difficult. However, continued medical research and scientific inquiry into psychedelic drugs may offer new ways to treat mental illness and addiction in patients who do not benefit from currently available treatments. The re-emerging paradigm of psychedelic medicine may open clinical and therapeutic doors long closed,” the researchers concluded. –by Amanda Oldt

Disclosure: Tupper reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.