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Research on Psychedelics for Mental Health Promising, but Limited

The majority of studies included in a new literature review identified significant improvement in a variety of psychiatric disorders among patients who took hallucinogenic drugs. But, researchers said it is difficult to draw conclusions because of key study limitations.

“To properly assess the risks and potential benefits of hallucinogens in psychiatric treatment, there is a need for well-designed, standardized studies that demonstrate the impact of hallucinogenic substances on psychiatric conditions,” wrote authors Matthew J. Begola, DO, and Jason E. Schillerstrom, MD, of the University of Texas Health Science Center at San Antonio, in the Journal of Psychiatric Practice.

The research review included 16 studies investigating the use of hallucinogens, alone or as part of augmentation therapy, for the treatment of mental health disorders including substance use disorders, depression, and anxiety. All but one study reported that the psychedelic drugs “produced clinically significant improvement in less time than commonly observed with traditional psychopharmacology or therapy,” the authors wrote.

MDMA Moving Closer to Therapeutic Use

According to the review:

• Lysergic acid diethylamide (LSD) in patients with alcohol use disorder increased insight into problems, provided a “new lease on life,” and resulted in strong resolutions to stop drinking. In one study, a single dose of LSD led to improvement over 6 months.

• Psilocybin reduced anxiety and depression in patients with cancer and also led to lasting improvement in patients with obsessive compulsive disorder.

• Ketamine produced positive results in patients with opioid use disorder, depression, and alcohol use disorder.

Other hallucinogens that showed psychotherapeutic benefits included the Amazonian botanical brew ayahuasca, the psychoactive alkaloid ibogaine, and 3,4-methylenedioxymethamphetamine (MDMA), a synthetic drug also known as “ecstasy.” However, small sample sizes, inconsistent measures, and poor research design across studies prevented reviewers from drawing definitive takeaways.

“Despite promising findings in therapeutic hallucinogen trials, current factors, including funding, laws, and stigma, continue to impose limitations on further research,” Drs. Begola and Schillerstrom said. “At some point, the field must overcome these barriers if we are to advance our knowledge about the impact of hallucinogenic agents on the treatment of serious mental conditions.”

—Jolynn Tumolo

References

Begola MJ, Schillerstrom JE. Hallucinogens and their therapeutic use: a literature review. Journal of Psychiatric Practice. 2019;25(5):334-346.

Psychedelics in psychiatry? Studies show benefits of hallucinogenic drugs for mental health treatment [press release]. Philadelphia, Pennsylvania: Wolters Kluwer; September 11, 2019.

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