PSYCHEDELIC RESEARCH IN PSYCHIATRY
Most psychedelic research is currently being conducted in the field of psychiatry. Psychedelic assisted therapy appears to have transdiagnostic benefits with beneficial effects being shown in trials for Depression, Anxiety, Addiction, Eating Disorders, and PTSD. Published studies to date are restricted by small sample sizes but this will change over the coming year as many large scale, multi-centre RCT's are being conducted worldwide.
DEPRESSION
Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder A Randomized Clinical Trial. A Davis, JAMA Psychiatry, 2021
This phase 2 randomised controlled trial on the effects of psilocybin + supportive psychotherapy vs placebo showed that 71% of participants had >50% reduction in their Depression scores and 54% were in remission by the end of the 4 week trial period. The effect sizes reported in this study were 2.5 times greater than the effect sizes found in psychotherapy and >4 times greater than the effect sizes found in psychopharmacological depression treatment studies.
POST TRAUMATIC STRESS DISORDER
MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. J Mitchell, Nature, 2021
This randomized, double-blind, placebo-controlled, multi-site phase 3 clinical trial tested the efficacy and safety of MDMA assisted therapy for the treatment of patients with severe PTSD, including those with comorbidities such as dissociation, depression, a history of alcohol and substance use disorders, and childhood trauma. MDMA was found to induce significant and robust attenuation in PTSD scores compared with placebo and to significantly decrease functional impairment.
PSILOCYBIN VS SSRIS
Trial of Psilocybin versus Escitalopram for Depression. R Charhart-Harris, NEJM, 2021
This phase 2, double-blind, randomized, controlled trial involved patients with long-standing, moderate-to-severe major depressive disorder, and compared psilocybin with escitalopram, a selective serotonin-reuptake inhibitor and first line treatment for moderate to severe Depression, over a 6-week period. Remission occurred in 57% of the participants on psilocybin and 28% of those on Escitalopram.
EATING DISORDERS
Positive effects of psychedelics on depression and wellbeing scores in individuals reporting an eating disorder. M Spriggs, Spinger, 2020
This study provides the first quantitative exploration of the psychological after effects of a psychedelic experience in those reporting a lifetime diagnosis of an ED. The results demonstrate overwhelming evidence for improvements in both depression symptomology and psychological wellbeing.
ANXIETY
Safety and efficacy of lysergic acid diethylamide-assisted psychotherapy for anxiety associated with life-threatening diseases. P Gasser, 2014
A double-blind, randomized, active placebo-controlled pilot study. Treatment included drug-free psychotherapy sessions supplemented by two LSD-assisted psychotherapy sessions. Positive trends were found via the State-Trait Anxiety Inventory (STAI) in reductions in trait anxiety which were sustained on follow up one year later.
RESEARCH SUBJECTS' EXPERIENCES
Patients’ Accounts of Increased “Connectedness” and “Acceptance” After Psilocybin for Treatment-Resistant Depression. Rosalind Watts, 2017
Patients enrolled in an open label trial of psilocybin for treatment-resistant depression participated in a semistructured interview at 6-month follow-up. They reported experiencing a change from disconnection (from self, others, and world) to connection, and a change from avoidance (of emotion) to acceptance. Patients reported that medications and some short-term talking therapies tended to reinforce their sense of disconnection and avoidance, whereas treatment with psilocybin encouraged connection and acceptance.
PATIENT EXPERIENCES DURING TRIALS
Patient Experiences of Psilocybin-Assisted Psychotherapy: An Interpretative Phenomenological Analysis. A Belser 2017
Semistructured interviews were carried out with participants with clinically elevated anxiety associated with a cancer diagnosis. Participants received a moderate dose of psilocybin and adjunctive psychotherapy with an emphasis on the process of meaning-making. Patients reported experiencing joy, bliss, and love; embodiment; a movement from feelings of separateness to interconnectedness; catharsis of powerful emotion, improved relationships after treatment, and forgiveness.
EMOTIONAL BREAKTHROUGH
Emotional breakthrough and psychedelics: Validation of the Emotional Breakthrough Inventory. Leor Roseman, Journal of Psychopharmacology, 2019
. Emotional breakthrough is an important and distinct component of the acute psychedelic experience that appears to be a key mediator of subsequent longer-term psychological changes.
PSILOCYBIN VS ANTIDEPRESSANTS
The Drug Science Podcast
Robin Carhart-Harris heads the Psychedelic Research Group within the Centre for Psychiatry at Imperial College London, where he has designed several functional brain imaging studies with psilocybin, LSD, MDMA and DMT, plus a clinical trial of psilocybin for treatment resistant depression. He has over 50 published papers in peer-reviewed scientific journals; two of which were ranked in the top 100 most impactful academic articles of 2016. Robin’s research has featured in major national and international media and he has given a popular TEDx talk.