Psychedelic Assisted Psychotherapy

Human hallucinogen research: guidelines for safety

Journal of Psychopharmacology · 2008

This paper from Johns Hopkins reviews the history of human research with classic psychedelics, the risks involved, and how researchers can reduce them. It is a review and set of guidelines rather than a trial. The authors note that while these substances carry relatively low physical risk and are not considered drugs of dependence, they carry unique psychological risks. The most likely is overwhelming distress during the session, and rarer risks include prolonged psychotic reactions. Recommended protections include screening out people with a personal or family history of psychotic or other severe psychiatric disorders, building trust before the session, careful preparation, a supportive physical setting, and at least two monitors present. A limitation is that these guidelines were written for research settings rather than everyday clinical practice.

Attenuation of psilocybin mushroom effects during and after SSRI/SNRI antidepressant use

Journal of Psychopharmacology · 2023

Researchers at Johns Hopkins wanted to know whether common antidepressants change how strongly psilocybin mushrooms are felt. They ran an online retrospective survey of people who had used psilocybin mushrooms while taking an antidepressant, or within two years of stopping one. In this study, across 611 reports of use while on an antidepressant, weaker-than-expected effects were reported about 47% of the time with SSRIs, 55% with SNRIs, and 29% with bupropion. Among 1,542 reports after stopping an SSRI or SNRI, reduced effects were still reported up to three to six months later. An honest limitation: this is self-reported, retrospective survey data, so recall and expectation may have shaped the answers. Psilocybin remains a Schedule I substance under US federal law, and regulated access currently exists only through state programs in Oregon and Colorado; it is not available in New Jersey.

MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study

Nature Medicine · 2021

This phase 3 randomized, double-blind, placebo-controlled trial tested MDMA-assisted therapy for severe PTSD in 90 adults, including people with dissociation, depression, substance use histories and childhood trauma. Everyone received the same manualized therapy, with three preparation and nine integration sessions; the difference was whether the medicine sessions used MDMA or placebo. In this study, PTSD symptom scores fell more in the MDMA group than the placebo group two months after the last session, and functional impairment also improved more. The researchers did not observe signs of abuse potential, increased suicidality, or heart rhythm problems. A limitation is that the placebo group also improved considerably, and blinding is difficult with MDMA. MDMA remains a Schedule I substance and is not an approved treatment in the United States.