Psychedelics: Psychiatry of the Future

Phase 3 results on MDMA-assisted therapy look promising for the treatment of PTSD. What other disorders can psychedelics help treat?

CONFERENCE REPORTER

Rick Doblin, PhD, in his talk at the 2021 Annual Psychiatric TimesTM World CME Conference, gave an overview of the recent research on psychedelics in psychiatry. Doblin is the founder and executive director of Multidisciplinary Association for Psychedelic Studies (MAPS), which has raised more than $115 million in grants and donations for psychedelic therapy and medical marijuana research and education.

“MAPS has been practicing psychedelic science for 35 years,” shared Doblin.

According to Doblin, phase 3 trial results1 examining 3,4-methylenedioxy-methamphetamine (MDMA)-assisted therapy for posttraumatic stress disorder (PTSD) look promising, as echoed by a number of publications, including The New York Times2 and Scientific American.3 By the study’s end, two-thirds of the MDMA group no longer qualified for a PTSD diagnosis after 3 MDMA sessions. There was a small p value (0.0001), a large effect size (0.91 and 2.1), no site-to-site variability, a good safety profile, and results were replicated from phase 2 trials. The 12-month follow up results will be available next year.

Doblin also believes psychedelics show promise in treating depression,4 alcohol dependence,5 obsessive-compulsive disorder,6 and even demoralization in AIDS survivors.7

“I really think psychedelics will play a major role in psychiatry in the future,” concluded Doblin.

References

1. Mitchell JM, Bogenschutz M, Lilienstein A, et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med. 2021;27(6):1025-1033.

2. Jacobs A. The psychedelic revolution is coming. Psychiatry may never be the same. The New York Times. May 9, 2021. Accessed October 2, 2021. https://www.nytimes.com/2021/05/09/health/psychedelics-mdma-psilocybin-molly-mental-health.html

3. Cormier Z. MDMA shows new promise for trauma, but the drug alone is not a cure. Scientific American. May 12, 2021. Accessed October 2, 2021. https://www.scientificamerican.com/article/mdma-shows-new-promise-for-trauma-but-the-drug-alone-is-not-a-cure/

4. Carhart-Harris R, Giribaldi B, Watts R, et al. Trial of psilocybin versus escitalopram for depression. N Engl J Med. 2021;384(15):1402-1411.

5. Bogenschutz MP, Forcehimes AA, Pommy JA, et al. Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study. J Psychopharmacol. 2015;29(3):289-99.

6. Jacobs E. A potential role for psilocybin in the treatment of obsessive-compulsive disorder. Journal of Psychedelic Studies. 2020;4(2):77-87.

7. Anderson BT, Danforth A, Daroff PR, et al. Psilocybin-assisted group therapy for demoralized older long-term AIDS survivor men: an open-label safety and feasibility pilot study. EClinicalMedicine. 2020;27:100538.