Special issue of APA’s official journal focuses on psychedelic medication
WASHINGTON, D.C., Jan. 1, 2025—As the body of research grows around the potential promise of psychedelic medications in psychiatry, many questions and challenges remain. The January issue of the American Journal of Psychiatry features a series of articles, including new research, reviews and commentaries, on the use of these treatments.
The issue addresses many of the ongoing challenges and looming questions in the field of psychiatric psychedelic research and treatment. These include issues relevant to basic pharmacology and effects on neural circuits, evidence of clinical efficacy, methodological challenges/ limitations of existing research (such as possibly large expectancy effects and functional unblinding), and contextual factors pertaining to public health and policy considerations. Other issues include drug interactions; whether patients can experience therapeutic benefits without experiencing the altered state (“psychedelic experience”) associated with psychedelic treatments; and the role of the drug (regulated by the FDA), the role of the psychological support/therapy component (likely not to be FDA-regulated) and the interaction of the two in treatment.
“Sufficiently addressing and answering these scientific and clinical questions will be critical for the future clinical success of these agents,” AJP’s Editor-in-Chief Ned Kalin, M.D., writes in the introduction to the issue co-authored with Guest Editors Gregory A. Fonzo, Ph.D., and Charles B. Nemeroff, M.D., Ph.D. “The potential for therapeutic strategies utilizing psychedelic drugs is exciting and yet there is a long path ahead toward clinical success.”
A few of the articles from the issue are highlighted below.
- “Psychedelics for the Treatment of Psychiatric Disorders: Methodologic Considerations and Guidance for Future Research, Clinical Development and Implementation,” Roger S. McIntyre, M.D. et al.
This review addresses general methodological considerations for psychedelic clinical trial data and provides recommendations. The paper is intended to help facilitate the interpretability and translatability of psychedelic studies and provides guidance for their future research and implementation, to ensure that development of psychedelic treatments is rigorous with respect to safety and the actual benefits of these treatments. - “Single-dose Psilocybin for Depression with Severe Treatment Resistance: a Non-Randomized Controlled Trial,” Scott T. Aaronson, M.D., et al.
Original research from Aaronson and colleagues describes positive findings from an open-label trial of psilocybin treatment in individuals with severe treatment-resistant depression. This small open-label study demonstrated significant safety and efficacy of synthetic psilocybin in severe treatment resistant depression. - “Benefits and Challenges of Ultra-Fast, Short-Acting Psychedelics in the Treatment of Depression,” Johannes G. Ramaekers, Ph.D., et al.
Ramaekers and colleagues review the evidence for ultra-fast, short-acting psychedelics such as dimethyltryptamine and 5-methoxy-dimethyltryptamine (5-MeO-DMT and DMT) which potentially offer benefits such as individualized dosing regimens to maximize treatment outcome and facilitate less complex and less costly implementation. - “Primum Non Nocere: The Onus to Characterize the Potential Harms of Psychedelic Treatment” Sharmin Ghaznavi, M.D., Ph.D., et al.
As with all therapeutic interventions, research is needed not only into their benefits, but also potential risks, including scrutiny in broad populations with psychiatric and medical comorbidities typically excluded from clinical trials. Among the known and potential harms of psychedelic treatments reviewed by Ghaznavi and colleagues include enduring perceptual disturbances; overuse, misuse and dependence; challenging experiences or “bad trips”; acute and cumulative cardiovascular effects; and more. They also make recommendations for further research and monitoring.
More information
- For a copy of full articles, contact press@psych.org
- APA Position Statement: Use of Psychedelic and Empathogenic Agents for Mental Health Conditions
American Psychiatric Association
The American Psychiatric Association, founded in 1844, is the oldest medical association in the country. The APA is also the largest psychiatric association in the world with more than 38,900 physician members specializing in the diagnosis, treatment, prevention and research of mental illnesses. APA’s vision is to ensure access to quality psychiatric diagnosis and treatment. For more information, please visit www.psychiatry.org.
Journal
American Journal of Psychiatry
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