PTSDAnxiety DisordersAlcohol Use Disorder (AUD)Tobacco/Nicotine Use Disorder (TUD)Palliative & End-of-Life DistressAutism Spectrum Disorder (ASD)Substance Use Disorders (SUD)Depressive DisordersPsilocybinMDMA

Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA

This commentary article (2016) by Mithoefer, Grob, and Brewerton gives an overview of recent research into psilocybin and MDMA.

Authors

  • Michael Mithoefer
  • Charles Grob
  • Timothy Brewerton

Published

Lancet Psychiatry
meta Study

Abstract

4-phosphorloxy-N,N-dimethyltryptamine (psilocybin) and methylenedioxymethamfetamine (MDMA), best known for their illegal use as psychedelic drugs, are showing promise as therapeutics in a resurgence of clinical research during the past 10 years. Psilocybin is being tested for alcoholism, smoking cessation, and in patients with advanced cancer with anxiety. MDMA is showing encouraging results as a treatment for refractory post-traumatic stress disorder, social anxiety in autistic adults, and anxiety associated with a life-threatening illness. Both drugs are studied as adjuncts or catalysts to psychotherapy, rather than as stand-alone drug treatments. This model of drug-assisted psychotherapy is a possible alternative to existing pharmacological and psychological treatments in psychiatry. Further research is needed to fully assess the potential of these compounds in the management of these common disorders that are difficult to treat with existing methods.

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Research Summary of 'Novel psychopharmacological therapies for psychiatric disorders: psilocybin and MDMA'

Introduction

Grob and colleagues frame their Personal View against a longstanding clinical problem: conventional psychopharmacology and psychotherapy, while beneficial for many patients, often fail to cure underlying psychiatric disorders and can be limited by modest efficacy, non-response, and adverse effects from long-term dosing. The authors note growing interest in improving psychological treatments, especially for conditions such as post-traumatic stress disorder (PTSD), existential distress at the end of life, and treatment-resistant disorders, and they highlight patient preference for psychotherapy over medication as a further impetus for novel approaches. This paper outlines and evaluates a model in which classic psychedelics (psilocybin) and the entactogen MDMA are administered on one or a few occasions to catalyse or augment psychotherapy. Rather than presenting these compounds as daily pharmacotherapies, Grob and colleagues describe them as adjuncts that can facilitate intense therapeutic experiences thought to produce rapid and potentially durable clinical benefits. The authors state their aim as reviewing evidence from early and recent clinical studies of psilocybin- and MDMA-assisted psychotherapy, discussing mechanisms, safety considerations, challenges (for example masking), and directions for future research.

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