Older AdultsMajor Depressive Disorder (MDD)Depressive DisordersPTSDAnxiety DisordersSubstance Use Disorders (SUD)Safety & Risk ManagementSet & Setting

Older adults in psychedelic-assisted therapy trials: A systematic review

This systematic review (n=1400; s=36) aimed to assess the prevalence of older adults in psychedelic clinical trials and explore safety data. Only 19 participants aged 65 or older were identified, constituting less than 1.4% of all trial participants. Detailed safety data for 10 of these older adults revealed no serious adverse events, with only transient mild-to-moderate adverse events related to anxiety, gastrointestinal upset, and hypertension during psychedelic dosing sessions.

Authors

  • Stephen Ross
  • Brian Anderson
  • Yvan Beaussant

Published

Journal of Psychopharmacology
meta Study

Abstract

Background

Growing clinical interest in psychedelic-assisted therapies has led to a second wave of research involving psilocybin, lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA) and other substances. Data suggests that these compounds have the potential to treat mental health conditions that are especially prevalent in older adults such as depression, anxiety, existential distress, and posttraumatic stress disorder.

Aims

The goal of this study was to quantify the prevalence of older adults enrolled in psychedelic clinical trials and explore safety data in this population.

Methods

A systematic review was conducted following the 2020 PRISMA guidelines. Search criteria included all trials published in English using psychedelic substances to treat psychiatric conditions, including addiction as well as existential distress related to serious illness. Articles were identified from literature searches on PubMed, EBSCO, and EMBASE.

Results

4376 manuscripts were identified, of which 505 qualified for further review, with 36 eventually meeting eligibility criteria. Of the 1400 patients enrolled in the 36 studies, only 19 were identified as 65 or older, representing less than 1.4% of all trial participants. For 10 of these 19 older adults, detailed safety data was obtained. No serious adverse events (AEs) occurred in any older adults and only transient mild-to-moderate AEs related to anxiety, gastrointestinal upset, and hypertension were reported during the psychedelic dosing sessions.

Conclusions

While existing data in older adults is limited, it suggests that psychedelic-assisted psychotherapy can be safe and well tolerated in older adults. Therefore, psychedelic-assisted psychotherapy should be more rigorously investigated for the treatment of psychiatric conditions in this population.

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Research Summary of 'Older adults in psychedelic-assisted therapy trials: A systematic review'

Introduction

Research into psychedelic compounds has resurged after decades of legal restrictions, with recent trials of psilocybin and MDMA receiving regulatory attention such as Breakthrough Therapy designations for major depressive disorder and PTSD. Earlier waves of research treated tens of thousands of people, but older adults have been underrepresented in contemporary psychedelic-assisted therapy (PAT) trials despite high burdens of conditions like depression, anxiety, existential distress and PTSD in older populations, and despite the predominance of new cancer diagnoses occurring in people aged 65 and older. Bouchet and colleagues set out to quantify how frequently older adults (defined here as age 65 or older) have been enrolled in clinical trials of psychedelic-assisted therapies and to examine safety data for this subgroup. The study is a systematic review following PRISMA-P 2020 guidance and aims to describe prevalence, participant characteristics, therapies used, indications studied, and adverse events reported in older adults within eligible PAT trials.

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Study Details

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