Major Depressive Disorder (MDD)Depressive DisordersObsessive-Compulsive Disorder (OCD)Alcohol Use Disorder (AUD)Substance Use Disorders (SUD)Palliative & End-of-Life DistressNeuroimaging & Brain MeasuresAnxiety DisordersPsilocybin

The therapeutic potential of psychedelic drugs: past, present, and future

This review (2017) looks at the potential of psychedelics to be used in treatment of mental disorders, with a focus on psilocybin for depression.

Authors

  • Robin Carhart-Harris
  • Guy Goodwin

Published

Neuropsychopharmacology
meta Study

Abstract

Plant-based psychedelics, such as psilocybin, have an ancient history of medicinal use. After the first English language report on LSD in 1950, psychedelics enjoyed a short-lived relationship with psychology and psychiatry. Used most notably as aids to psychotherapy for the treatment of mood disorders and alcohol dependence, drugs such as LSD showed initial therapeutic promise before prohibitive legislature in the mid-1960s effectively ended all major psychedelic research programs. Since the early 1990s, there has been a steady revival of human psychedelic research: last year saw reports on the first modern brain imaging study with LSD and three separate clinical trials of psilocybin for depressive symptoms. In this circumspective piece, RLC-H and GMG share their opinions on the promises and pitfalls of renewed psychedelic research, with a focus on the development of psilocybin as a treatment for depression.

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Research Summary of 'The therapeutic potential of psychedelic drugs: past, present, and future'

Introduction

Psychedelic compounds such as psilocybin and LSD have a long history of medicinal and ritual use, and they were widely investigated by psychiatrists and psychologists from the 1950s until prohibitive legislation in the mid-1960s halted much formal research. After a roughly 25-year hiatus, human research into psychedelics resumed in the early 1990s and has since produced neuroimaging, psychopharmacology, and early-phase clinical studies. These contemporary reports include small trials of psilocybin and LSD for conditions such as obsessive–compulsive disorder, addiction, end-of-life distress, and major depressive disorder, together with modern brain-imaging work. This paper is a circumspective commentary in which Carhart-Harris and Goodwin set out contrasting but convergent perspectives on the therapeutic potential of psychedelics, with particular attention to developing psilocybin as a treatment for depression. Carhart-Harris offers a cautiously optimistic account emphasising potential advantages over conventional antidepressants, while Goodwin provides a more sceptical appraisal focused on patient selection, trial design, and evidential limitations. The authors jointly discuss the current evidence base, mechanisms of action, methodological challenges, and recommendations for future clinical development.

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