The Resurgence of Psychedelic Psychiatry: An Exciting Yet Cautious Advance
- A. Papp MD & Julie Myers, PsyD, MSCP
- Jul 7, 2024
- 3 min read
Updated: 4 days ago
Read about the potential of psychedelics like MDMA and ketamine in treating psychiatric conditions, the advancements in research, and our commitment to safety in exploring these powerful therapies.
Introduction
Psychedelic psychiatry and psychedelic-assisted therapy are experiencing a remarkable revival in the field of psychiatry and psychology. Several jurisdictions have decriminalized magic mushrooms, and institutions, emboldened by the success of organizations like MAPS (the Multidisciplinary Association for Psychedelic Studies), have launched dedicated psychedelic research programs. Furthermore, MDMA—commonly known as ecstasy—may at some point in the future may receive FDA approval for treating PTSD.
Over the past five to six years, psychedelic psychiatry has moved from fringe research to
mainstream clinical investigation, with large trials studying compounds such as psilocybin, MDMA, and lysergic acid diethylamide (LSD) for depression, PTSD, anxiety, and substance use disorders. Several of these therapies have received Breakthrough Therapy designation from the U.S. Food and Drug Administration, accelerating clinical development.
At the Point Loma Clinic, we are part of this innovative movement, offering treatments with ketamine—a nonclassical psychedelic—either as a standalone therapy or in conjunction with psychotherapy.
Emphasizing Safety in Psychedelic Therapies
While these advances are promising, it is crucial to maintain a vigilant approach regarding the safety and potential adverse effects of these powerful substances.
Classical psychedelics like psilocybin, LSD, DMT/ayahuasca, and mescaline can induce profound altered states of consciousness. These experiences often include ego-dissolution, a sense of timelessness, and synesthesia. The therapeutic index for psilocybin and LSD is notably broad, which means that the range between an effective dose and a potentially harmful dose is large. There are documented instances where individuals inadvertently ingested massive doses of pure LSD—with no serious long-term consequences. However, even at normal doses, users may experience anxiety, confusion, headaches, nausea, and increases in blood pressure and heart rate. Amid these developments, stories about individuals microdosing psychedelics find that the widely claimed benefits of microdosing remain unproven.
Though rare, these substances can also precipitate suicidality, violence, convulsions, panic attacks, paranoia, mania, and prolonged dissociation, particularly in individuals with preexisting psychiatric conditions.
Fortunately, physical dependence is uncommon with these psychedelics, and habitual use is rare.
MDMA: Benefits and Risks
MDMA, distinct from classical psychedelics, primarily enhances feelings of well-being and increases emotional closeness with others. However, it is a more toxic compound, frequently causing anxiety, headaches, and muscle tension. Elevated blood pressure, heart rate, and body temperature are common adverse effects, and severe outcomes like intracerebral hemorrhage, acute liver damage, heart failure, heatstroke, and suicide have been linked to acute or frequent use. MDMA also presents a moderate risk of abuse, with chronic use potentially leading to insomnia, depression, anxiety, and cognitive impairments.
Conclusion: A Balanced Perspective
These details might seem daunting, but it is essential to recognize that these agents are
generally well-tolerated, and the incidence of serious adverse effects remains low. As we continue to explore the therapeutic potentials of psychedelics, ensuring patient safety and conducting thorough assessments will remain paramount at the Point Loma Clinic.
Patients in San Diego who are interested in exploring ketamine treatment are encouraged to schedule a consultation with our clinical team to determine whether these approaches are appropriate for their individual needs.
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