Psych News Alert: Special AJP Issue Focuses on Challenges, Opportunities Around Psychedelics

This month’s issue of The American Journal of Psychiatry is entirely focused on the burgeoning field of psychedelic medicine in psychiatry, delving into the ongoing challenges and looming questions within the field.

“This marks a moment of legitimacy for what was once considered a fringe, fledgling movement driven solely by a select group of zealously dedicated scientists and clinicians,” AJP Editor in Chief Ned Kalin, M.D., wrote in an editor’s note co-authored with guest editors Gregory A. Fonzo, Ph.D., and Charles B. Nemeroff, M.D., Ph.D. Fonzo and Nemeroff are co-directors of the Center for Psychedelic Research and Therapy at Dell Medical School at the University of Texas at Austin.

The issue addresses some of the fundamental questions related to the use of psychedelics, such as the substances’ basic pharmacology, their effects on neural circuits, their clinical efficacy, and public health policy considerations. It also explores pressing questions such as whether patients can experience the therapeutic benefits of psychedelics without reaching an altered state of consciousness, and how the drugs interact with the psychological support/therapy component of treatment.

Additional topics explored in the issue include:

• Methodological considerations: A review by Roger S. McIntyre, M.D., and colleagues addresses general methodological considerations for psychedelic clinical trials and offers recommendations. The paper is intended to provide guidance for future research and development of psychedelic treatment in psychiatry.
• Original research into psilocybin: Scott T. Aaronson, M.D., and colleagues publish the findings of a small open-label trial, in which they demonstrated significant safety and efficacy of a single dose of synthetic psilocybin in patients with severe treatment-resistant depression.
• Review of the evidence around short-acting psychedelics: Johannes G. Ramaekers, Ph.D., and colleagues review the evidence for ultra-fast, short-acting psychedelics such as dimethyltryptamine (DMT) and 5-methoxy-dimethyltryptamine (5-MeO-DMT), which potentially offer benefits including individualized dosing regimens to maximize treatment outcome with less complex and less costly implementation.
• Potential risks: Sharmin Ghaznavi, M.D., Ph.D., and colleagues review the known and potential harms of psychedelic treatments, which include enduring perceptual disturbances; overuse, misuse, and dependence; challenging experiences or “bad trips”; and acute and cumulative cardiovascular effects. They also make recommendations for further research and monitoring.

“Sufficiently addressing and answering these scientific and clinical questions will be critical for the future clinical success of these agents,” Fonzo, Nemeroff, and Kalin wrote. “The potential for therapeutic strategies utilizing psychedelic drugs is exciting and yet there is a long path ahead toward clinical success.”

For additional information, see the Psychiatric News article “AJP Brings Scientific Rigor to the Study of Psychedelic Medicine.”

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