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Home / Current Opinion in Psychiatry, Volume 35, Number 1

Psychedelic medicines for mood disorders: current evidence and clinical considerations

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Purpose of review

Despite advances in treatment modalities for mood disorders over recent decades, further therapeutic options are still required. Increased research is occurring, with the pursuit of psychedelic-based pharmacotherapies for a range of mood disorders and other conditions.

Recent findings

Serotonergic psychedelics have been found to modulate brain networks underlying various psychiatric disorders, as well promoting neurogenesis and neuroplasticity. Randomized placebo-controlled trials have found psilocybin with psychological support effective at treating depression, including treatment-resistant depression; with emergent research also signalling N,N-dimethyltryptamine/ayahuasca also as a potential option for the treatment of depression. Lysergic acid diethylamide has been found to have anxiolytic effects, whereas 3,4-methylenedioxymethamphetamine (MDMA) has been used effectively to treat post-traumatic stress disorder (PTSD), with Phase III clinical trial evidence. Microdosing of psychedelics is a growing phenomenon that has shown benefits in some preclinical data; however, a recent self-directed controlled trial reported no evidence of improved mood.Summary

Current research with medicinal psychedelics, usually as an adjunct to psychotherapy, has shown encouraging results in treating mood disorders. However, there are challenges regarding blinding and sample sizes remain small, and there have been no definitive Phase III studies (aside from MDMA for PTSD). Further work exploring novel formulations, interface with pharmacogenomics and the microbiome, and inflammatory pathways can be advised.

Keywords: 3,4-methylenedioxymethamphetamine; ayahuasca; lysergic acid diethylamide; psilocybin; psychedelic-assisted psychotherapy

Document Type: Research Article

Affiliations: 1: Psychae Institute, Melbourne, Victoria, NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Florey Institute of Neuroscience and Mental Health, Parkville, The Melbourne Clinic Professorial Unit, Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia 2: Psychae Institute, Melbourne, Victoria 3: NICM Health Research Institute, Western Sydney University, Westmead, New South Wales, Laboratory of Hormone Measurement, Department of Physiology and Behavior, Postgraduate Program in Psychobiology and Department of Physiology and Behavior, Federal University of Rio Grande do Norte, Natal, Brazil 4: Psychae Institute, Melbourne, Victoria, University of Melbourne, Centre for Mental Health, Swinburne University of Technology, Melbourne, Victoria, Australia

Publication date: January 1, 2022

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