Psychedelics for treating psychiatric disorders: Are they safe?

Psychedelics, including psilocybin, LSD, DMT/ayahuasca, MDMA, and ketamine, are being investigated as treatments for depression, PTSD, and substance use disorders, often within psychedelic-assisted psychotherapy. Although generally well-tolerated, these substances have been linked to various adverse effects. The article reviews the safety profiles of both classical and nonclassical psychedelics, noting that ketamine is already used for depression and FDA approval is anticipated for other psychedelics.

Study at a glance

Abstract

SAM FALCONERP sychedelics are a class of substances known to produce alterations in consciousness and perception.In the last 2 decades, psychedelic research has garnered increasing attention from scientists, therapists, entrepreneurs, and the public.While many of these compounds remain illegal in the United States and in many parts of the world (Box, 1 page 16), a recent resurrection of psychedelic research has motivated the FDA to designate multiple psychedelic compounds as "breakthrough therapies," thereby expediting the investigation, development, and review of psychedelic treatments.There is growing evidence that psychedelics may be efficacious for treating a range of psychiatric disorders.Potential clinical indications for psychedelics include some forms of depression, posttraumatic stress disorder (PTSD), and substance use disorders (Table 1, 2,3 page 17).In most instances, the clinical use of psychedelics is being investigated and offered in the context of psychedelic-assisted psychotherapy, though ketamine is a prominent exception.Ketamine and esketamine are already being used to treat depression, and FDA approval is anticipated for other psychedelics.An examination of the safety considerations of psychedelics for the treatment of psychiatric disorders is therefore highly relevant and timely.This article examines the adverse effect profile of classical (psilocybin ["mushrooms"], lysergic acid diethylamide [LSD], and N,N-dimethyltryptamine [DMT]/ayahuasca) and nonclassical (the entactogen 3,4-methylenedioxymethamphetamine [MDMA, known as "ecstasy"] and the dissociative anesthetic ketamine) psychedelics.Psychedelics for treating psychiatric disorders: Are they safe?Though generally well-tolerated, these agents have been associated with a range of adverse effects