Psychedelics for the Treatment of Obsessive–Compulsive Disorder: Efficacy and Proposed Mechanisms

Psychedelics are being investigated as treatments for several mental health conditions, including obsessive–compulsive disorder (OCD). Since the 1960s, case studies have reported improvements in obsessive and compulsive behaviors after recreational psychedelic use. A small 2006 open-label trial found that psilocybin significantly reduced OCD symptoms, and rodent models show reduced compulsive behaviors after psilocybin. However, the mechanisms remain unclear, with hypotheses involving acute pharmacological effects, neuroplasticity changes, and altered resting state neural networks. This review evaluates evidence for psychedelics in OCD treatment, discusses mechanisms, and notes ongoing trials addressing current knowledge gaps.

Study at a glance

Abstract

Abstract Psychedelics are emerging as potential treatments for a range of mental health conditions, including anxiety and depression, treatment-resistant depression, and substance use disorders. Recent studies have also suggested that the psychedelic psilocybin may be able to treat obsessive–compulsive disorder (OCD). Since the 1960s, case studies have reported improvements to obsessive and compulsive behaviors in patients taking psychedelics recreationally. The effects of psilocybin were then systematically assessed in a small, open-label trial in 2006, which found that psilocybin significantly reduced the symptoms of OCD. Reduced compulsive behaviors have also been seen in rodent models of OCD after administration of psilocybin. Nonetheless, the mechanisms underlying the effects of psychedelics for OCD are unclear, with hypotheses including their acute pharmacological effects, changes in neuroplasticity and resting state neural networks, and their psychological effects. This review will evaluate the evidence supporting the theory that psychedelics can be used for the treatment of OCD, as well as the data regarding claims about their mechanisms. It will also discuss issues with the current evidence and the ongoing trials of psilocybin that aim to address these knowledge gaps.