Psychedelics for treatment resistant depression: are they game changers?

Expert Opin Pharmacother. 2023 Nov 10. doi: 10.1080/14656566.2023.2281582. Online ahead of print.ABSTRACTINTRODUCTION: A new era of treatment for adults with treatment-resistant depression (TRD), which involves psychedelic substances, is dawning. Emerging evidence indicates that psychedelics can exert antidepressant effects through multiple neurobiological and psychological mechanisms. However, it remains to be seen if these new treatments will revolutionize the treatment of TRD.AREAS COVERED: The present review focuses on the efficacy of classic serotoninergic psychedelics psilocybin, lysergic acid diethylamide (LSD), 5-Methoxy-N,N-dimethyltryptamine (DMT), ayahuasca and mescaline (3,4,5-trimethoxyacetonitrile), as well as 3,4-methylenedioxymethamphetamine (MDMA), for TRD. A systematic search was conducted for psilocybin in TRD as emerging trials had not yet been subject to review. A narrative review summarized findings on other psychedelics.EXPERT OPINION: Psychedelic therapy has created a paradigm shift in the treatment of TRD, as it can maximize therapeutic benefits and minimize potential risks. Psilocybin holds promise as a potential game-changer in the treatment of TRD, with initial evidence suggesting a rapid antidepressant effect sustained for some responders for at least 3 months. Nevertheless, further adequately powered, double-blind, comparator-controlled trials are required to explore and clarify the mechanisms of action and long-term effects of psychedelics in TR...
Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Authors: Source Type: research