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Therapeutic interventions for PTSD – current evidence on the the role of psychedelics

Published online by Cambridge University Press:  13 August 2021

I. Figueiredo ,
F. Viegas ,
F. Ferreira ,
A. Santos ,
J. Ramos  and
J. Miranda
I. Figueiredo*
Affiliation:
Mental Health Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
F. Viegas
Affiliation:
Mental Health Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
F. Ferreira
Affiliation:
Psychiatry, Hospital Professor Doutor Fernando Fonseca, Lisboa (Amadora), Portugal
A. Santos
Affiliation:
Mental Health Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
J. Ramos
Affiliation:
Mental Health Department, Hospital Professor Doutor Fernando Fonseca, Amadora, Portugal
J. Miranda
Affiliation:
Serviço Psiquiatria E Saúde Mental, Centro Hospitalar de Leiria, Amarante, Portugal
*
*Corresponding author.

Abstract

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Introduction

Post-traumatic stress disorder (PTSD) is often a chronic condition, despite the existence of evidence-based treatment options. Psychotherapy is the designated first line treatment for PTSD, although high rates of psychiatric and medical comorbidity are observed among patients who have undergone treatment. The psychoactive properties of psychedelics may be of particular interest within a substance-assisted psychotherapy approach, offering new treatment opportunities for this debilitating disorder.

Objectives

Review current evidence, therapeutic context, and possible mechanisms of action of different types of psychedelics in the treatment of PTSD.

Methods

Literature review using Medline database.

Results

3,4-methylenedioxymethamphetamine (MDMA)-assisted psychotherapy appears to be a potentially safe, effective, and durable treatment for individuals with treatment-refractory PTSD. Based on a small number of studies, ketamine administration appears to result in temporary symptom relief and may, in combination with psychotherapy, lead to lasting reductions in PTSD symptoms. Although these have not yet been investigated in controlled studies, it is known that psilocybin and LSD induce psychoactive effects that could as well contribute to the psychotherapeutic treatment of PTSD.

Conclusions

The use of psychedelic compounds within a substance-assisted psychotherapy framework offers a novel method for pharmacotherapy-psychotherapy integration, although there is still much to learn from both a clinical and neurobiological perspective. It is necessary to generate more data regarding the safety and efficacy of psychedelics, in addition to research on cost-effectiveness, its use in mental health care infrastructure and also regarding the training of specialized therapists.

Keywords

psychedelicsMDMAKetaminePosttraumatic Stress Disorder
Type
Abstract
Information
European Psychiatry , Volume 64 , Special Issue S1: Abstracts of the 29th European Congress of Psychiatry , April 2021 , pp. S452 - S453
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2021. Published by Cambridge University Press on behalf of the European Psychiatric Association
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