The Emerging Role of Psilocybin and MDMA in the Treatment of Mental Illness

This narrative review (2020) evaluates the therapeutic potential of psilocybin and MDMA for the treatment of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and anxiety. The review explains the need for effective mental health treatments and highlights the lack of dose-response studies in placebo-controlled settings with a real-world clinical population.

Abstract

“Introduction: Mental illness has a chronic course of illness with a number of clinical manifestations. Affected individuals experience significant functional, emotional, cognitive and/or behavioral impairments. The growing prevalence of mental illness has been associated with significant social and economic costs. Indeed, the economic burden of mental illness is estimated to exceed $1.8 trillion USD over the next 30 years. A significant number of individuals affected by mental illness fail to respond to first-line treatment options. Therefore, there remains an unmet need for rapidly attenuating therapeutic options for mental health disorders with minimal social and economic burden.

Areas covered: The paucity of novel treatment options warrants a renewed investigation of psychedelic-based psychotherapy. Herein, the authors will evaluate the therapeutic potential of traditional psychedelics, psilocybin and MDMA, in the treatment of mental illness with a narrative review of available literature.

Expert opinion: Psychedelics, such as psilocybin and MDMA, offer an alternative avenue of therapy for many mental health disorders. Available evidence indicates that psychedelics may offer a single-dose, rapid effect model that have robust effects with treatment-resistant mental disorders and a unique advantage as a possible monotherapy for mental illness. Novel clinical trials that evaluate the safety, tolerability and efficacy in clinically representative populations are warranted.”

Authors: Hartej Gill, Barjot Gill, David Chen-Li, Sabine El-Halabi, Nelson B. Rodrigues, Danielle S. Cha, Orly Lipsitz, Yena Lee, Joshua D. Rosenblat, Amna Majeed, Rodrigo B. Mansur, Flora Nasri, Roger Ho & Roger S. McIntyre

Notes

Roger S. McIntryre is the CEO of Apotheosis Scientific which is developing psilocybin- and MDMA-related treatments for mental illness.

Joshua D. Rosenblat is the medical director of CRTCE, a private clinic providing intravenous ketamine infusions and intranasal esketamine for depression.