The Psychedelic Future of Post-Traumatic Stress Disorder Treatment

Abstract

Post-traumatic stress disorder (PTSD) is a mental health condition that can occur following exposure to a traumatic experience. An estimated 12 million U.S. adults are presently affected by this disorder. Current treatments include psychological therapies (e.g., exposure-based interventions) and pharmacological treatments (e.g., selective serotonin reuptake inhibitors (SSRIs)). However, a significant proportion of patients receiving standard-of-care therapies for PTSD remain symptomatic, and new approaches for this and other trauma-related mental health conditions are greatly needed. Psychedelic compounds that alter cognition, perception, and mood are currently being examined for their efficacy in treating PTSD despite their current status as Drug Enforcement Administration (DEA)- scheduled substances. Initial clinical trials have demonstrated the potential value of psychedelicassisted therapy to treat PTSD and other psychiatric disorders. In this comprehensive review, we summarize the state of the science of PTSD clinical care, including current treatments and their shortcomings. We review clinical studies of psychedelic interventions to treat PTSD, trauma-related disorders, and common comorbidities. The classic psychedelics psilocybin, lysergic acid diethylamide (LSD), and N,N-dimethyltryptamine (DMT) and DMT-containing ayahuasca, as well as the entactogen 3,4-methylenedioxymethamphetamine (MDMA) and the dissociative anesthetic ketamine, are reviewed. For each drug, we present the history of use, psychological and somatic effects, pharmacology, and safety profile. The rationale and proposed mechanisms for use in treating PTSD and traumarelated disorders are discussed. This review concludes with an in-depth consideration of future directions for the psychiatric applications of psychedelics to maximize therapeutic benefit and minimize risk in individuals and communities impacted by trauma-related conditions.

Thematic Selection: Stress and Stress-related Disorders Posttraumatic Stress Disorder (Part 2)

“…The first paper by Burback et al comes from Professor Vermetten’s research group in Leiden NL, and offers a very large, state-of-the-art comprehensive review on pharmacological, psychotherapeutic, behavioral and technology-related treatment of PTSD, which also initially provides an expert overview on symptomology, diagnostic issues, neurobiology and risk factors of PTSD and includes almost 1,000 references [ 22 ]. The second seminal paper by Zaretsky et al comes from Professor Yehuda’s research group at Mount Sinai in New York, USA, and offers a state-of-the-art comprehensive review on the data supporting the current and future use of psychedelics in the treatment of PTSD while also presenting history of use, pharmacology and safety profile of all reviewed substances and includes almost 900 references [ 23 ].…”