A recent paper from Portland Psychotherapy researchers summarizes the results of the strongest research studies examining psychedelic-assisted therapy – placebo-controlled randomized clinical trials, the same kinds of studies that have been used to test COVID vaccines. Placebo-controlled randomized clinical trials are the “gold standard” for testing interventions – such as psychedelic-assisted psychotherapy – where participants are randomly assigned into one of two groups, either the experimental intervention group, or the placebo group. These studies utilized one of the following psychedelic agents; MDMA, LSD, psilocybin, or ayahuasca- in conjunction with psychotherapy. Among the clinical trials analyzed, four different treatment-resistant conditions were treated:
- 4 studies for PTSD
- 3 for anxiety related to life-threatening disease
- 1 for major depressive disorder
- 1 for social anxiety among autistic adults
What was the treatment?
Each of the 9 placebo-controlled trials had comparable study designs. They all had pre-dosing psychotherapy sessions, where participants discussed expectations and intentions for the dosing sessions and built rapport with their therapist team who would remain with them throughout the journey of the study’s sessions. Studies ranged from 1-3 dosing sessions that occurred over the course of a few days or weeks, where participants were either given a placebo or the psychedelic substance. While experiencing the dosing therapeutic session, study participants were with two therapists in an environment that was created for comfort and visually appealing. After the dosing sessions, therapists in all 9 studies met with participants to help them integrate what they had learned into their lives and sustain changes.
Psychedelics Had Large Effects Compared to Placebo
The findings of the metanalysis supported the efficacy of the 9 trials, showing that 80% of randomly selected patients would have more successful outcomes in psychedelic-assisted therapy compared to the placebo. With psychedelic-assisted therapy, the participants only received the psychopharmacological agent 1-3 times and had a high percentage of success, compared to established medication treatments where individuals are prescribed medication(s) to take daily. Additionally, the effect size of the 9 trials, when considered together was very large. The effect of the psychedelics was larger than other more established treatments, such as talk therapy or standard drug treatment with antidepressants, which had small to moderate effect sizes, compared to psychedelic-assisted therapy’s large effect sizes. Furthermore, for the subset of studies that had follow up data, effects appeared to be enduring, lasting for at least several months. This is encouraging as it suggests long-lasting effects of psychedelic therapy, working beyond the acute biological effects of the substance.
Psychedelic-assisted therapy is gaining momentum in the US and Europe, but is still very early in its process, and there is much more to learn. Science is beginning to push policy and change culture surrounding psychedelics, as this novel therapeutic approach continues to move forward, more research is needed on all aspects of the process to better understand how to support patients, and increase accessibility of these treatments. These early results are very encouraging, but more research is also needed.
If you are interested in supported psychedelic assisted psychotherapy research, please consider supporting our clinical trial of MDMA-assisted therapy for Social Anxiety Disorder. More information at our study website.
Authors: Jason Luoma, Angelica Spata, True Overlie
Author: Jason Luoma, Ph.D.
Jason is a psychologist and scientist who studies ways to help people with shame, stigma, and social anxiety, including using psychedelic and MDMA-assisted therapy
