The Future of Psychedelic Therapy Treatments
Psychedelic therapy is getting some serious attention from the media, the public, academic institutions, investors, and the psychedelic community at large —and for good reason! Many studies being released, and that already exist, continue to point towards the power and potential of these experiences to facilitate important healing experiences for clients.
There are a few specific conditions, such as treatment-resistant depression (TRD), anxiety, and PTSD, that psychedelic therapy is currently an FDA-approved treatment for. However, these are not the only conditions that psychedelic therapy may be able to provide help with, these are just the only conditions that are currently FDA-approved for treatment using psychedelics.
What other conditions can psychedelic therapy help to address? There are many, and this article will explore some potential future treatments that psychedelic therapy may have a part to play in.
Current Conditions Treated by Psychedelic Therapy
Let’s start at the beginning —what conditions is psychedelic therapy already approved for and already treating people for?
To clarify, this is for treatments that are available to the public in the United States, or to specifically designated groups of individuals (such as army veterans or cancer patients). There are many more treatments for specific conditions being studied and that have great promise, but have not yet been approved by regulators and health authorities.
Ketamine treatment can currently be prescribed to individuals off-label to help address depressive disorders like major depression disorder (MDD) and bipolar depression and depression’s associated symptoms.
An individual can now ask for a recommendation to a ketamine clinic from their healthcare practitioner, or reach out directly to a clinic or ketamine provider to check their eligibility for treatment and begin the program.
Similarly, ketamine treatment is available for off-label use in individuals with anxiety disorders or acute anxiety and its symptoms. You can begin a conversation with your care team, or reach out directly to a clinician or clinic to begin the process of enrolling in a ketamine treatment program.
This is listed separately from depression as it’s a notable case in and of itself. We’ve written about psychedelic therapy’s potential to help with treatment-resistant depression before.
What’s notable here is that by definition, treatment-resistant means that other therapeutic interventions haven’t been successful. Psychedelic therapy presents an option to those who currently do not have any, and this is worth recognizing.
Currently, there is an FDA-approved medication for TRD, Spravato, which is an esketamine intranasal spray, and is the ONLY FDA approved psychedelic therapy for mental health at this time. Additionally it is approved for major depressive disorder (MDD) WITH suicidal ideation.
There are currently significant studies underway for MDMA therapy to treat PTSD and complex-PTSD sponsored by MAPS (Multidisciplinary Association for Psychedelic Studies).
The results have been promising, and it has received Breakthrough Therapy designation from the FDA. While this treatment isn’t available to military veterans through the U.S. Department of Veterans Affairs (VA), some MAPS studies are focusing on veterans specifically.
Currently moving through Stage 3 trials, as long as outcomes data and safety profile remain consistent, it is likely that MDMA-assisted therapy will become an approved treatment in the next few years.
At the time of this writing, ketamine for major depression, treatment-resistant depression, and anxiety are the only available treatments for the public given a clinical intake process, diagnosis, and approval.
However, there are a number of additional studies and reviews, at various stages of the approval process, currently underway, with promising results. With continued study and investment in the regulatory process, far more psychedelic therapy treatments may be available in the coming years.
Actively Studied Conditions for Potentially Psychedelic Therapy Treatment
There are 3 major FDA-approval phases, appropriately titled Phase 1, Phase 2, and Phase 3, that a new treatment and compound must move through before being approved and scheduled as an available medical treatment.
There are a number of conditions and use-cases that psychedelic medicine and psychedelic therapy protocols are currently being studied for. Some have a history of scientific research done dating back several decades, while others are emerging or are demonstrating potential as a treatment option.
The psychedelic experience often brings an individual to confront topics such as meaning, engagement in life, purpose, and passion. These explorations, paired with neurobiological effects that assist with treating and managing depression, making psychedelic therapy a promising candidate for addressing suicidality and suicidal ideation.
Although active suicidal ideation or a history of attempts is a contraindication for many studies or existing psychedelic therapy programs, with refined protocols, appropriate dosing, and ongoing support, psychedelic therapy may prove to be an asset in helping individuals to deal with suicidal ideation.
Obsessive-Compulsive Disorder (OCD) is another field that psychedelic therapy is currently being studied. OCD patterns are often driven by rigid behavioral patterns and high levels of control, something psychedelic therapy helps individuals to confront directly.
There have been some studies in this area, and it is a field that certainly warrants future study and research within. OCD can be quite challenging or debilitating for individuals, and treating OCD and its symptoms through traditional psychotherapeutic or pharmacological methods can be hit or miss. Psychedelic therapy may present a new option for the treatment of OCD.
End-of-Life Anxiety / Depression
End-of-life anxiety or depression in terminally ill patients has been one of the longest studied potential use-cases for psychedelic therapy, particularly with psilocybin as the active compound used.
There are many studies with promising results available to support this thesis. However, this is not yet a fully approved management treatment option for these individuals in the United States. However, Canada is making strides in studies and treatment using this modality, approving psilocybin use for four end-of-life patients in 2020.
Given the results of previous trials, and the great service that this experience can serve for these individuals, moving psychedelic therapy for end-of-life anxiety along the approval and regulatory process seems like a wise decision.
There are fewer studies around the role of psychedelic therapy in smoking cessation, however the initial results have been extremely promising.
Given that the best currently available solution has a success rate of around 17%, and the early trials with psychedelic therapy provided nearly 80% success, the initial results are significant enough to warrant much further study and research. The results will need to be replicated and tested further, but psychedelic therapy may prove to be a powerful asset for those trying to quit smoking or nicotine addictions.
Building on the above, psychedelic therapy seems to be uniquely suited to assist with addictive patterns and substance dependence overall.
Initial studies and results seem to show great potential for helping individuals manage addictive patterns of behavior, navigate or mitigate the tapering or withdrawal period, and stay abstinent afterwards. Substance and alcohol addiction affects many members of society quite drastically, and psychedelic therapy is uniquely suited to help manage this.
All of these potential treatment areas have had at least some research and study put into them, but have not completed the approval and regulatory process required to make them fully available treatments to the public.
Given the initial promise of these early studies, and the benefit and healing they could bring to the affected populations of individuals, it seems like further study is warranted and it would be powerful to start moving these treatments through the regulatory process.
Potential/Speculative Conditions for Psychedelic Therapy Treatment
In previous resources, we have covered the neurobiological and phenomenological benefits and effects of psychedelic therapy treatments. Given their ability to act on the physical, mental, emotional, and at times spiritual levels, psychedelic therapy and psychedelic medicines hold an immense potential to bring healing and wholeness to modern culture.
There are a number of fields where these effects and experiences may be extremely beneficial, in many kinds of individuals. Early study and research into these areas must be done to confirm these hypotheses, but there are several areas where it seems that safe and effective psychedelic therapy programs would be highly effective and greatly healing.
Nearly everyone has experienced trauma in their lifetime, and each person responds to these traumas differently.
Psychedelic therapy presents a powerful option to assist in the psychotherapeutic healing of trauma. It helps to reconcile the past, help you manage and understand your emotions, and help create a bold vision of a positive future for yourself.
The field of psychedelic-assisted psychotherapy, where traditional therapeutic techniques are used in conjunction with psychedelic medicines, has great potential to create a whole and healed society. Exploring the use of medicines like ketamine, MDMA, psilocybin, and perhaps other compounds may bring great benefits to future generations.
Personality & Mood Disorders
Personality or mood disorders, such as bipolar disorder, dissociative identity disorder (multiple personality disorder), borderline personality disorder, and others are often a contraindication for many existing programs.
However, it is possible that a psychedelic therapy protocol can be developed that would be uniquely suited to assist this population. With the right Set and Setting, preparation and integration, ongoing support, and effective medicine and dosing protocols, psychedelic medicines may be helpful in the treatment and management of personality disorders.
One of the most exciting potential areas of future application for psychedelic medicines isn’t in the healing space, but in the personal growth and development field.
Most traditional medicines move through this availability arc:
- Available to highly specific populations and situations via controlled clinical trials
- As a publicly available, FDA-approved medicine with a specific application
- General medical availability (like off-label prescription)
Psychedelic therapy has immense potential for healing, but also for personal growth. It can help individuals become more themselves, helps them love more, clears up challenging experiences and emotions, and helps them rise to new levels of satisfaction and engagement with their lives.
This may be down the line, but the study of psychedelic therapy in the “neurotypical” population may hold great promise.
Psychedelic therapy, particularly MDMA-assisted psychotherapy, also has immense potential in the field of couples therapy, family therapy, and relationship-specific counseling, and was actually used in couples therapy prior to the FDA making it a Schedule I substances.
Psychedelic medicines can radically increase empathy, sympathetic joy, open-mindedness, and assist in reconciling the past and previous emotions Because of this, there is immense potential for psychedelic therapy to assist in interpersonal relationships. It can bring families closer together, facilitate a deeper love with each other in couples, and create a more compassionate society, which can have major ripple effects for the quality of life of everyone in that culture. It warrants at least initial research and study, to kick things off.
There are many more areas that may hold great potential when combined with psychedelic therapy programs and protocols. While we are still at the stage of making these treatments available for those in need of deep healing, it is always beautiful to look towards what the future may hold as general awareness and medical acceptance of psychedelic therapy continues to grow.
Psychedelic therapy is still in its nascent stages, where the medical and clinical worlds are working to align themselves with the emerging scientific data around the safety and efficacy of these programs.
Across many areas, from end-of-life anxiety, to substance use disorders, to treatment-resistant depression, psychedelic medicines are demonstrating their power and potential as safe and effective treatments for a variety of mental health conditions.
Moving through the approval and regulatory process is an expensive and time-consuming process, but when the potential for healing and wholeness on the other side is this great, it’s worth the investment. It’s an investment in people's lives, in their quality of life, and in the stewardship of a healthy society.
As more scientific data arises, as the awareness and acceptance continues to grow, it is likely we will see many more use-cases and treatment options available and approved. Then we can continue to look into the far future, at the role psychedelic therapy can play in moving everyone towards the healing and wholeness that is their human right.
This article is for informational purposes only and is not intended to be a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. If you are in a life-threatening situation, call the National Suicide Prevention Line at +1 (800) 273-8255, call 911, or go to the nearest emergency room.
Ketamine is not FDA-approved for the treatment of depression or anxiety. Learn more about off-label uses here.
Side effects of ketamine treatment may include: altered sense of time, anxiety, blurred vision, diminished ability to see/hear/feel, dry mouth, elevated blood pressure or heart rate, elevated intraocular or intracranial pressure, excitability, loss of appetite, mental confusion, nausea/vomiting, nystagmus (rapid eye movements), restlessness, slurred speech, synesthesia (a mingling of the senses).
Do not proceed with ketamine treatment if any of the following apply to you:
- Allergic to ketamine
- Symptoms of psychosis or mania
- Uncontrolled high blood pressure
- CHF or other serious heart problem
- Severe breathing problem
- History of elevated intraocular or intracranial pressure
- History of hyperthyroidism
- Other serious medical illness
- Pregnant, nursing, or trying to become pregnant
Ketamine has been reported to produce issues including, but not limited to, those listed below. However, lasting adverse side-effects are rare when medical protocols are carefully followed.
While ketamine has not been shown to be physically addictive, it has been shown to cause moderate psychological dependency in some recreational users.
- In rare cases, frequent, heavy users have reported increased frequency of urination, urinary incontinence, pain urinating, passing blood in the urine, or reduced bladder size
- Ketamine may worsen problems in people with schizophrenia, severe personality disorders, or other serious mental disorders.
- Users with a personal or family history of psychosis should be cautious using any psychoactive substance, including ketamine, and discuss potential risks with your MindBloom® clinician before proceeding with treatment.
- The dissociative effects of ketamine may increase patient vulnerability and the risk of accidents.
To promote positive outcomes and ensure safety, follow these ketamine treatment guidelines:
- Do not operate a vehicle (e.g., car, motorcycle, bicycle) or heavy machinery following treatment until you’ve had a full night of sleep
- Refrain from taking benzodiazepines or stimulants for 24 hours prior to treatment
- Continue to take antihypertensive medication as prescribed
- Avoid hangovers or alcohol intake
- Refrain from consuming solid foods within 3 hours prior to treatment and liquids within 1 hour prior to treatment
- Ketamine treatment should never be conducted without a monitor present to ensure your safety