About this Research Topic

Background

The history of biological psychiatry and psychedelic substances has been intertwined since the distribution of LSD for medical research purposes in the 1950s. The discovery of the clinically relevant serotonergic system in our brains owes a lot to this mysterious and highly potent semi-synthetic molecule. However, people interested in understanding the human mind, from traditional shamans to philosophers and psychologists, have been drawn to the insights gleaned from altered states of consciousness long before the advent of modern medicine.

Despite the prohibition of the 1970s, traditional healing and underground therapy with psychedelic medicines continued. The arduous rekindling of clinical research into these substances, in the mid-1990s, opened the door to a new exploration of the therapeutic value of psychedelic medicines using modern scientific methods. Various Phase 2 randomized-controlled trials with psilocybin are showing promising results for clinical depression and MDMA therapy is taking the lead with recruitment for Phase 3 clinical trials for the treatment of PTSD.

With the development of services providing medicinal cannabis for difficult-to-treat conditions, ketamine treatment centers for clinical depression and psilocybin retreats, such as ‘Synthesis’ in the Netherlands, our Research Topic will focus on how we might incorporate psychedelic- and MDMA-assisted psychotherapy into established healthcare systems. We aim to present up-to-date evidence supporting the efficacy of these treatments, discussion of their psychotherapeutic and neurological mechanisms, and elucidate potential challenges/limitations in their use outside research settings. Our topic will contribute to discussion around ensuring equitable access to these therapies, diversity in research/clinical settings and safety/ethical considerations when developing future services. We also welcome contributions covering economic assessment of the psychedelic therapy model.

Can the evidence convince skeptical mental health professionals that the ‘Psychedelic Renaissance’ isn’t all hype and wishful thinking? Will the trials satisfy the European Medicines Agency (EMA) and the Food and Drug Administration (FDA)? Will there be sufficient evidence of cost-effectiveness to ensure National Institute of Clinical Excellence (NICE) approval in the UK? Where is this field heading? If supported by robust evidence, what could the future look like on this new frontier in mental healthcare?

This Research Topic will bring together a selection of Original Research, Review, Hypothesis and Theory, Perspective, and Opinion articles. We would like to invite papers that focus on the future of psychedelic therapy and its practical implementation.

We encourage the submission of papers on the following themes:

1. The biological mechanisms of action of traditional psychedelics (eg. LSD, psilocybin, DMT), MDMA, ketamine, ibogaine and other novel substances with purported medicinal value (eg. 2C-B, mescaline, DPT, muscimol);
2. Bridging the gap between biological mechanisms and subjective cognitive/psychological processes related to therapeutic effect;
3. The principles of psychedelic psychotherapy and similarities/differences with current psychological/psychiatric approaches;
4. The efficacy of these treatments for various types of mental health conditions, including the rationale for a pan-diagnostic approach;
5. The safety and ethical considerations associated with best practice in this emerging field of therapy;
6. Ensuring equity of access and diversity in psychedelic therapy and research;
7. Economic and/or cultural assessments around the introduction of these therapies to mainstream healthcare systems;
8. Assessment of the investment landscape and pharmaceutical/biotech involvement in developing psychedelic medicine;
9. Horizon scanning for future developments in the field;
10. Reasoned critiques of the psychedelic therapy approach.

The Topics Editors would like to thank the participant from the first Psilocybin study for Treatment-Resistant Depression (2016) who submitted the cover image for us to use. He called it 'The Golden Frame and the Psychedelic Brain’ and wrote:

Colour is often missing from the life of someone living with depression
Psilocybin brings back that colour
The Golden frame is the safety of the Room, Therapist, Drug and Music
The four sides of the frame

Keywords: Psychedelic, Healthcare, Safety, Economic, Psychotherapy

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