Older adults in psychedelic-assisted therapy trials: A systematic review
Journal of Psychopharmacology – January 01, 2024
Source: OpenAlex
Summary
Psychedelic-assisted psychotherapy appears safe and well-tolerated for older adults, with no serious adverse events among the 10 participants for whom detailed safety data was available. This systematic review, using MEDLINE and other sources for Psychedelics and Drug Studies, analyzed 36 trials involving 1400 patients. Yet, only 19 (less than 1.4%) were aged 65 or older. While initial findings suggest these substances, often from chemical synthesis and alkaloids, modulating neurotransmitter receptors for behavioral influence, are safe, their potential in geriatric Psychology and Medicine warrants further exploration by psychotherapists.
Abstract
Background: Growing clinical interest in psychedelic-assisted therapies has led to a second wave of research involving psilocybin, lysergic acid diethylamide (LSD), 3,4-methylenedioxymethamphetamine (MDMA) and other substances. Data suggests that these compounds have the potential to treat mental health conditions that are especially prevalent in older adults such as depression, anxiety, existential distress, and posttraumatic stress disorder. Aims: The goal of this study was to quantify the prevalence of older adults enrolled in psychedelic clinical trials and explore safety data in this population. Methods: A systematic review was conducted following the 2020 PRISMA guidelines. Search criteria included all trials published in English using psychedelic substances to treat psychiatric conditions, including addiction as well as existential distress related to serious illness. Articles were identified from literature searches on PubMed, EBSCO, and EMBASE. Results: 4376 manuscripts were identified, of which 505 qualified for further review, with 36 eventually meeting eligibility criteria. Of the 1400 patients enrolled in the 36 studies, only 19 were identified as 65 or older, representing less than 1.4% of all trial participants. For 10 of these 19 older adults, detailed safety data was obtained. No serious adverse events (AEs) occurred in any older adults and only transient mild-to-moderate AEs related to anxiety, gastrointestinal upset, and hypertension were reported during the psychedelic dosing sessions. Conclusions: While existing data in older adults is limited, it suggests that psychedelic-assisted psychotherapy can be safe and well tolerated in older adults. Therefore, psychedelic-assisted psychotherapy should be more rigorously investigated for the treatment of psychiatric conditions in this population.