Psychedelic medicines for end-of-life care: Pipeline clinical trial review 2022
Palliative & Supportive Care – June 19, 2023
Source: OpenAlex
Summary
Upcoming clinical trials are exploring psychedelics as a promising new frontier in psychiatry for end-of-life anxiety. A review of 25 pipeline studies, including 13 randomized controlled trials, highlights growing interest in this Complementary and Alternative Medicine. Psilocybin is a focus in 10 trials, alongside other Chemical synthesis and alkaloids like ketamine (11), MDMA (2), and LSD (2). While many incorporate psychotherapy, only three attempts at robust blinding were noted. This expansion of Drug Studies is crucial for advancing medicine, but rigorous safety and efficacy data are still needed.
Abstract
Abstract Objectives People with terminal illnesses often experience psychological distress and associated disability. Recent clinical trial evidence has stimulated interest in the therapeutic use of psychedelics at end of life. Much uncertainty remains, however, mainly due to methodological difficulties that beset existing trials. We conducted a scoping review of pipeline clinical trials of psychedelic treatment for depression, anxiety, and existential distress at end of life. Methods Proposed, registered, and ongoing trials were identified from 2 electronic databases (ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform). Recent reviews and both commercial and non-profit organization websites were used to identify additional unregistered trials. Results In total, 25 studies were eligible, including 13 randomized controlled trials and 12 open-label trials. Three trials made attempts beyond randomization to assess expectancy and blinding effectiveness. Investigational drugs included ketamine ( n = 11), psilocybin ( n = 10), 3,4-methylenedioxymethamphetamine ( n = 2), and lysergic acid diethylamide ( n = 2). Three trials involved microdosing, and fifteen trials incorporated psychotherapy. Significance of results A variety of onging or upcoming clinical trials are expected to usefully extend evidence regarding psychedelic-assisted group therapy and microdosing in the end-of-life setting. Still needed are head-to-head comparisons of different psychedelics to identify those best suited to specific indications and clinical populations. More extensive and rigorous studies are also necessary to better control expectancy, confirm therapeutic findings and establish safety data to guide the clinical application of these novel therapies.