The renaissance of psychedelics in modern psychiatry: a new breakthrough or the myth of a “magic bullet”?

Interest in psychedelic research has surged, with compounds like psilocybin, MDMA, DMT, and LSD showing rapid therapeutic effects for depression, PTSD, anxiety, and OCD, especially when paired with psychotherapy. However, many studies are methodologically weak, lacking adequate placebo controls and standardized dosing, using small samples, and being influenced by contextual factors. This article critically reviews the evidence, discusses historical context including early Russian work with ketamine by E.M. Krupitsky, and urges Russian psychiatrists to assess the data carefully and develop a balanced approach that accounts for evidence quality and local regulations.

Study at a glance

Abstract

In recent years, there has been a significant surge of interest in psychedelic research. These studies encompass both neuroscience and their potential clinical applications. This phenomenon, often referred to as the "Psychedelic Renaissance", includes studies on compounds such as psilocybin, MDMA, DMT, and LSD used for the treatment of depression, post-traumatic stress disorder, anxiety, and obsessive-compulsive disorders. These substances offer a novel treatment paradigm due to their rapid therapeutic effect and their ability to induce long-term mental state changes, particularly when supported by appropriate psychotherapeutic interventions. At the same time, many studies that praise psychedelics remain methodologically weak, limiting integration of these compounds into medical practice. This article provides a discussion of current perspectives on psychedelics and a critical review of existing scientific evidence. It explores the historical context of psychedelic use, including early research and the psychedelic therapy methodology with ketamine developed in Russia by Professor E.M. Krupitsky. Key challenges are discussed in detail, including the lack of adequate placebo controls and standardized dosing, small sample sizes, and the significant influence of contextual factors that may confound study outcomes. Based on this analysis, the author encourages Russian psychiatrists to critically assess the available data and develop a balanced approach to the use of psychedelics in therapy, considering the quality of the evidence base and the specifics of the Russian regulatory framework.