Narrative review of the potential for psychedelics to treat Prolonged Grief Disorder
International Review of Psychiatry – May 23, 2024
Source: OpenAlex
Summary
Up to 10% of bereaved individuals suffer Prolonged Grief Disorder, a severe form of complicated grief. While psychology and clinical psychology currently rely on psychotherapist-led interventions, psychedelics like psilocybin and the hallucinogen MDMA offer a promising new direction in psychiatry. Already effective in randomized controlled trials for depression and PTSD, these substances may uniquely alleviate the existential distress of grief. Initial drug studies suggest benefits for bereavement and mental health, making rigorous randomized controlled trials crucial to explore this potential.
Abstract
Prolonged Grief Disorder (PGD) is distinct from yet related to non-pathologic grief, depression, addiction, and Post-Traumatic Stress Disorder (PTSD) with a prevalence of up to 10% in bereaved populations. Hallmarks of PGD include functional impairment a year or more post-bereavement and intense yearning for the deceased. Current treatments for PGD are typically psychological rather than psychopharmacological, and more treatment options are needed. Psychedelics such as psilocybin and MDMA may be a promising treatment avenue for PGD. Randomized clinical trials demonstrated the efficacy of psilocybin in reducing symptom severity in depression and MDMA in reducing PTSD symptomatology. Furthermore, psychedelics often produce subjective effects (such as transcendence, mystical experiences, and a sense of oneness) that may be uniquely relevant to the existential distress experienced in PGD. No randomized clinical trials have thus far been conducted on the safety and efficacy of psychedelics for PGD. Initial research, including survey-based studies and an open-label trial, has begun to shed light on the possible benefits of psychedelics in the alleviation of grief. While the evidence from these studies is preliminary, it suggests a consistent trend towards the effectiveness of psychedelics in grief reduction. Conducting a randomized clinical trial would be an appropriate next step to explore the potential efficacy of using psychedelics to treat PGD.