International review of neurobiology
January 1, 2025
Stephan Tap, Tijmen Bostoen, Joost Breeksema et al.
4 citations
Patients with life-threatening disease often experience end-of-life distress—physical, psychological, emotional, and spiritual suffering linked to chronic illness and the prospect of death. Palliative care aims to improve quality of life, but current psychological and pharmacological interventions show inconclusive evidence with only short- to moderate effects and often require months to work. Over the past decade, psychedelic-assisted therapy has been investigated for addressing end-of-life distress, producing highly significant and sometimes sustained decreases in depression and death anxiety, along with improvements in meaning, spiritual well-being, optimism, life satisfaction, and attitudes toward disease. This chapter describes end-of-life distress, its prevalence, limitations of palliative interventions, the evidence for psychedelic-assisted therapy, why it may work for these patients, and future directions.
International review of neurobiology
January 1, 2025
Tijmen Bostoen, Stephan Tap, Joost Breeksema et al.
1 citation
MDMA-assisted therapy shows substantial and sustained reductions in PTSD symptoms, especially for patients resistant to conventional treatments. Over the past two decades, it has emerged as one of the most promising psychedelic treatments, with the FDA designating it a 'breakthrough therapy' in 2017. However, due to methodological concerns such as unblinding and potential expectancy effects, the FDA decided in 2024 not to approve it for clinical use, requiring additional research. The chapter examines psychological and neurobiological mechanisms of action, methodological challenges, and future directions for psychedelic-assisted therapies for PTSD.
February 20, 2024
Joost Breeksema
Patients with treatment-resistant depression who received ketamine or psilocybin often had intense, overwhelming experiences that could cause temporary anxiety. Those who felt unprepared or unsupported struggled to surrender to the experience, increasing discomfort. Trust in therapists, realistic expectations, and emotional support made surrender easier and reduced anxiety. Ketamine produced effects like openness, detachment from negative thoughts, and mystical experiences. Recommendations include offering multiple psilocybin sessions, longer-term therapeutic support, and better staff training to improve patient comfort and possibly treatment outcomes.