Psychedelic therapy may hold potential for treating personality disorders by promoting adaptive changes in personality, though rigorous research is lacking. This review first examines research on psychedelics in individuals with personality disorders using the DSM-5-TR categorical model, then applies the dimensional DSM-AMPD framework to explore how psychedelics might affect self-functioning, interpersonal functioning, and pathological personality traits. The authors discuss clinical relevance, safety considerations, gaps, and recommendations for treating these complex populations.
Psilocybin-assisted psychotherapy (PAP) may be safe when given alongside certain serotoninergic antidepressants, and stopping those antidepressants before treatment might not be required. In an adult with difficult-to-treat depression who took duloxetine and vortioxetine, a first PAP session with both drugs produced a partial response. After he discontinued duloxetine but kept vortioxetine, his anxiety and depression worsened. Psilocybin was well tolerated in both sessions; mild headaches were the main adverse effect, with no cardiovascular concerns. This single case suggests that combining psilocybin with serotoninergic antidepressants appears safe and that antidepressant discontinuation prior to PAP may be unnecessary, potentially improving treatment accessibility.