Anesthesiology
October 1, 2023
Akash Goel, Yeshith Rai, Shayan Sivadas et al.
29 citations
Chronic pain affects about 1.5 billion people worldwide. Current treatments like opioids and non-opioid drugs can cause side effects, addiction, or fail to relieve pain. Psychedelics such as LSD and psilocybin may alter pain perception through serotonin receptor activation, anti-inflammatory effects, and synaptic remodeling. This scoping review identified 21 human studies on psychedelics for pain. Few clinical trials exist, and sample sizes are small, limiting clinical use. Overall, psychedelics show promise for analgesia in certain headache disorders and cancer pain. Future research should examine combining psychotherapy with psychedelics for chronic pain.
JAMA Psychiatry
April 15, 2026
Diana Orsini, Sabrina Wong, Sara Di Luch et al.
4 citations
In randomized clinical trials of psychedelic drugs for psychiatric disorders, the drugs' strong subjective effects often reveal which treatment participants or raters think they received, a phenomenon called functional unblinding. A systematic review of 112 trials found that only 29.5% assessed whether blinding was maintained, yet 57.1% cited blinding as a limitation. Blinding failure exceeded 90% in psilocybin, LSD, and ayahuasca studies and 85% in MDMA trials with inert placebos. Ketamine trials rarely assessed blinding but fared better when midazolam was used as an active comparator. No control strategy consistently preserved ideal blinding, raising concerns about the validity of efficacy estimates.
Canadian Journal of Pain
November 8, 2024
Jiwon Lee, Kaylyssa Philip, Hance Clarke et al.
3 citations
A proposed clinical trial design for psilocybin as a treatment for neuropathic pain, called the PEACE-PAIN trial, is supported by patient survey responses but could be improved by adding detailed discussions of the existing evidence on efficacy, safety, tolerability, and management of adverse effects. The finding that individuals with prior psychedelic use are interested in participating has important implications for the trial's inclusion and exclusion criteria.
JMIR research protocols
April 17, 2024
Akash Goel, Bhavya Kapoor, Hillary Chan et al.
2 citations
Chronic pain affects about 8 million Canadians (20%) and costs the healthcare system over US $60 billion yearly. This paper describes the planned protocol for a pilot randomized controlled trial testing three treatments: intravenous ketamine alone, cognitive behavioral therapy with mindfulness meditation (CBT/MM), or a combination of both. The primary goal is to assess feasibility—recruitment, consent, withdrawal, adherence, missing data, and adverse events—in 30 participants over 20 weeks. Secondary outcomes include changes in pain intensity and pain interference at week 20. Recruitment had not started as of November 2023; the study is expected to complete by December 2025. Results will inform a larger trial.
Journal of Pain Research
June 1, 2022
Sandra J Drozdz, Akash Goel, Matthew W Mcgarr et al.
2 citations
Ketamine-assisted psychotherapy (KAP) can, in specific circumstances, initiate and prolong clinically significant reductions in pain, anxiety, and depressive symptoms, while encouraging rapport and treatment engagement, and promoting abstinence in patients addicted to other substances. A systematic review of seventeen articles including 603 participants found that combining ketamine with psychotherapy, provided before, during, and after ketamine sessions, can maximize and prolong benefits despite much variance in how KAP is applied. Additional large-scale randomized controlled trials are warranted to understand better the mutually influential relationships between psychotherapy and ketamine in optimizing responsiveness and sustaining long-term benefits in patients with chronic pain.
Canadian Journal of Pain
March 4, 2026
Nandana D. Parakh, Danielle Lessor, Kevin Dang et al.
All participants reported decreased pain with ketamine infusions, though pain experiences varied. To improve ketamine's benefit for chronic neuropathic pain, it is important to address stigma, research ways to extend the duration of its effects, and provide a safe treatment environment. Understanding barriers and facilitators, along with implementing participant suggestions, can inform ketamine programs, improve access to pain management, and guide future research.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
September 1, 2025
Mindy Lu, Victoria Tucci, Nandana Parakh et al.
Most patients with chronic pain at a Toronto pain clinic were willing to join a clinical trial testing MDMA-assisted therapy for pain relief. Among 42 patients surveyed, 76% expressed willingness to participate in the EASE-Pain trial, which compares MDMA with an active placebo. White/European participants were more likely to be willing than nonwilling. The main motivators were pain relief (62%) and seeking alternatives to ineffective treatments (26%). Common concerns included side effects (43%), impacts on comorbidities (19%), and stigma associated with MDMA (19%). The findings suggest that protocol modifications, such as better patient education on drug effects, may improve trial enrollment and acceptability.