Psychedelics as a Therapeutic Opportunity or Threat: A Narrative Review.
Cureus December 1, 2025 Paweł Liszka, Agata Ogórek, Klaudia M Olejnik-Chlewicka et al.
Classic psychedelics and MDMA are being revisited as potential psychiatric treatments. They work primarily by stimulating 5-HT2A receptors, inducing neuroplastic changes, and modifying functional brain networks, which may help shift entrenched cognitive and emotional patterns. Randomized trials with psilocybin show rapid and sustained reduction of depressive symptoms in treatment-resistant depression and cancer patients, as well as promise for alcohol use disorders. MDMA combined with psychotherapy shows substantial potential for PTSD. Caution is needed due to risks of adverse reactions and drug interactions, especially with serotonergic agents and MAOIs. Further multicenter studies with greater statistical power and longer follow-up are required before routine clinical use.