Clinicians and researchers are increasingly interested in psychedelic-assisted therapy for patients who do not improve with conventional antidepressants. This updated review covers recent developments, including data on lesser-studied compounds like DMT and 5-MeO-DMT, findings from large clinical trials, and evolving regulatory landscapes. In treatment-resistant depression, Ketamine stands out for its fast-acting but often short-lived effects. Psilocybin and Ayahuasca have shown meaningful symptom reduction in both randomized trials and real-world settings. Emerging data on LSD and MDMA-assisted psychotherapy suggest potential in mood disorder treatment.
Psychedelic therapies show promise for conditions like PTSD, depression, and substance use disorders, but their success heavily depends on the facilitator and the setting. The field remains outside mainstream medicine and faces stigma from historical prohibition, despite positive trial results. For addiction medicine, facilitators often lack skills to manage substance abstinence. This review offers a clinical guide for managing opioid withdrawal symptoms after psychedelic use, aiming to provide a safer transition for people with opioid use disorder. Several herbal substances—corydalis, saffron, berberine, and nigella sativa—may help ease opioid withdrawal and contribute to addressing the opioid crisis.