SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice
December 1, 2025
Dario Jalilzadeh Masah, Derin Marbin, Tomislav Majić
1 citation
Symptoms of depersonalization and derealization are common during the acute effects of classic psychedelics and can persist, leading to depersonalization-derealization disorder (DDD) with distress and help-seeking behavior. Three cases of DDD after use of LSD, psilocybin, and 5-methoxy-dimethyltryptamine are presented, all treated at an outpatient clinic for post-psychedelic complications. Symptoms emerged shortly after exposure and lasted months. Psychotherapeutic interventions were helpful, while initial misdiagnoses delayed treatment in some cases. Psychotherapy should be prioritized for psychedelic-related DDD, with pharmacological treatment as a second-line option. Exploring the acute drug experience may validate patients and strengthen the therapeutic relationship, while revealing psychodynamic factors underlying individual pathologies.
SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice
December 1, 2025
Alexander Wopfner, Thilo Beck, Louise Penzenstadler
The Swiss Society for Addiction Medicine (SSAM) advocates for evidence-based, patient-oriented treatment of addiction disorders. Given recent scientific findings and international developments, SSAM evaluates psychedelic-assisted psychotherapy (PAT) with classic psychedelics such as LSD or psilocybin and the atypical psychedelic ketamine as a therapy option for addiction disorders when guideline-based treatments do not provide sufficient stability. SSAM also supports an open, evidence-based debate on the legalization and appropriate regulation of classic and atypical psychedelics, including LSD, psilocybin, and the most widely used non-medical entactogen MDMA, in Switzerland. This includes both therapeutic applications and use outside a medical context to promote harm reduction and enable access to safe, quality-controlled substances.
SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice
December 1, 2025
Alexander Wopfner, Leila M. Soravia
In Switzerland, psilocybin can be used therapeutically under exceptional licenses. A clinic developed a standardized program for psilocybin-assisted group psychotherapy for addiction disorders, based on evidence and ethics. The quarterly program includes diagnostics, several individual and group preparation sessions, one psilocybin group session, and integrative follow-ups. Comprehensive quality assurance, strict selection criteria, specifically trained staff, and thorough preparation enhance safety. The group setting fosters resources such as belonging, acceptance, and compassion, and enables problem-actualizing and clarifying experiences. Over twelve cycles, 89 treatments were conducted with 36 patients without serious complications. The method shows potential for treatment-refractory addiction disorders but requires high therapeutic competence and institutional resources.
SUCHT - Zeitschrift für Wissenschaft und Praxis / Journal of Addiction Research and Practice
December 1, 2025
Johannes Klaus, Fritz Schneider, Rena Schaletzky et al.
An umbrella review of 13 systematic reviews and meta-analyses examined the efficacy of classic and non-classic psychedelics (LSD, psilocybin, ayahuasca, mescaline, and ibogaine) for treating substance use disorders, including alcohol, tobacco, opioid, and cannabis use disorders. Only two reviews performed meta-analyses; the rest provided narrative syntheses. Twelve reviews were rated critically low in methodological quality, and one was rated low. While some reviews reported promising effects, particularly for alcohol use disorder, others concluded the evidence remains inconclusive or inconsistent. Overlap of primary studies across reviews was slight. The overall evidence base is limited by methodological weaknesses and inconclusive results.