Serotonergic hallucinogen-assisted psychotherapy may prove safe and effective for treating substance use disorders in controlled trials, offering a novel treatment paradigm. These substances differ from other drugs of abuse by not producing dependence syndromes, with effects on the nucleus accumbens and dopamine ranging from inhibition to slight activation without causing addiction. Risks include adverse psychological events, manageable through careful screening, and low potential for misuse. Their ability to treat addictive, psychiatric, and existential disorders represents a potential paradigmatic shift in psychiatry.
Interest in using psychedelics to treat treatment-resistant depression is growing, but evidence for classic psychedelics like psilocybin, LSD, and ayahuasca/DMT remains limited, though early results are promising. Atypical psychedelics such as ketamine have also been studied. Researchers caution that the field may be experiencing a hype bubble. Future work should identify the essential components of psychedelic therapies and their neurobiological mechanisms to support clinical adoption.
Acceptance and commitment therapy (ACT), a third-wave cognitive-behavioral therapy emphasizing acceptance, mindfulness, and values-based actions, has been successfully applied to support recovery from psychosis across multiple contexts. This article outlines how to adapt ACT for individuals experiencing psychosis, offering practical clinical tips for practitioners. It also reviews research literature supporting ACT's efficacy for psychosis and discusses next steps in research and clinical innovations.