The Safety and Efficacy of Psychedelic-Assisted Therapies for Older Adults: Knowns and Unknowns.
C Bree Johnston, Maria Mangini, Charles Grob, Brian Anderson
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry January 1, 2023 DOI: 10.1016/j.jagp.2022.08.007 via PubMed
Summary
AI-generated from the abstractPsychedelics such as psilocybin and MDMA show promise for treating mood disorders, PTSD, prolonged grief, and psychological distress from serious illness in older adults, and may aid dementia patients or promote personal growth in healthy seniors. Both compounds act on the 5HT2A receptor and can be safely given to healthy adults under controlled conditions, but they raise blood pressure and heart rate, posing risks for older adults with cardiovascular disease. Few older adults or those with multiple health conditions have been included in clinical trials, limiting generalizability. More research is needed on safety and efficacy in this population.
Study at a glance
| Characteristics | Review Peer reviewed |
|---|---|
| Topics | Psilocybin |
| Keywords | 3,4-Methylenedioxymethamphetamine MDMA Pharmacology Psychedelics hallucinogens Entheogens |
| Citations | 33 |
| Key finding | Psychedelics like psilocybin and MDMA have therapeutic potential for conditions common in older adults, but safety concerns and lack of trial inclusion for this age group necessitate further research. |
Abstract
Psychedelics and related compounds have shown efficacy for the treatment of a variety of conditions that are prevalent among older adults, including mood disorders, the psychological distress associated with a serious medical illness, post-traumatic stress disorder (PTSD), and prolonged grief disorder. Psychedelics also have properties that could help provide therapeutic benefits for patients with dementing disorders, as well as promoting personal growth among healthy older adults. This article focuses on psilocybin, a classic psychedelic, and MDMA, a substituted amphetamine with properties similar to classic psychedelics. Both act on the 5HT2A receptor. Psychedelics can be safely administered to healthy adults in controlled conditions. However, both psilocybin and MDMA can increase blood pressure and heart rate, which could be a concern if used in older adults with cardiovascular disease. Very few older adults or patients with serious comorbidities have been included in clinical trials of psychedelics to date, raising the question of how generalizable study results are for the patients that most geropsychiatrists will be treating. Research on the neurophysiologic and mechanistic effects of psychedelics in older adults could also provide insights into the aging brain that could have clinical applications in the future. Given the potential of psychedelic compounds to benefit older adults, more research is needed to establish safety and efficacy among older adults, particularly those with multi-morbidity.