Narrative review of the potential for psychedelics to treat Prolonged Grief Disorder

Prolonged Grief Disorder (PGD) affects up to 10% of bereaved people, causing functional impairment and intense yearning for at least a year after loss. Current treatments are mainly psychological, and more options are needed. Psychedelics like psilocybin and MDMA may help because they reduce depression and PTSD symptoms in clinical trials and produce subjective effects relevant to existential distress in PGD. No randomized clinical trials have yet tested psychedelics for PGD, but initial survey and open-label studies suggest a consistent trend toward grief reduction. A randomized clinical trial is the appropriate next step to explore this potential.

Study at a glance

Abstract

Prolonged Grief Disorder (PGD) is distinct from yet related to non-pathologic grief, depression, addiction, and Post-Traumatic Stress Disorder (PTSD) with a prevalence of up to 10% in bereaved populations. Hallmarks of PGD include functional impairment a year or more post-bereavement and intense yearning for the deceased. Current treatments for PGD are typically psychological rather than psychopharmacological, and more treatment options are needed. Psychedelics such as psilocybin and MDMA may be a promising treatment avenue for PGD. Randomized clinical trials demonstrated the efficacy of psilocybin in reducing symptom severity in depression and MDMA in reducing PTSD symptomatology. Furthermore, psychedelics often produce subjective effects (such as transcendence, mystical experiences, and a sense of oneness) that may be uniquely relevant to the existential distress experienced in PGD. No randomized clinical trials have thus far been conducted on the safety and efficacy of psychedelics for PGD. Initial research, including survey-based studies and an open-label trial, has begun to shed light on the possible benefits of psychedelics in the alleviation of grief. While the evidence from these studies is preliminary, it suggests a consistent trend towards the effectiveness of psychedelics in grief reduction. Conducting a randomized clinical trial would be an appropriate next step to explore the potential efficacy of using psychedelics to treat PGD.