Psychedelic Research for Alcohol Use Disorder with Comorbid Major Depressive Disorder: An Unmet Need.

A narrative review of psilocybin- and LSD-assisted treatment for alcohol use disorder (AUD) and major depressive disorder (MDD) finds growing evidence that psilocybin produces a sustained reduction in drinking frequency among people with AUD, and a recent meta-analysis shows psilocybin therapy yields a large and consistent decrease in depressive symptoms compared to no treatment. AUD and MDD frequently co-occur, and this comorbidity worsens symptoms of both disorders and complicates treatment. The authors argue that an integrated therapy addressing both conditions simultaneously could benefit such patients and call for more research on psilocybin in this dual-diagnosis population.

Study at a glance

Abstract

In this narrative review, we discuss evidence for psilocybin- and LSD-assisted treatment of alcohol use disorder (AUD) and major depressive disorder (MDD). We describe limitations of psychedelic research and posit methodological considerations when designing a trial in patients with both disorders. In AUD, a growing evidence base for psilocybin treatment shows a promising beneficial and sustained effect on measures of drinking frequency. In MDD, a recent meta-analysis has demonstrated that psilocybin therapy provides a large and consistent reduction in depressive symptoms compared to no treatment. Co-occurrence of MDD and AUD is quite prevalent, and this comorbidity exacerbates symptomatology of the two individual disorders and complicates their treatment. Theoretically, patients presenting with both AUD and MDD would benefit from an integrated therapy that could treat MDD and AUD simultaneously. We believe that more research into the efficacy of psilocybin in patients with both AUD and MDD is warranted and justified.