The emerging role of psilocybin and MDMA in the treatment of mental illness

Expert Rev Neurother. 2020 Dec;20(12):1263-1273. doi: 10.1080/14737175.2020.1826931. Epub 2020 Sep 30.

Abstract

Introduction: Mental illness has a chronic course of illness with a number of clinical manifestations. Affected individuals experience significant functional, emotional, cognitive, and/or behavioral impairments. The growing prevalence of mental illness has been associated with significant social and economic costs. Indeed, the economic burden of mental illness is estimated to exceed $1.8 trillion USD over the next 30 years. A significant number of individuals affected by mental illness fail to respond to first-line treatment options. Therefore, there remains an unmet need for rapidly attenuating therapeutic options for mental health disorders with minimal social and economic burden.

Areas covered: The paucity of novel treatment options warrants a renewed investigation of psychedelic-based psychotherapy. Herein, the authors will evaluate the therapeutic potential of traditional psychedelics, psilocybin, and MDMA, in the treatment of mental illness with a narrative review of available literature.

Expert opinion: Psychedelics, such as psilocybin and MDMA, offer an alternative avenue of therapy for many mental health disorders. Available evidence indicates that psychedelics may offer a single-dose, rapid effect model that have robust effects with treatment-resistant mental disorders and a unique advantage as a possible monotherapy for mental illness. Novel clinical trials that evaluate the safety, tolerability, and efficacy in clinically representative populations are warranted.

Keywords: MDMA; anxiety; major depressive disorder; mood disorders; post-traumatic stress disorder; psilocybin; psychiatric disorders.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Hallucinogens / therapeutic use*
  • Humans
  • Mental Disorders / drug therapy*
  • N-Methyl-3,4-methylenedioxyamphetamine / therapeutic use*
  • Psilocybin / therapeutic use*

Substances

  • Hallucinogens
  • Psilocybin
  • N-Methyl-3,4-methylenedioxyamphetamine

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