Psychedelic therapy in the treatment of addiction: the past, present and future

Rayyan Zafar; Maxim Siegel; Rebecca Harding; Tommaso Barba; Claudio Agnorelli; Shayam Suseelan; Leor Roseman; Matthew Wall; David John Nutt; David Erritzoe

doi:10.3389/fpsyt.2023.1183740

Psychedelic therapy in the treatment of addiction: the past, present and future

Front Psychiatry. 2023 Jun 12:14:1183740. doi: 10.3389/fpsyt.2023.1183740. eCollection 2023.

Authors

Rayyan Zafar^{1

2}, Maxim Siegel^{1

2}, Rebecca Harding³, Tommaso Barba^{1

2}, Claudio Agnorelli^{1

2}, Shayam Suseelan^{1

2}, Leor Roseman^{1

2}, Matthew Wall^{1

2

4}, David John Nutt^{1

2}, David Erritzoe^{1

2}

Affiliations

¹ Centre for Psychedelic Research, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom.
² Neuropsychopharmacology Unit, Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom.
³ Clinical Psychopharmacology Unit, University College London, London, United Kingdom.
⁴ Invicro, London, United Kingdom.

Abstract

Psychedelic therapy has witnessed a resurgence in interest in the last decade from the scientific and medical communities with evidence now building for its safety and efficacy in treating a range of psychiatric disorders including addiction. In this review we will chart the research investigating the role of these interventions in individuals with addiction beginning with an overview of the current socioeconomic impact of addiction, treatment options, and outcomes. We will start by examining historical studies from the first psychedelic research era of the mid-late 1900s, followed by an overview of the available real-world evidence gathered from naturalistic, observational, and survey-based studies. We will then cover modern-day clinical trials of psychedelic therapies in addiction from first-in-human to phase II clinical trials. Finally, we will provide an overview of the different translational human neuropsychopharmacology techniques, including functional magnetic resonance imaging (fMRI) and positron emission tomography (PET), that can be applied to foster a mechanistic understanding of therapeutic mechanisms. A more granular understanding of the treatment effects of psychedelics will facilitate the optimisation of the psychedelic therapy drug development landscape, and ultimately improve patient outcomes.

Keywords: PET; addiction; drug developement; fMRI; neuropsychopharmacology; psychedelic therapy; randomized controlled trial (RCT); real world evidence (RWE).

Publication types

Review