Psychedelics as psychiatric medicines: Current challenges and future prospects

Abstract

Abstract This is an exciting time for psychedelics and related drugs, with a renewed scientific interest in their potential benefits for a range of mental health disorders and addictions. However, much is yet to be discovered about this group of drugs, including precisely how they work in the brain; how their biological effects interact with psychological support to effect therapeutic change; how long their benefits endure; and how safe they are in the longer term. The nature of the psychedelic experience, its necessity in obtaining therapeutic benefit, and how the psychological component can be safely delivered are outstanding issues. There are also questions to be answered regarding how these drugs can be integrated into mainstream service delivery, how they will be made available and funded, and what training will be required of therapists. Finally, gold-standard trial designs, addressing thorny issues such as blinding and placebo response, as well as expectancy bias, need to be agreed and adopted, as we explore efficacy and safety across a growing range of mental health and addictive disorders.