QOTD: What’s Your Hot Take on Psychedelics?

Psychedelics such as psilocybin and ketamine are one of the hottest topics in psychiatry right now, so Psychiatric News Medical Correspondent Mena Mirhom, M.D., asked attendees: What’s your hot take on this rapidly evolving topic?

“We need more research,” said Olufemi Popoola, M.D., a psychiatrist in Brooklyn, New York. “People need to be more aware of what it is and how effective and useful it can be for psychiatric care.”

Diya Perna, M.D., and Wesley Roach, D.O., specifically researched just how useful psychedelics can be for psychiatric care. The psychiatry residents from the University of Florida College of Medicine were presenting a poster that delved into the potential applications of psychedelics beyond posttraumatic stress disorder (PTSD) and depression.

“We are looking at emerging indications for psychedelics,” Perna told Mirhom. “There are some early, promising signs that it really should be studied more.”

Perna and Roach conducted a literature review and found that psychedelics have a reasonable safety profile in controlled settings with appropriate screening and psychotherapeutic support. They may also reduce symptom burden and enhance emotional processing. The preliminary findings suggested improved outcomes for patients with a variety of disorders, including substance use disorders, eating disorders, and cancer-related existential distress.

“You can take maybe the same substance, … but it works for all these different disorders,” Roach said. “It’s very promising.”

Mirhom also spoke with psychiatry residents Aditi Sarker, M.D., and Muhammad Yusfu, M.D., from Baptist Hospitals of Southeast Texas, who were presenting a poster on research they did comparing psychedelics with traditional antidepressants. Their systematic review found that ketamine, esketamine, and psilocybin demonstrated a safe, significant, rapid onset of antidepressant effect and short-term remission compared with traditional antidepressants. However, their abstract cautioned “the durability of response remains limited, necessitating ongoing or maintenance strategies.”

“Psychedelic drugs—they are rapid-onset, whereas the antidepressants, they take … four to six weeks,” Sarker said. More research is needed on this topic, Yusuf added. “I think it’s definitely something we can try.”

Many agreed that more evidence is needed about psychedelics before it is used on a wider scale, even while the potential is exciting. “It’s understudied,” said Anuj Vij, D.O., a psychiatry resident at Reading Hospital, “and the therapeutic effects are not fully understood.”

“I just feel like we don’t have enough evidence on it to really make a solid determination on whether we should use it in practice,” added Roger Kuna, D.O., also a psychiatry resident at Reading Hospital.

“It is very much a growing area of interest, so it’ll be interesting to see how it evolves in the next few years,” said Slawomir Piela, a medical student at Drexel University. ■