Psychedelic Medicines in Psychiatry

In this video, Lori Davis, MD, from the University of Alabama at Birmingham describes psychedelics in psychiatry. She says research on psychedelics for mental health conditions has been ongoing since the early 1940s, and that the past decade has brought resurgent interest, including large clinical trials, neuroimaging studies, and preclinical and translational research.

She contrasts psychedelics with standard monoamine agents, antidepressants, and anxiolytics, which she says have to be taken daily, have a delayed onset of action, and often have incomplete and unsatisfactory response and remission rates. She also describes a different dosing model for psychedelics, one day clinically supervised treatment with at least twelve weeks of response, and says these medicines appear to be faster acting, with some response within a day or two after treatment.

Davis then outlines pharmacologic and neurobiologic concepts, stating that psychedelics initially activate or partially activate the 5-HT2 receptor and have downstream effects that include releasing serotonin and other excitatory neurotransmitters, increasing neuroplasticity, and affecting brain networks such as the default mode network. She closes by noting that about one-third of patients do not respond or remit under current treatment plans, that psychedelic medicines used in clinically supervised settings can have some effects, and that these compounds remain investigational, are not yet FDA approved, and can only be administered in clinically supervised research settings.