Psychedelics are once again in focus, this time through both science and politics. Recently, Donald Trump signed an executive order to accelerate research and potential use in psychiatry. But what does the evidence actually say?
What we know
In recent years, several studies have shown strong effects, in the right context:
- MDMA for PTSD: Phase 3 trials show that a substantial proportion of patients no longer meet the criteria for PTSD after treatment in a controlled setting (e.g. Mitchell et al., Nature Medicine, 2021).
- Psilocybin for depression: Studies show rapid and sometimes lasting improvements, even in treatment-resistant depression (e.g. Carhart-Harris et al., NEJM, 2022).
- Addiction (alcohol, smoking): Early studies indicate reduced consumption in some groups.
- Existential anxiety (e.g. in cancer): Improved quality of life and reduced anxiety in smaller studies.
What these findings have in common:
- The effects are seen in structured, therapeutic settings
- The substances are used as part of a treatment, not as traditional medication
What we do not know
At the same time, important questions remain:
- Long-term effects in broader populations
- Reproducibility outside controlled studies
- Risks of misuse
- How these treatments can be implemented safely in healthcare
We are still early in the clinical application.
The bigger picture
This reflects a broader development in medicine: from continuous symptom relief to interventions that potentially affect the course of disease more fundamentally. In psychiatry, where treatment outcomes have historically been limited, this is particularly interesting.
We at Executive Health currently have no clinical experience of our own with these treatments and therefore cannot comment on their use in clinical practice.
The research is interesting and moving fast. At the same time, the same principle applies here as in all of medicine: promising study results need to be followed by safe, reproducible and scalable clinical implementation.
