title: Psychedelics in the treatment of unipolar mood disorders: a systematic review.
abstract: Unipolar mood disorders, including major depressive disorder and persistent depressive disorder (dysthymia), confer high rates of disability and mortality and a very high socioeconomic burden. Current treatment is suboptimal in most cases and there is little of note in the pharmaceutical development pipeline. The psychedelic drugs, including lysergic acid diethylamide and psilocybin, were used extensively in the treatment of mood disorders, and other psychiatric conditions, before their prohibition in the late 1960s. They are relatively safe when used in medically controlled environments, with no reported risk of dependence. Here, we present a systematic review of published clinical treatment studies using psychedelics in patients with broadly defined UMD, and consider their place in psychiatry. Whilst all of the included studies have methodological shortcomings, of 423 individuals in 19 studies, 335 (79.2%) showed clinician-judged improvement after treatment with psychedelics. A recently completed pilot study in the UK favours the use of psilocybin with psychological support in treatment resistant depressive disorder. The evidence overall strongly suggests that psychedelics should be re-examined in modern clinical trials for their use in unipolar mood disorders and other non-psychotic mental health conditions.
authors.affiliation: The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK james.rucker@kcl.ac.uk.|South West London and St George's Mental Health NHS Trust, London, UK.
authors.forename: James Jh
authors.initials: JJ
authors.lastname: Rucker
authors.affiliation: The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Luke A
authors.initials: LA
authors.lastname: Jelen
authors.affiliation: King's College London School of Medicine, London, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Flynn
authors.affiliation: King's College London School of Medicine, London, UK.
authors.forename: Kyle D
authors.initials: KD
authors.lastname: Frowde
authors.affiliation: The Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.|South London and Maudsley NHS Foundation Trust, London, UK.
authors.forename: Allan H
authors.initials: AH
authors.lastname: Young
mesh_terms: D061218:Depressive Disorder, Treatment-Resistant / Q000188:drug therapy; D006213:Hallucinogens / Q000627:therapeutic use*; D006801:Humans; D008238:Lysergic Acid Diethylamide / Q000627:therapeutic use; D019964:Mood Disorders / Q000188:drug therapy*; D010865:Pilot Projects; D011562:Psilocybin / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D006213:Hallucinogens; D011562:Psilocybin; D008238:Lysergic Acid Diethylamide
keywords: Depression; LSD; dysthymia; psilocybin; psychedelics