The Safety and Efficacy of Psychedelic-Assisted Therapies for Older Adults: Knowns and Unknowns.

Oct 2, 2022The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry

Safety and Benefits of Psychedelic Therapies for Older Adults: What We Know and Don’t Know

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Abstract

Psychedelics like psilocybin and MDMA may offer therapeutic benefits for older adults with various psychological conditions.

Psychedelics have shown efficacy for treating mood disorders and psychological distress in older adults.
Both psilocybin and MDMA act on the 5HT receptor, which is involved in mood regulation.
Psychedelics can be safely administered to healthy adults in controlled settings.
Increased blood pressure and heart rate from psilocybin and MDMA may pose risks for older adults with cardiovascular disease.
Limited clinical trials have included older adults or those with serious health conditions, raising questions about the applicability of findings.
Further research is needed to assess safety and efficacy of psychedelics in older adults, especially those with multiple health issues.

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Psychedelics and related compounds have shown efficacy for the treatment of a variety of conditions that are prevalent among older adults, including mood disorders, the psychological distress associated with a serious medical illness, post-traumatic stress disorder (PTSD), and prolonged grief disorder. Psychedelics also have properties that could help provide therapeutic benefits for patients with dementing disorders, as well as promoting personal growth among healthy older adults. This article focuses on psilocybin, a classic psychedelic, and MDMA, a substituted amphetamine with properties similar to classic psychedelics. Both act on the 5HTreceptor. Psychedelics can be safely administered to healthy adults in controlled conditions. However, both psilocybin and MDMA can increase blood pressure and heart rate, which could be a concern if used in older adults with cardiovascular disease. Very few older adults or patients with serious comorbidities have been included in clinical trials of psychedelics to date, raising the question of how generalizable study results are for the patients that most geropsychiatrists will be treating. Research on the neurophysiologic and mechanistic effects of psychedelics in older adults could also provide insights into the aging brain that could have clinical applications in the future. Given the potential of psychedelic compounds to benefit older adults, more research is needed to establish safety and efficacy among older adults, particularly those with multi-morbidity. 2A

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The Safety and Efficacy of Psychedelic-Assisted Therapies for Older Adults: Knowns and Unknowns.

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