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World J Psychiatry. May 19, 2023; 13(5): 182-190
Published online May 19, 2023. doi: 10.5498/wjp.v13.i5.182
Therapeutic role of psilocybin and 3,4-methylenedioxymethamphetamine in trauma: A literature review
Lakshan N Fonseka, Benjamin KP Woo
Lakshan N Fonseka, Harvard South Shore-Psychiatry Residency Program, Veteran Affairs Boston Healthcare System, Brockton, MA 02301, United States
Benjamin KP Woo, Chinese American Health Promotion Laboratory, University of California, Los Angeles, Los Angeles, CA 90095, United States
Benjamin KP Woo, Department of Psychiatry and Biobehavioral Sciences, Olive View - University of California, Los Angeles Medical Center, Sylmar, CA 91342, United States
Benjamin KP Woo, Asian American Studies Center, University of California, Los Angeles, Los Angeles, CA 90095, United States
Benjamin KP Woo, Podiatric Medicine and Surgery, Western University of Health Sciences, Pomona, CA 91766, United States
Author contributions: Fonseka LN and Woo BKP both performed the collection of data and contributed to the manuscript drafting; All authors have read and approve the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Benjamin KP Woo, MD, Professor, Chinese American Health Promotion Laboratory, University of California, Los Angeles, 3230 Campbell Hall, Los Angeles, CA 90095, United States. bkpwoo@ucla.edu
Received: January 19, 2023
Peer-review started: January 19, 2023
First decision: February 20, 2023
Revised: February 28, 2023
Accepted: April 13, 2023
Article in press: April 13, 2023
Published online: May 19, 2023
Processing time: 119 Days and 18.9 Hours
Abstract

With the Food and Drug Administration designation in 2017 of 3,4-methylenedioxymethamphetamine (MDMA) as a breakthrough therapy in post-traumatic stress disorder and psilocybin in treatment-resistant depression, psychedelic drugs have continued to garner the attention of researchers and clinicians for their promise of unmatched, rapid improvement in a multitude of psychiatric conditions. Classic psychedelic drugs including psilocybin, lysergic acid diethylamide, and ayahuasca, as well as non-classic drugs such as MDMA and ketamine, are currently being investigated for a potential therapeutic role in trauma, depressive disorders, and other psychopathologies. However, psilocybin and MDMA each have a functional profile well-suited for integration with psychotherapy. The present review focuses on psilocybin and MDMA in psychedelic-assisted therapy (PAT), as these studies compose most of the literature pool. In this review, we discuss the current and future uses of psychedelic drugs, with an emphasis on the role of MDMA and psilocybin in PAT in the setting of trauma and related comorbidities on the efficacy of psychedelic drugs across multiple psychiatric disorders. The article concludes with thoughts for future research, such as incorporating wearables and standardization of symptom scales, therapy styles, and assessment of adverse drug reactions.

Keywords: Psychedelics; Trauma; Depression; Methylenedioxymethamphetamine; Ecstasy; Psilocybin

Core Tip: Psychedelic-assisted therapy with psilocybin or 3,4-methylenedioxymethamphetamine (MDMA) is strongly supportive across psychiatric conditions, especially trauma and related comorbidities, as demonstrated through a pattern of rapid and sustained symptom relief. Both treatments seem to have benefits beyond the Food and Drug Administration breakthrough designations of treatment-resistant depression for psilocybin and post-traumatic stress disorder for MDMA.