Andrew Penn

Background and Aims: Mental health challenges such as depression, anxiety, and existential distress are common among individuals with terminal illness. Preliminary evidence suggests that death acceptance may protect against these issues, but there is limited research on the role of psychedelic-assisted therapy in fostering death acceptance. This scoping review aims to explore the potential of psychedelic-assisted therapy to promote death acceptance among terminally ill patients. Methods: A scoping review was conducted, examining studies published between 1990 and 2023. The review included studies on psychedelic-assisted therapy for death acceptance and closely related constructs, such as psychological flexibility, existential distress, and demoralization in terminally ill populations. Results: Findings indicate that psychedelic-assisted therapy may lead to significant and lasting reductions in anxiety, depression, and existential distress. These improvements appear to be mediated by enhanced death acceptance. The therapy may also increase psychological flexibility and reduce demoralization, supporting better mental health outcomes for terminally ill individuals. Conclusions: Psychedelic-assisted therapy represents a promising approach to improving quality of life for terminally ill patients by fostering acceptance of their prognosis and mortality. However, further research is needed to confirm these findings. The development of standardized measurement tools and consideration of patient demographics, such as age and spiritual beliefs, are recommended.

Mood dysfunction is highly prevalent in Parkinson’s disease (PD), a main predictor of functional decline, and difficult to treat—novel interventions are critically needed. Psilocybin shows early promise for treating depression and anxiety, but its potential in PD is unknown, as safety concerns have excluded people with neurodegenerative disease from previous trials. In this open-label pilot (NCT04932434), we examined the feasibility of psilocybin therapy among people with mild to moderate stage PD plus depression and/or anxiety. 12 participants (mean age 63.2 ± 8.2 years, 5 women) received psilocybin (one 10 mg followed by one 25 mg dose) with psychotherapy. There were no serious adverse events, no medical interventions required to manage effects of psilocybin, and no exacerbation of psychosis. Ten participants experienced treatment-emergent adverse events; the most frequent were anxiety, nausea, and increased blood pressure. We observed no worsening of PD symptomology measured by the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). On the contrary, non-motor (MDS-UPDRS Part I: –13.8 ± 1.3, p < 0.001, Hedges’ g = 3.0) and motor symptoms (Part II: –7.5 ± 0.9, p < 0.001, g = 1.2; Part III: –4.6 ± 1.3, p = 0.001; g = 0.3) as well as performance in select cognitive domains (Paired Associates Learning [-0.44 ± 0.14, p = .003, g = 0.4], Spatial Working Memory [–0.52 ± 0.17, p = 0.003, g = 0.7], and Probabilistic Reversal Learning [2.9 ± 0.9, p = 0.003, g = 1.3]) improved post-treatment, and improvements were sustained until the final safety assessment one month following drug exposure. Baseline Montgomery-Asberg Depression Rating Scale (MADRS) and Hamilton Anxiety Rating Scale (HAM-A) scores were 21.0 ± 8.7 and 17.0 ± 3.7, respectively. Both improved to a clinically meaningful degree post-treatment; these improvements persisted to the final assessment three months following drug exposure (MADRS: -9.3 ± 2.7, p = .001, g = 1.0; HAM-A: –3.8 ± 1.7; p = 0.031, g = 0.7). This study provides the first data on psilocybin’s effects in any neurodegenerative disease. Results suggest that psilocybin therapy in PD warrants further investigation.

: The reemergence of psychedelic medicines as clinical treatments has generated considerable interest in both professional and popular arenas. Although evidence is promising for psychedelic-assisted therapy (PAT), there is much that is not yet known and needs to be researched so as to understand how to safely and effectively utilize PAT in clinical populations and to most effectively deploy PAT to patients. In addition, non-clinical stakeholders introduce interests and agendas that may differ from those of clinicians. This article reviews the history of how psychedelics were initially outlawed and then introduces research questions that will help to fill these gaps in knowledge.

Background: Rates of cannabis use are increasing in the United States, likely as a result of changes in societal attitudes and expanding legalization. Although many patients report wanting to discuss the risks and benefits of cannabis use with their clinical providers, many providers hold conflicting beliefs regarding cannabis use and often do not engage patients in discussion about cannabis. This dilemma is underscored by the limitations imposed on cannabis related research, and lack of empirically based best-practice guidelines for clinicians when addressing cannabis use with patients. Objectives: We aimed to briefly summarize clinician and patient attitudes toward cannabis use and review current clinical guidelines and provide suggestions to assist health care providers and clinicians in increasing their comfort and skill in discussing cannabis use with patients. Methods: A narrative review on attitudes toward cannabis use and clinical guidelines was performed to summarize the literature and provide evidence-based recommendations. Results: Attitudes toward cannabis use have been shaped by personal and political factors and contribute to clinician hesitance in speaking with patients about the topic. Administrative barriers have hindered the development of clearer public health guidelines that might enable the dissemination of evidence-based information on the health effects of cannabis use and might ultimately lead to better health outcomes. Conclusion: Not discussing cannabis use with patients may be a crucial missed opportunity for harm reduction. In the absence of empirically supported best-practice guidelines, a person-centered approach can facilitate conversations on the harms and benefits of cannabis use.

Mental health problems including depression, anxiety, suicide, and burnout are common among health care providers. Resilience and well-being are factors thought to protect against these incidents. Clinical trials and naturalistic studies of psychedelic compounds have shown decreases in depression, anxiety, and suicidality while suggesting improvements in well-being. This secondary analysis of a large cross-sectional online survey consisting of participants with at least one lifetime psychedelic use sought to examine how use affects health care providers who treat psychiatric disorders with medications. In total, 228 respondents retrospectively completed measures of depression, anxiety, and well-being before and after psychedelic exposure. They also reported lifetime use, harms attributed to use, and preferred psychedelic agent. Psychedelic use was associated with improvements in depression, anxiety, and well-being. Reported suicidality decreased and resilience increased. A factor analysis suggested that a cluster of mystical, interpersonal, and personal items predicted improvement in depression, anxiety, well-being, suicidality, and resilience. Preferred psychedelic agent did not affect outcomes. Frequency of use was not associated with outcomes although differences in effect sizes were seen. Harm reported was consistent with the general population, with 13.2% ( n = 30) reporting at least one harm. Pre-exposure alcohol use, aggressive impulses, and desire to die by suicide improved most often while marijuana use most often worsened or did not change. These results are consistent with clinical trials and naturalistic studies examining psychedelic use in the general population and suggest that health care providers who treat psychiatric disorders with medications may benefit from psychedelic use, although some harm was reported. Given the current mental health crisis among health care providers, further research is warranted to examine whether interventions utilizing psychedelics could improve well-being and effectiveness of health care providers while decreasing adverse mental health outcomes associated with working in health care. ClinicalTrials.gov (ID: NCT04040582).

The research and use of psychedelic medicines to treat common mental health disorders has increased substantially in the past 2 decades. At the same time, knowledge is relatively uncommon among midwives regarding (1) the relative benefits of psychedelic‐assisted therapy, (2) best practices associated with the delivery of psychedelic‐assisted therapy, and (3) responsible integration of this potentially useful intervention into mental health treatment plans. The purpose of this review is to describe current applications of psychedelic medicines to treat common mental health disorders, to describe the current legal status of these medicines used in this context, and to explore the potential for midwifery practice in this area with further training. This article also addresses the disparities regarding LGBTQIA+ and BIPOC populations in relation to this topic and their historical exclusion from research and treatment access in this field.

Psychedelics are a class of psychoactive substances that were studied extensively between 1943 and 1970 as potential therapies for treating a host of mental health disorders, including addiction. Despite promising early results, U.S. psychedelic research was halted in the early 1970s with the enactment of the Controlled Substances Act. As the field of psychedelic-assisted therapy develops, nurses can decide the role they will play in the continuing clinical and scholarly research of these substances, which may soon be used in controlled settings to treat some of the most widespread mental health disorders. To prepare for this task, this article proposes that nurses become familiar with the history, relevant language, and scientific findings related to the field of psychedelic research. learn about existing psychedelic-assisted therapy and research resources. examine their thoughts, judgments, and opinions about therapeutic psychedelic use. consider the potential role of nursing in psychedelic-assisted therapies going forward.

Click on the article title to read more.