Psychedelikaassistierte Psychotherapie

ZUSAMMENFASSUNG

Die Anwendung von Psychedelika in der Psychotherapie wirft erhebliche ethische, soziale und klinische Fragen auf.

Gesundheitliche Risiken, Spezifika des Informed Consent, medialer Einfluss, die Rolle der Therapeuten, Sicherheitsaspekte und der rechtliche Status sind exemplarische Schlüsselbereiche.

Auch in der wissenschaftlichen Evaluation der psychedelikaaugmentierten Psychotherapie sind zahlreiche methodische Herausforderungen zu bewältigen. Dazu gehören unter anderem geeignete Kontrollbedingungen, Placebospezifika und Verblindungsprozeduren, um belastbare Erkenntnisse zu generieren. Erwartungsverzerrungen müssen minimiert und/oder inferenzstatistisch herausgerechnet werden.

Kontinuierliche Forschung, Ausbildung und Zusammenarbeit zwischen verschiedenen Interessengruppen sind notwendig, um die komplexen klinischen, ethischen und methodischen Dimensionen der psychedelischen Forschung und Therapie effektiv zu bewältigen.

ABSTRACT

Using psychedelics in therapy raises important ethical, social, and clinical issues. Health risks, specifics of informed consent, media influence, the role of therapists, safety aspects and legal status are exemplary key areas.

The scientific evaluation of psychedelic-augmented psychotherapy faces the same methodological obstacles as in the clinical domain: suitable control conditions, placebo specifics, and blinding procedures are needed to ensure that reliable conclusions are reached. Expectation distortions must be minimized and/or statistically be controlled for.

To effectively address these complex clinical, ethical, and methodological dimensions of psychedelic research and therapy, continuous research, training, and collaboration among diverse stakeholders is necessary.

Schlüsselwörter

Psychedelika - Psychotherapie - Risiken - Herausforderungen

Key words

Psychedelics - psychotherapy - risks - challenges

Publication History

Article published online:
14 May 2024

• Literatur

• 1 Aday JS, Heifets BD, Pratscher SD. et al Great Expectations: recommendations for improving the methodological rigor of psychedelic clinical trials. Psychopharmacology 2022; 239 (06) 1989-2010
• 2 Aday JS, Mitzkovitz CM, Bloesch EK. et al Long-term effects of psychedelic drugs: A systematic review. Neurosci Biobehav Rev 2020; 113: 179-189
• 3 Azevedo N, Oliveira Da Silva M. et al Ethics of Psychedelic Use in Psychiatry and Beyond – Drawing upon Legal, Social and Clinical Challenges. Philosophies 2023; 08 (05) 76
• 4 Bishop MD, Mintken P, Bialosky JE. et al Factors shaping expectations for complete relief from symptoms during rehabilitation for patients with spine pain. Physiother Theory Pract 2019; 35 (01) 70-79
• 5 Bodnár KJ, Kakuk P. Research ethics aspects of experimentation with LSD on human subjects: a historical and ethical review. Med Health Care Philos 2019; 22 (02) 327-337
• 6 Constantino MJ, Vîslă A, Coyne AE. et al A meta-analysis of the association between patients’ early treatment outcome expectation and their posttreatment outcomes. Psychotherapy 2018; 55 (04) 473-485
• 7 Drozdz SJ, Goel A, McGarr MW. et al Ketamine Assisted Psychotherapy: A Systematic Narrative Review of the Literature. J Pain Res 2022; 15: 1691-1706
• 8 Forstmann M, Sagioglou C. How psychedelic researchers’ self-admitted substance use and their association with psychedelic culture affect people’s perceptions of their scientific integrity and the quality of their research. Public Underst Sci 2021; 30 (03) 302-318
• 9 Freedland KE. Purpose-guided trial design in health-related behavioral intervention research. Health Psychol 2020; 39 (06) 539-548
• 10 Juul S, Gluud C, Simonsen S. et al Blinding in randomised clinical trials of psychological interventions: a retrospective study of published trial reports. BMJ Evid Based Med 2021; 26 (03) 109
• 11 Ko K, Kopra EI, Cleare AJ. et al Psychedelic therapy for depressive symptoms: A systematic review and meta-analysis. J Affect Disord 2023; 322: 194-204
• 12 Peterson A, Tagliazucchi E, Weijer C. The ethics of psychedelic research in disorders of consciousness. Neurosci Conscious 2019; 2019 (01) niz013
• 13 Phelps J.. Developing Guidelines and Competencies for the Training of Psychedelic Therapists. Journal of Humanistic Psychology 2017; 57 (05) 450-487
• 14 Pilecki B, Luoma JB, Bathje GJ. et al Ethical and legal issues in psychedelic harm reduction and integration therapy. Harm Reduct J 2021; 18 (01) 40
• 15 Schmid Y, Liechti ME. Long-lasting subjective effects of LSD in normal subjects. Psychopharmacology 2018; 235: 535-545
• 16 Smith KW, Sicignano DJ, Hernandez AV. et al MDMA-Assisted Psychotherapy for Treatment of Posttraumatic Stress Disorder: A Systematic Review With Meta-Analysis. J Clin Pharmacol 2022; 62 (04) 463-471
• 17 van Elk M, Yaden DB. Pharmacological, neural, and psychological mechanisms underlying psychedelics: A critical review. Neurosci Biobehav Rev 2022; 140: 104793
• 18 Vîslă A, Constantino MJ, Newkirk K. et al The relation between outcome expectation, therapeutic alliance, and outcome among depressed patients in group cognitive-behavioral therapy. Psychother Res 2018; 28 (03) 446-456
• 19 Williams NR, Heifets BD, Bentzley BS. et al Attenuation of antidepressant and antisuicidal effects of ketamine by opioid receptor antagonism. Mol Psychiatry 2019; 24 (12) 1779-1786