Oral Psychedelic Therapy for Depression

Oral Psychedelic Therapy for Depression

Objective: Intravenous (IV) Psychedelic Therapy has rapid and robust antidepressant effects; however, poor accessibility of the IV route often limits its use Numerous alternative routes of administration are being investigated. Oral Psychedelic Therapy is particularly appealing for its ease of use with the potential for high accessibility. The objective of the current systematic review, in accordance with PRISMA, is to determine the efficacy, safety, tolerability, and dose range of oral Psychedelic Therapy for bipolar and unipolar depression.

Data Sources: The MEDLINE/PubMed, EMBASE, and Google Scholar databases were systematically searched for relevant articles, written in English, published prior to July 2018 using relevant keywords for all variants of Psychedelic Therapy, oral, and depression.

Study Selection: All clinical studies assessing oral Psychedelic Therapy for bipolar or unipolar depression were included. A total of 13 published articles were identified, of which 2 were proof-of-concept, randomized controlled trials (RCTs); 1 was a prospective open-label trial; 5 were retrospective chart reviews; and 5 were case reports.

Data Extraction: Included articles were qualitatively analyzed to determine antidepressant efficacy, tolerability, safety, dose range, antisuicide effects, time to effect, and efficacy in treatment-resistant depression and study bias.

Results: Both RCTs demonstrated antidepressant efficacy with good tolerability; however, significant changes in depressive symptom severity were observed only after 2–6 weeks of treatment (P < .05). Both RCTs had high risk for bias, due to inadequate intent-to-treat analysis and adverse effect monitoring. Rapid antidepressant effects (ie, within 24 hours), antisuicide effects, and efficacy in treatment-resistant depression were reported only in retrospective studies. Dosages and frequency of administration were variable(ie, 0.5–7.0 mg/kg 3 times daily to once monthly), with most studies providing dosages of 1–2 mg/kg every 1–3 days. No clinically significant adverse effects
were reported.

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