Stay up to date on the latest research in psychedelic medicine

Every month, around 100 new studies on psychedelics are published, adding to what we know about these substances. To help clinicians and practitioners stay up-to-date with the most important findings, the Psychedelic Provider Network has teamed up with Blossom to review the latest studies.

November 2024 Research Summary

To help clinicians and practitioners stay up-to-date with the most important findings, the Psychedelic Provider Network has teamed up with Blossom to review the latest studies from November 2024.

This month, we explore significant developments in psychedelic research across diverse areas of investigation. First, we investigate the potential of ketamine to treat obsessive-compulsive disorder (OCD), now studied in a double-blind study. Next, we examine a systematic review challenging assumptions about psychedelic-induced psychosis, revealing surprisingly low incidence rates and suggesting potential reconsideration of absolute exclusion criteria in clinical trials. Finally, we explore a comprehensive survey study introducing the Psychedelic-related Major Life Changes Questionnaire (P-MLCQ), which reveals how psychedelic experiences can catalyze profound changes across multiple life domains, from personal values to career choices.

Ketamine for Obsessive Compulsive Disorder

An area of mental health treatment where we’ve seen limited progress with psychedelics is in treating obsessive-compulsive disorder (OCD). To our knowledge, only five trials have been conducted, and no more than a dozen research articles have been published on the topic. Of these, most relied on case studies. This changes with a new study of ketamine for OCD.

This double-blind, active-controlled study represents one of the most rigorous investigations to date of ketamine for OCD. The research team compared intramuscular ketamine at two different doses (0.5 mg/kg and 1.0 mg/kg) with fentanyl (50 μg) as a psychoactive control. The study included 12 participants with treatment-resistant OCD, with 10 completing the full protocol.

The findings revealed a dose-dependent reduction in OCD symptoms, as measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Particularly noteworthy was the duration of effect, with symptom improvements persisting up to seven days post-treatment. The lower dose (0.5 mg/kg) showed promising results, with a 60% response rate at 24 hours compared to 18% for the higher dose and 10% for fentanyl. This unexpected finding suggests that "more" isn't necessarily "better" when it comes to ketamine dosing for OCD.

For clinicians, these results offer an important insight. The superior tolerability of the lower dose challenges the common assumption that higher doses (e.g. as used with Spravato) are necessary for therapeutic effect. Two participants withdrew due to dissociative effects, highlighting the importance of careful dose titration and patient monitoring.

Psychosis Following Psychedelics

The relationship between psychedelics and psychosis has long been a topic of concern in the field. While previous research has focused on the therapeutic potential of these substances for conditions like depression and PTSD, individuals with schizophrenia or psychotic disorders have typically been excluded from clinical trials. A comprehensive new systematic review and meta-analysis challenges some long-held assumptions about these exclusion criteria.

The researchers analyzed 131 publications, including 14 systematic reviews, 35 randomized controlled trials, and various other study types spanning from 1947 to 2023. Their findings reveal surprisingly low incidence rates of psychedelic-induced psychosis: 0.002% in population studies, 0.2% in uncontrolled trials, and 0.6% in randomized controlled trials. Even among individuals with schizophrenia participating in uncontrolled trials, only 3.8% developed long-lasting psychotic symptoms. However, the data also showed that 13.1% of those who experienced psychedelic-induced psychosis later developed schizophrenia, suggesting some relationship between vulnerability to psychosis and adverse reactions to psychedelics.

These findings are particularly relevant as psychedelic therapy moves toward broader clinical implementation. The extremely low incidence rates in the general population suggest that current screening practices may be adequate for most patients. However, the higher rates in clinical trials highlight the importance of controlled settings and careful monitoring, especially when working with potentially vulnerable individuals.

The Effect of MDMA on Personality

While much research focuses on clinical outcomes like symptom reduction, psychedelics can catalyze profound life changes that extend far beyond traditional medical measures. A new survey study introduces the Psychedelic-related Major Life Changes Questionnaire (P-MLCQ) to systematically assess these broader impacts. This research builds on previous findings suggesting that psychedelics can influence personality traits and personal values, now examining specific life domains affected by psychedelic experiences.

The study surveyed 581 individuals about their naturalistic psychedelic use, finding that an overwhelming 83% reported at least one major life change attributed to their psychedelic experiences. The most common areas of change were life goals (53.7%), personal values (53.5%), and spirituality (49.1%). Perhaps most striking was how positively these changes were viewed - participants rated their satisfaction with these changes at 4.64 out of 5, with less than 1% viewing the changes negatively. Interestingly, the frequency of psychedelic use correlated with more reported changes, while higher education levels were associated with fewer changes.

These findings have important implications for both clinical practice and harm reduction. For practitioners, the results highlight the need to prepare clients for potentially profound life changes that extend beyond symptom improvement. Someone entering psychedelic therapy for depression, for instance, might also experience shifts in their career goals, relationships, or spiritual beliefs. This raises important considerations for informed consent and integration support.

However, several caveats warrant attention. The study relied on self-selected participants, many recruited through psychedelic advocacy events, suggesting possible positive bias. Additionally, the retrospective nature of the survey makes it difficult to establish causality - whether psychedelics directly caused these changes or simply coincided with natural life transitions remains unclear. Nevertheless, these results provide valuable insights into the broader impacts of psychedelic use and underscore the importance of comprehensive integration support in clinical settings.

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November 2024 in Psychedelic Research

This month's research brings novel insights for clinicians working with psychedelics. First, a rigorous study of ketamine for OCD reveals promising results with lower doses, showing a 60% response rate at 24 hours and sustained effects up to seven days, challenging assumptions about optimal dosing strategies. A comprehensive meta-analysis examining psychedelic-induced psychosis finds remarkably low incidence rates in the general population (0.002%), suggesting that the absolute exclusion of individuals with psychotic disorders from research may warrant reconsideration.

Additionally, a survey study introduced a new tool for measuring psychedelic-related life changes, finding that 83% of participants reported major positive changes in areas like life goals and personal values. These findings emphasize the importance of preparing clients for broad life changes beyond symptom improvement and highlight the need for comprehensive integration support. 

As psychedelic medicine continues to evolve, these studies provide valuable guidance for developing safe and effective treatment protocols while expanding our understanding of who might benefit from these therapies.