Evaluating psychedelics and psychedelic assisted psychotherapies for Veterans amidst enthusiasm and advertising hype

Abstract: Purpose of Review: There is growing enthusiasm for psychedelics and psychedelic assisted therapies (PATs) in psychiatric care broadly as well as in the military Veteran community. We address gaps between public advertising, scientific evidence, and clinical practice guidelines (CPGs). Our primary concern is the premature adoption of PATs and the risk posed to Veterans, amongst unresolved regulatory, methodological, and other concerns. Recent Findings: While recent randomized controlled trials suggest short-term benefit of compounds such as ketamine and 3,4-methylenedioxymethamphetamine (MDMA) for depression and PTSD, these effects are often small, transient, and confounded by methodological concerns. CPGs from the Department of Veterans Affairs and Department of Defense recommend caution in utilizing PATs or appropriately recognize there has been insufficient information to make more definitive recommendations on their use. Marketing strategies often exceed evidentiary support, involving misleading claims without adequate discussion of risks or regulatory contexts. Summary: Current data do not justify broad implementation of PATs in Veteran populations. We urge adherence to established CPGs for Veterans and specific psychiatric disorders until more rigorous research occurs and demonstrates clear effectiveness in subsequent meta-analysis and systematic review. Careful dismantling studies, industry independent investigations, and expanded Veteran-representative samples are also important to assess the safety and effectiveness of PATs in the future. Finally, we recommend improved regularity oversight of advertising.

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