Gateway Psychiatric just joined the Psychedelic Medicine Association. This membership is a continuation of our longstanding interest in alternative treatments for depression. I have been working with Bay Psychiatric Associates and Roberto Estrada for nearly five years providing ketamine infusion and now nasal esketamine to patients with treatment resistant depression.
This followed attending the 2017 Ketamine Conference which was held in Oakland and was sponsored by Kaiser.
More recently, several articles have been published with exciting preliminary results that find psilocybin to be as effective as escitalopram for depression, and adjunctive MDMA to be safe and effective in treating severe PTSD.
These results are preliminary, and a true sense of the relative value of psychedelic medication in the treatment of depression and PTSD will await more results and more experience.
As an example, a recent article notes that there are much higher rates of several serious adverse effects from esketamine compared with other treatments of depression, including dissociation, psychosis and suicidal ideation (for example, the rate of suicidal ideation was 24 times higher than the rate of reporting for other antidepressant treatments).
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References
Carhart-Harris R, Giribaldi B, Watts R, et al. Trial of Psilocybin versus Escitalopram for Depression. The New England journal of medicine. 2021;384:1402-1411. https://www.nejm.org/doi/full/10.1056/NEJMoa2032994
Gastaldon C, Raschi E, Kane J, Barbui C, Schoretsanitis G. Post-Marketing Safety Concerns with Esketamine: A Disproportionality Analysis of Spontaneous Reports Submitted to the FDA Adverse Event Reporting System. Psychotherapy and psychosomatics. 2020;2021;90:41-48. https://doi.org/10.1159/000510703
Introductory Guide to Psychedelic Medicines 2020 from the Psychedelic Medicine Association.
van der Kolk B, Adjunctive MDMA Safe Effective for Severe PTSD. European Psychiatric Association (EPA) 2021 Congress: Abstracts O206 and O209. Presented April 11, 2021.