Could psychedelics aid in the treatment of OCD?

Scientists have begun to investigate whether psychedelic substances could aid in the treatment of Obsessive-Compulsive Disorder. A preliminary study, published in Scientific Reports, has found that more than 30% of individuals with OCD who consumed these substances reported positive effects lasting for more than three months.

OCD is a mental health condition that affects millions worldwide, causing individuals to experience intrusive thoughts (obsessions) and engage in repetitive behaviors (compulsions). These symptoms can significantly disrupt daily life, leaving sufferers searching for effective treatments.

Conventional therapies for OCD include cognitive-behavioral therapy and antidepressant medications. However, these treatments don’t always work for everyone, spurring the quest for alternative approaches to provide relief for those living with OCD.

“Our team has been working with patients with OCD for some time, and especially on refractory patients in which regular therapeutic approaches do not work well. In the framework of the psychedelic renaissance, classic psychedelics might constitute a great opportunity for these patients,” said study author Anne Buot, a postdoctoral fellow in cognitive neuroscience at the Paris Brain Institute.

To investigate whether psychedelics, particularly classic psychedelics like psilocybin mushrooms and LSD, could offer respite to individuals suffering from OCD symptoms, the researchers conducted an online survey, gathering valuable insights from 174 participants.

The average age of participants was 29 years, with roughly equal gender distribution (54% female). Most participants were employees or students living in urban or suburban areas. The sample included those diagnosed with OCD by healthcare professionals (n=9), those with an Obsessive-Compulsive Inventory score greater than 18 (n=62), or both (n=103).

The researchers found that classic psychedelics, such as psilocybin mushrooms and LSD, showed promise in reducing OCD symptoms (such as the dissipation of obsessive thoughts, less need to engage in rituals, and reduced anxiety and avoidance behavior) A significant number of participants reported experiencing substantial improvements in their condition after using these substances.

“We showed that people with OCD symptoms (sampled from the general population) report a reduction in OCD symptoms following the intake of classic psychedelics,” Buot told PsyPost. “Interestingly, this effect was observed only for classic psychedelics but not with other recreational psychoactive substances such as ketamine or MDMA.”

However, she noted that “online surveys suffer for many biases and are not an appropriate method for demonstrating that a treatment is efficient. But this observation tells us that it is worth launching well-controlled randomized controlled trials to evaluate the potential efficacy of classic psychedelics in OCD.”

Participants had a range of expectations regarding the impact of psychedelics on their OCD symptoms. Most reported no specific context for their psychedelic experiences. Overall, the intensity and pleasantness of the psychedelic experience were associated with the magnitude of improvement in OCD symptoms.

“This is surprising since it is not in accordance with what has been reported in previous RCT using psychedelics in other pathologies (in which therapeutic effects were not associated with the pleasantness of the psychedelic experience),” Buot said.

“This could be interpreted in two ways: the first one would be that in this population, the quality/pleasantness of the psychedelic experience is an important factor in predicting therapeutic effects, which would have repercussion on the design of clinical trials and how patients are handled during dosing. The other interpretation is that participants were biased, with people having a pleasant experience attributing more therapeutic effects than the one having unpleasant experiences.

Participants reported that the improvement in their OCD symptoms varied in terms of persistence, with some reporting effects lasting less than a week and others reporting improvements lasting more than three months. However, no specific factors were found to predict the persistence of these improvements.

“The second surprising observation is the random distribution of the persistence data,” Buot told PsyPost. “In other words, when asking participants how long therapeutic effects persisted, we had very different reports without even a trend toward short or long delays. This could mean that there is a variety of responses and more research would be needed to be able to predict which patient might benefit from this therapeutic approach.”

A subset of participants continued to use psychedelics, with some using them at least once a week. The probability of subsequent intake increased with a stronger improvement in OCD symptoms and their persistence. Notably, some participants reported using microdoses of psychedelics for OCD symptom management.

While this research offers hope for those with OCD, it’s essential to acknowledge its limitations. The study relied on an online survey, which can introduce biases, and the participants self-reported their symptoms and experiences. Consequently, these findings should be considered preliminary, highlighting the need for further investigation.

Looking ahead, the study suggests that controlled clinical trials are warranted to confirm these promising observations and establish optimal dosages and protocols for using psychedelics as a potential treatment for OCD.

“It is important not to interpret this study as a proof that classic psychedelics are efficient for treating OCD, given the massive biases linked to online survey,” Buot explained. “But it encourages the establishment of controlled clinical trial to get an objective evaluation of therapeutic effects.”

“We believe that both researchers, clinicians and journalists have to be very careful on how we communicate on this topic, if we want the field to move forward in a peaceful way. Too much emphasis on the promises of classic psychedelics could promote consumption in harmful context. This is in part what happened in the 70s, which led to a cessation of all research with classic psychedelics.”

The study, “Improvement in OCD symptoms associated with serotoninergic psychedelics: a retrospective online survey“, was authored by Anne Buot, Cecile Pallares, Alina Oganesyan, Charles Dauré, Valérie Bonnelle, Eric Burguière, Joao Flores Alves Dos Santos, Karim N’Diaye, Michael Ljuslin, Pauline Smith, Vincent Verroust, Benjamin Wyplosz, Margot Morgiève, and Luc Mallet.

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