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Caution at psychiatry’s psychedelic frontier

Nature Medicine volume 27, pages 1687–1688 (2021)Cite this article

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Matters Arising to this article was published on 11 October 2021

The Original Article was published on 10 May 2021

arising from J. M. Mitchell et al. Nature Medicine https://doi.org/10.1038/s41591-021-01336-3 (2021)

At a time when new psychiatric treatments are needed more than ever, a promising line of psychedelic treatment options has emerged, and there is a palpable buzz surrounding them. While there are many unique considerations for this field moving forward, recent clinical trials of psychedelics are forcing psychiatry to carefully contemplate the way it views and weighs blinding and placebo effects. Historically, blinding has been a foundational component that ensures the validity of placebo-controlled clinical trial results. The main purpose of blinding is to avoid introducing bias from study personnel and to ensure equal distribution of placebo effects (i.e., beneficial effects associated with positive expectation and other contextual factors surrounding treatment rather than the treatment itself) across the trial arms. However, what happens when the treatment you are studying makes it challenging (if not impossible) to properly blind participants? Can we interpret trial results in line with the previous frameworks? Or should we simply focus on whether or not patients get better?

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Acknowledgements

The content of this article is the opinion of the authors. It does not necessarily represent the official views of the University of Toronto or Harvard Medical School (and their affiliated academic health care centers).

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Authors and Affiliations

  1. Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

    Matthew J. Burke & Daniel M. Blumberger

  2. Division of Neurology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada

    Matthew J. Burke

  3. Harquail Centre for Neuromodulation and Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada

    Matthew J. Burke

  4. Division of Cognitive Neurology, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Matthew J. Burke

  5. Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, Toronto, Canada

    Daniel M. Blumberger

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M. J. B., concept/design, drafting manuscript; D. M. B., concept/design, critical revision of manuscript.

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Correspondence to Matthew J. Burke.

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Burke, M.J., Blumberger, D.M. Caution at psychiatry’s psychedelic frontier. Nat Med 27, 1687–1688 (2021). https://doi.org/10.1038/s41591-021-01524-1

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