The authors of a new review of clinical trials, titled “The Safety and Efficacy of Psychedelic-Assisted Therapies for Older Adults: Knowns and Unknowns,” highlight that older adults often face common health challenges such as chronic health conditions and cardiovascular issues. According to estimates from the Centers for Disease Control, 60% of older adults manage at least two chronic health conditions, and 75% of adults over the age of 60 have been diagnosed with hypertension. These health issues may potentially contraindicate the use of psychedelics among the elderly.
The review also notes that older adults are prone to develop psychological distress from their illnesses, including cancer anxiety and bereavement-related grief. The authors suggest that psychedelic-assisted therapies may be effective in treating such distress in older adults.
When reviewing clinical trials conducted over the past 30 years that examined the use of psychedelics such as psilocybin and MDMA-assisted therapies, the authors found almost no reports of serious adverse reactions in study participants, including in older adults. However, they also noted that most study participants who received psychedelics were relatively healthy, and very few were over the age of 60. For instance, among the phase I, II, and III clinical trials for MDMA-assisted therapy that were reviewed, the average participant was 41 years old.
The authors also highlighted that some psychedelics, including MDMA and psilocybin, have been found to increase blood pressure and may cause irregular heartbeats. They noted that there was one severe case of heart problems in a clinical trial for MDMA-assisted therapy, where a participant experienced a transient increase in pre-existing ventricular ectopy that required overnight monitoring. However, there were no reports of heart attacks or strokes in the clinical trial subjects, despite some experiencing a spike in blood pressure during the acute effects of the medicine.
Brian Anderson, assistant clinical professor of psychiatry at the University of California, San Francisco and senior author of the review, noted that while some participants did experience a spike in blood pressure, it was not associated with any neurologic damage. No detectable strokes were reported in these participants. However, the authors caution that the impact of psychedelics on older adults, especially those with chronic illnesses, is still unknown due to the low average age of participants in the clinical trials that have been conducted so far.
C. Bree Johnston, director of palliative care at Skagit Regional Health and professor of medicine at the University of Arizona, who led the review, pointed out that the studies of psychedelic-assisted therapies have mostly been conducted on relatively healthy young adults. However, the conditions that have been studied, such as depression stemming from a terminal illness, are particularly relevant to the elderly community. Johnston noted that prolonged grief from the death of a loved one, which is estimated to affect 7-10% of older adults, is one example of a related condition that has not been studied in the context of psychedelic-assisted therapies.