Scientists have begun to investigate whether psychedelic substances could help in the treatment of obsessive-compulsive disorder (OCD). A preliminary study published in Scientific Reports found that more than 30% of people with OCD who used these substances reported positive effects that lasted for more than three months.
Obsessive Compulsive Disorder (OCD) is a mental health condition that affects millions of people worldwide, causing them to experience intrusive thoughts (obsessions) and repetitive behaviours (compulsions). These symptoms can be very disruptive to daily life and leave sufferers searching for effective treatments.
Conventional treatments for OCD include cognitive behavioural therapy and antidepressants. However, these treatments don’t always work for everyone, prompting the search for alternative approaches to provide relief for people with OCD.
“Our team has been working with patients with OCD for some time, particularly with refractory patients who do not respond well to conventional treatments. In the context of the psychedelic renaissance, classic psychedelics could be a great opportunity for these patients,” said study author Anne Buot, a postdoctoral researcher in cognitive neuroscience at the Paris Brain Institute.
To investigate whether psychedelics, particularly classic psychedelics such as psilocybin mushrooms and LSD, could offer respite to people suffering from OCD symptoms, the researchers conducted an online survey and gathered valuable insights from 174 participants.
The average age of the participants was 29 years, with a fairly even gender split (54% female). Most participants were professionals or students living in urban or suburban areas. The sample included those diagnosed with OCD by health 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 dissipating obsessive thoughts, reducing the need to engage in rituals, and reducing anxiety and avoidance behaviours), with a significant number of participants reporting a significant improvement in their condition after using these substances.
“We showed that people with OCD symptoms (sampled from the general population) reported a reduction in OCD symptoms after taking classic psychedelics,” Buot told PsyPost. “Interestingly, this effect was only observed for classic psychedelics, but not for other recreational psychoactive substances such as ketamine or MDMA.”
However, she cautioned that “online surveys suffer from many biases and are not an appropriate method to demonstrate that a treatment is effective. But this observation tells us that it is worth conducting well-controlled randomised controlled trials to evaluate the potential efficacy of classical psychedelics in OCD.
Participants had a range of expectations about the effects 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 extent of improvement in OCD symptoms.
“This is surprising because it is not consistent with what has been reported in previous RCTs of psychedelics in other pathologies (in which therapeutic effects were not associated with the pleasantness of the psychedelic experience),” said Buot.
“This could be interpreted in two ways: the first would be that in this population, the quality/pleasantness of the psychedelic experience is an important factor in predicting therapeutic effects, which would have implications for the design of clinical trials and how patients are managed during dosing. The other interpretation is that participants were biased, with those who had a pleasant experience attributing more therapeutic effects than those who had an unpleasant experience.
Participants reported that the improvement in their OCD symptoms varied in terms of duration, 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 we asked participants how long the therapeutic effects lasted, we had very different reports, without even a trend towards 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 patients might benefit from this therapeutic approach.”
A subset of participants continued to use psychedelics, with some taking them at least once a week. The likelihood of subsequent use increased with greater improvement in OCD symptoms and their persistence. Notably, some participants reported using microdoses of psychedelics to treat OCD symptoms.
While this research offers hope for people with OCD, it’s important to acknowledge its limitations. The study relied on an online survey, which can introduce bias, and participants self-reported their symptoms and experiences. Therefore, these findings should be considered preliminary and highlight the need for further research.
Looking ahead, the study suggests that controlled clinical trials are warranted to confirm these promising observations and to establish optimal dosages and protocols for using psychedelics as a potential treatment for OCD.
“It is important not to interpret this study as proof that classical psychedelics are effective in treating OCD, given the massive biases associated with online surveys,” Buot explained. “But it does encourage the establishment of a controlled clinical trial to obtain an objective evaluation of the therapeutic effects.”
“We believe that both researchers, clinicians and journalists need to be very careful about 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 encourage use in harmful contexts. This is in part what happened in the 70s, which led to the cessation of all research on classical psychedelics.
