A real therapeutic option? |
 |  | Translated by Marta Campbell |
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06.10.2025 12:00 Uhr |
During therapy, it is also possible that a present therapist suggests things to the patient, who is especially receptive due to the altered state of consciousness, but which may not necessarily be helpful. / © Adobe Stock/Lorenzo Antonucci
About one third of people affected by depression experience no improvement under established pharmacological and psychotherapeutic treatments. This increases the pressure to explore new therapies. Currently, psychoactive substances as medications are again coming into focus. They may not only work in depression, but caution is required.
These substances are known from their recreational use, since they alter consciousness and thus perception: psilocybin and lysergic acid diethylamide (LSD), or also 3,4-methylenedioxymethamphetamine (MDMA). But that does not exclude the possibility that under strictly defined conditions they might also have therapeutic effects. History in fact shows that substances have sometimes been assigned rather arbitrarily to the group of medications or to that of drugs, and this classification has often shifted.
Physicians such as Dr. Tomislav Majic of the Psychiatric University Clinic at Charité say that, through the altered state of consciousness these substances induce, new insights can be gained in a medical-therapeutic context: people can better perceive what they actually feel, they may attune more strongly to the thoughts and feelings of others, and their social connectedness may improve.
In the »Deutsches Ärzteblatt«, the psychiatrist writes that the strongest evidence currently exists for the treatment of depression with psychedelics, especially psilocybin, as well as for the treatment of post-traumatic stress disorder (PTSD) with MDMA. The positive effects of therapy often last for weeks and months, he notes.
Dosage and treatment intervals differ fundamentally from conventional psychiatric medications. Psychoactive substances are administered only a few times. Whether the treatment succeeds depends greatly on the experiences the person has under the substance and on how well they are therapeutically guided.
