Narrative review of the potential for psychedelics to treat Prolonged Grief Disorder

Abstract

Prolonged Grief Disorder (PGD) is distinct from yet related to non-pathologic grief, depression, addiction, and Post-Traumatic Stress Disorder (PTSD) with a prevalence of up to 10% in bereaved populations. Hallmarks of PGD include functional impairment a year or more post-bereavement and intense yearning for the deceased. Current treatments for PGD are typically psychological rather than psychopharmacological, and more treatment options are needed. Psychedelics such as psilocybin and MDMA may be a promising treatment avenue for PGD. Randomized clinical trials demonstrated the efficacy of psilocybin in reducing symptom severity in depression and MDMA in reducing PTSD symptomatology. Furthermore, psychedelics often produce subjective effects (such as transcendence, mystical experiences, and a sense of oneness) that may be uniquely relevant to the existential distress experienced in PGD. No randomized clinical trials have thus far been conducted on the safety and efficacy of psychedelics for PGD. Initial research, including survey-based studies and an open-label trial, has begun to shed light on the possible benefits of psychedelics in the alleviation of grief. While the evidence from these studies is preliminary, it suggests a consistent trend towards the effectiveness of psychedelics in grief reduction. Conducting a randomized clinical trial would be an appropriate next step to explore the potential efficacy of using psychedelics to treat PGD.

Keywords:

• Psychedelics
• prolonged grief disorder
• PTSD
• depression

Author contributions

The authors confirm contribution to the manuscript as follows: Manuscript conception: RE, MA, DBY. Manuscript drafting and preparation: RE, MA, DBY, JKP. All authors reviewed and approved the final version of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

Support for Dr. Yaden through the Johns Hopkins Center for Psychedelic and Consciousness Research was provided by Tim Ferriss, Matt Mullenweg, Blake Mycoskie, Craig Nerenberg, and the Steven and Alexandra Cohen Foundation. Dr. Agrawal is CEO of Sunstone Therapies. Dr. Ehrenkranz is supported by funds from Sunstone Therapies. Dr. Penberthy is the endowed by the Chester F. Carlson Chair at the University of Virginia School of Medicine.