Journeying to Ixtlan: Ethics of Psychedelic Medicine and Research for Alzheimer’s Disease and Related Dementias

Abstract

In this paper, we examine the case of psychedelic medicine for Alzheimer’s disease and related dementias (AD/ADRD). These “mind-altering” drugs are not currently offered as treatments to persons with AD/ADRD, though there is growing interest in their use to treat underlying causes and associated psychiatric symptoms. We present a research agenda for examining the ethics of psychedelic medicine and research involving persons living with AD/ADRD, and offer preliminary analyses of six ethical issues: the impact of psychedelics on autonomy and consent; the impact of “ego dissolution” on persons experiencing a pathology of self; how psychedelics might impact caregiving; the potential exploitation of patient desperation; institutional review boards’ orientation to psychedelic research; and methods to mitigate inequity. These ethical issues are magnified for AD/ADRD but bear broader relevance to psychedelic medicine and research in other clinical populations.

Keywords:

• Psychiatry
• Alzheimer’s disease
• dementia
• psychoactive drugs
• drug use
• drugs

This article is referred to by:

The Road to Ixtlan in Neuro-Degenerative Diseases Is Paved with Palliative Cobblestones

Ethical Considerations at the Intersection Between Psychedelic-Assisted Psychotherapy and Medical Assistance in Dying

Barriers and Facilitators to the Equitable Access of Psychedelic Medical Care and Research in Alzheimer’s Disease and Related Dementias

Avoiding the Premature Introduction of Psychedelic Medicines in Alzheimer’s Disease and Related Disorders

The Ethical Spectrum of Consciousness

Whose Mental Data? Privacy Inequities and Extended Minds

Publishing the Biotechnical Futures of Alzheimer’s Disease

Why Canada’s Artificial Intelligence and Data Act Needs “Mental Data”

Psychedelic Research for Dementia Risks Perpetuating Structural Failures and Inadequacies in Aged Care

Journey to Narayama: Cultural Complexities, Psychedelics and Dementia

Toward a Broader Psychedelic Bioethics

Implications from Jaworska’s Account of Autonomy and Self for Dementia and Psychedelic Research

DISCLOSURE STATEMENT

DS reports paid consultation for Compass Pathways.

Additional information

Funding

AP is funded by National Institute on Aging (R21-AG069805). JK is supported by the National Institute on Aging (P30-AG-010124) and (R21-AG069805). EL is supported by the National Institute on Aging (K01-AG064123) and a Greenwall Faculty Scholar Award. HFL is supported by a Greenwall Faculty Scholar Award. The content of this article does not necessarily represent the official views of the NIH or private foundations. The funders played no role in the preparation, review, approval, or decision to submit this manuscript for publication.