Is the Psychedelic Therapy Bubble About to Burst?

In April 2021, a widely anticipated paper in the field of psychedelics dropped. The study, a small trial run at Imperial College London and published in The New England Journal of Medicine, investigated the use of psilocybin, the active ingredient in magic mushrooms, to treat depression. Led by Robin Carhart-Harris, who now directs the Neuroscape Psychedelics Division at the University of California, San Francisco, the research compared psilocybin with a standard antidepressant. The findings were somewhat lackluster: it found that the psychedelic was only marginally better than traditional treatments at relieving depression.

Back in 2017, Rosalind Watts, an author on that paper and a former clinical lead for the trial at Imperial, had given a TEDx talk on the power of psilocybin to treat depression, prompted by the time she had spent working on the study. In the talk, she shared her belief that psilocybin could “revolutionize mental health care.” But in February of this year, Watts published a Medium piece in which she expressed regret at her initial unbridled enthusiasm. “I can’t help but feel as if I unknowingly contributed to a simplistic and potentially dangerous narrative around psychedelics; a narrative I’m trying to correct,” she wrote.

“I just reflected on how I myself had got caught up in the black and white of like, ‘This is wonderful,’” she says today. “Now having been through that trial … I’m much more neutral and agnostic.”

We’re firmly in the midst of a psychedelic renaissance, with substances long regarded simply as recreational drugs—such as psilocybin, LSD, and MDMA—being reappraised as potential treatments for a number of mental health conditions. At the same time, legislation and stigma surrounding psychedelics has slowly begun to loosen in recent years, and it increasingly looks like it might shake loose altogether. “Now all of a sudden, within the past year or so, the pendulum has swung all the other way,” says David Yaden, an assistant professor at the Johns Hopkins University School of Medicine who studies the subjective effects of psychedelics.

But Yaden thinks the field is in danger of overcorrecting. In a new opinion piece published in the Journal of the American Medical Association, Yaden—with his coauthors Roland Griffiths and James Potash, two experts in psychedelics and psychiatry, respectively—argues that if we don’t tread carefully, psychedelic research could end up back where it started: treated with deep suspicion, if not completely outlawed. “I don’t want to be a wet blanket,” Yaden says. “I think there’s a real reason for excitement. But I think it’s a really important message to get out.” 

To trace psychedelics’ potential future, Yaden, Griffiths, and Potash looked to a model called the Gartner Hype Cycle, which can be used to characterize the trend cycle of new technologies, like virtual reality or 4D printing. The pattern has gone something like this: Forbidden for decades, psychedelics began to reemerge in recent years out of fringe underground communities and into labs as potential revolutionary treatments for mental illnesses. Then in 2018, the US Food and Drug Administration granted psilocybin “breakthrough therapy” status for depression, which gives a treatment the fastest possible route to approval. The media leapt at it and startups sprung up, followed by obsessive patenting of psychedelic compounds.

But what began as a welcome glimmer of hope for new ways to treat mental illness (which psychedelics irrefutably are, even if trial results so far have been modest) has morphed into actual misinformation, Yaden argues. Claims began to crop up ranging from the unsubstantiated to the outlandish: that psychedelics can “cure” mental illness, solve massive social problems, and create a “psychedelic utopia.” We’re in the midst of what Yaden and his coauthors call the psychedelic hype bubble. And they argue that scientists should be the ones to burst it.