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The Potential for Psychedelics to Improve Coping Skills and Resilience in Persons With Newly Diagnosed Mild Cognitive Impairment or Early Alzheimer’s Disease

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Abstract

Purpose of Review

Mild Cognitive Impairment and mild Alzheimer’s disease are associated with depression and existential distress, but high quality evidence supporting psychotropic or psychotherapeutic intervention is lacking. There is encouraging research suggesting benefit of psychedelic compounds such as psilocybin in treating depression, as well as existential distress in terminal illness. This article will summarize research to date of psychedelic use in depression and terminal illness and discuss pre-clinical evidence suggesting that these benefits may also extend to Mild Cognitive Impairment and mild Alzheimer’s disease as well as important safety caveats in older patients.

Recent Findings

From the early 1950s to the 1960s, and then since the mid 2000s, hundreds of studies have suggested benefit of psychedelics in treating numerous psychiatric conditions, including depression and existential distress in terminal illness. Psychedelics appear to be well tolerated, and the use of careful screening and pre-, peri-, and post-administration psychological support can minimize the risk of psychological adverse effects, such as hallucinogen persisting perception disorder. Several strains of pre-clinical and neuroimaging research also suggest that psychedelics may be helpful in early Alzheimer’s disease and Mild Cognitive Impairment. Despite encouraging findings, caveats remain regarding psychedelic use in the elderly population, including limited inclusion in research and potential cardiovascular risks.

Summary

Mild Cognitive Impairment and mild Alzheimer’s disease are associated with depression and existential distress, and evidence supporting psychotropic or psychotherapeutic treatment is limited. Encouraging research has suggested benefit of psychedelics in treating depression, as well as existential distress in terminal illness. Pre-clinical research and neuroimaging data suggest potential benefit of psychedelics in Mild Cognitive Impairment and mild Alzheimer’s disease. Safety concerns include limited research in the elderly and potential cardiovascular events. Further research is indicated to determine whether benefit extends to those with Mild Cognitive Impairment or mild Alzheimer’s disease.

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Funding

Paul Rosenberg has received grants or contracts from: Lilly, Alzheimer's Association, Alzheimer’s Trials Research Institute and Alzheimer’s Cooperative Trials Consortium, Eisai, Functional Neuromodulation, National Institute on Aging, Alzheimer’s Clinical Trials Consortium, and Richman Family Alzheimer’s Disease Precision Center of Excellence. He has received consulting fees from: GLG, Leerink, Cerevel, Cerevance, Bioxcel, Sunovion, Acadia, Medalink, Novo Nordisk, Noble Insights, TwoLabs, Lundbeck, and Biogen. He has received payment or honoraria for Medscape and Neurology Week. He has received support for attending meetings and/or travel from Lundbeck. He participates in data safety monitoring and/or advisory board for Synaptogenix. Albert Garcia-Romeu is a paid scientific advisor to NeonMind Biosciences, InnerWell, and ETHA Natural Botanicals.

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    Martin Steinberg, Paul Rosenberg & Albert Garcia-Romeu

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Steinberg, M., Rosenberg, P. & Garcia-Romeu, A. The Potential for Psychedelics to Improve Coping Skills and Resilience in Persons With Newly Diagnosed Mild Cognitive Impairment or Early Alzheimer’s Disease. Curr Geri Rep 12, 149–155 (2023). https://doi.org/10.1007/s13670-023-00395-3

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