Psychedelic-assisted psychotherapy: Emerging paradigm

To review psychedelic-assisted psychotherapy (PAP), including its principles, mechanisms of action, safety considerations, and current state of evidence relevant to Canadian primary care.

The evidence of PAP is evolving and is primarily derived from phase 2 and 3 clinical trials in specialized research settings. Systematic reviews and meta-analyses suggest potential benefit for selected conditions, though heterogeneity is high, and long-term comparative effectiveness relative to standard treatments remains uncertain.

PAP combines structured psychotherapy with supervised administration of psychedelic medicines in controlled settings. While not a first-line treatment or a primary care-delivered intervention, family physicians may encounter patients seeking information, referral, or guidance regarding PAP and should be familiar with basic evidence, contraindications, access pathways, and harm-reduction considerations.

PAP represents an emerging intervention with potential clinical relevance for select patients. As research and regulatory frameworks continue to evolve in Canada, cautious, evidence-informed engagement by family physicians is warranted.