Long-COVID symptoms improved after MDMA and psilocybin therapy: A case report, 2024, Chopra et al

The subject of the new case study is a previously healthy 41-year-old woman who experienced severe Long-COVID symptoms after contracting the virus in February 2022. Despite receiving three vaccinations, she developed a wide range of post-COVID symptoms, including severe anxiety, depression, insomnia, joint pain, cognitive difficulties, and a unique type of headache distinct from her pre-existing migraines.

Initial traditional treatments provided little relief. These included medications, physical therapy, massage, intermittent fasting, and meditation. The patient even tried chiropractic and osteopathic therapies, which offered only mild, short-lived improvements. Frustrated by the lack of effective solutions and long wait times at specialized clinics, she decided to explore the use of psychedelics under the guidance of a therapist.

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I’ve talked with quite a few people who have tried LSD, psyilicobin, or MDMA with ME/CFS. I just once was told that someone with mild ME improved for a year with LSD and then deteriorated again. Other times people described the experience as null or even overwhelming and leading to a crash. Personally, I had an experience myself before I was diagnosed with ME (but already had the symptoms) and was still mild, I found it to cause a crash, but also that psychologically it helped me partially come to terms with my symptoms.

 

Recently in the news, seniors in Canada are arriving at the ER more frequently because of cannabis use. I think some are avoiding doctors and treating themselves.

 

Are you telling me a study such as this one, relying solely on subjective symptom reporting in a single person who only very recently developed LC, where natural recovery is very common, is not convicing?

If anything it should be rather alarming to the medical community that this person was experimenting with all sorts of alternative medicine and drugs simply because the waiting time at the LC clinic was too long.

 

There is a study that suggests psychedelics could alleviate pain syndromes/disorders. This could help improve the QOL for ME/CFS associated pain. Of course it should be monitored under the supervision of a trained therapist.

I've read many stories about pwMS who have benefitted from cannabis treatment when other meds/treatments haven't worked.

 

All that is reported in the case report takes place less than one full year from the subject's confirmed Covid infection, so nothing to suggest that this person might not have recovered naturally without taking random drugs.

 

Methodological issues undermine evidence about adverse effects of psilocybin-
assisted psychotherapy
We read with interest the recent meta-analysis of acute adverse effects of psilocybin in the treatment of depression and anxiety, in which the authors report that findings “ suggest a tolerable acute adverse effect profile for therapeutic doses of psilocybin”

1. Unfortunately, upon closer examination we noted issues in the approach taken that may affect the validity of this conclusion.
The main methodological concern identified relates to the risk of bias assessment, which found low risk of bias across studies. We are unclear how this rating could have been arrived at given the widespread functional unblinding that has hampered interpretation of evidence in this field.

2 The authors purported to include only double-blind studies in the review, excluding one single-blind trial. However, most included studies – although described as double blind – did not assess the integrity of blinding. One that did, found that therapists were able to correctly identify the treatment allocation for 97% of participants

3. Even in studies where no assessment of blinding was conducted, the acute and side effects of psilocybin reported support the likely occurrence of functional unblinding. These factors are not reflected in the risk of bias ratings reported.
A second key issue relates to the narrow framing of the review to focus only on the acute effects of psilocybin – as if these could be separated out from the overall effects of psilocybin-assisted psychotherapy – by definition a combined treatment modality. This resulted in the review reporting that no serious adverse events (SAEs) occurred in the studies reviewed within the limited time-frame covered (i.e., within 24 hours after dosing). Yet, one included study documented
nineteen SAEs, including suicidal ideation and self-injurious behaviour, occurring after the initial dosing day

4. Moreover, these events were dose-dependent. Thus, the evidence generated using such a limited timeframe is clearly insufficient to describe the actual risk of harms associated with this treatment modality.
Despite these limitations, we note that this report has already received extensive media and social media coverage, resulting in a current Altmetric rating in the 99% percentile for same age articles.

There is widespread public interest in psychedelic-assisted psychotherapies and increasing moves towards implementing these methods in clinical practice in various jurisdictions. Given this, it is imperative to more comprehensively assess potential harms of psilocybin-assisted psychotherapy to protect patients, facilitate informed
consent, and mitigate risks associated with psychedelic-assisted treatment.

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