Today's Perspective

Kristin Wiisanen, PharmD, FAPhA, FCCP, Pharmacy Today editor in chief

Psychedelics derived from plants, such as mescaline and psylocibin, have been used by indigenous peoples as part of religious rites for centuries, and more recently by patients seeking relief from PTSD and severe depression, despite their potentially harmful effects.

If approved by FDA this fall, Lykos Therapeutics’ midomafetamine (MDMA) will become the first FDA-approved psychedelic therapy. Lykos Therapeutics is seeking authorization to treat PTSD in combination with psychotherapy…but keep an eye out for more psychedelic drug approvals for other indications on the horizon.

This month’s Pharmacy Today cover story takes a deep dive into psychedelics. It is no longer a question of whether or not psychedelic medicines will join our treatment armamentarium, but rather when they will do so. Psylocibin, an agent naturally found in mushrooms, is undergoing clinical trials for treatment of severe depression and may be approved in the coming years. Ketamine, classified as a dissociative drug, is already being used as an adjuvant to psychotherapy.

These types of drugs have two primary effects: neuroplastic changes to repair or reset broken or disrupted neural networks and psychedelic effects. Researchers hope that these combined actions may ultimately achieve improved therapeutic outcomes with fewer adverse effects. Research is underway to tease out the optimal drug and/or combination of medications and psychotherapy to determine if the neuroplastic and psychedelic effects of these agents can and should be separated, and, if so, how best to do this.

In this issue of Today, you’ll also learn more about using cranberry for UTIs, how Xolair (omalizumab—Genentech) works to address food allergies, and how gabapentin may worsen COPD symptoms. You’ll also get the latest on preventing medication errors with reconstituted products and stay current with your CPE with this month’s article on migraine.

While we wait for these emerging psychedelic medications to become more mainstream, pharmacists can prepare to answer patients’ questions. Concerns may range from curiosity about others who have taken similar medications to a desire to learn about clinical trials or patient support organizations. Encourage patients to talk to you and their other health care providers before starting or stopping any new medication(s).

Have a great Today! ■