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

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.