In this instance, “PAP” stands for Psilocybin Assisted Psychotherapy, an emerging treatment for depression, anxiety, PTSD, and other disorders. After a decade or so of research, it seems we’ve accumulated enough evidence to draw reliable conclusions as to its effectiveness.
In short, PAP does appear to be effective in terms of reducing symptoms. That’s the good news. It’s effects may not be as significant as we’ve heard described in the media, however. In fact, when properly measured, psychedelic therapy appears no more effective than conventional antidepressant medication.
Because the subjective experience of taking psychedelic drugs can be so dramatic — way beyond anything that you might experience from Zoloft or Prozac— 90%-95% of PAP patients are immediately able to tell whether they’ve been given “the real thing”, or a placebo. That suggests that the patient’s expectation is a powerful force in the outcome, rather than a direct result of the treatment.
A Systematic Review of Study Design and Placebo Controls in Psychedelic Research
Since expectation can be a powerful force on its own, it could well skew the results of a research study.
That’s not to say there isn’t some inherent value in psychedelic therapies. But it’s as much about the setting and the patient’s own mindset as the medication.
That’s why I expect people will continue going on ayahuasca expeditions in the Central American jungle. Sure, it’s uncomfortable, but something about the ritual appeals to them.
Meanwhile, our humble antidepressants have their own advantages. For one thing, convenience. And affordability.
And not every patient is looking for an intense, life-altering episode. They’re seeking a result, rather than an experience.
So in conclusion, I think we can safely say that both methodologies, hallucinogenic and not, can be expected to produce some level of result. It’s up to the individual to decide which approach “works” best for them.
But outside of that, the difference in effectiveness is likely to be, as one researcher put it, negligible.
