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.
Its effects may not be as significant as we’ve heard described in the media, however. In fact, when properly measured, psychedelic therapy appears to be no more effective than conventional antidepressant medication.
”It’s an alternative, rather than a replacement” for other treatments, remarked one clinician.
Because the subjective experience of taking psychedelic drugs is distinctive — beyond anything that you might experience from taking Zoloft or Prozac — some 90%-95% of PAP research participants are correctly able to tell whether they’ve been given “the real thing”, or a placebo.
That makes truly “blind” controlled experiments difficult or even impossible. Here’s a review of the issue:
A Systematic Review of Study Design and Placebo Controls in Psychedelic Research
When scientists control for that, the much publicized advantages in effectiveness between PAP and medication seem to disappear. One isn’t superior to the other. The differences are, as one researcher put it, negligible.
That’s not to say there isn’t some inherent value in the psychedelic experience itself. But it’s as much about the setting and the patient’s mindset as the drug itself.
I expect people will continue going on ayahuasca expeditions in the Central American jungle. Sure, it’s uncomfortable, and costly, but something about the experience, or the idea of the experience, appeals to them.
Meanwhile, our humble antidepressants have their own advantages. For one thing, convenience. For another, affordability.
And not every patient is looking for an intense, life-altering episode. They’re seeking a result.
So in conclusion, I think we can safely say that both methodologies, hallucinogenic and not, can be expected to produce some degree of benefit. It’s up to the individual to decide which approach will “work” for them.
