Psychedelic replications in virtual reality and their potential as a therapeutic instrument: an open-label feasibility study

Abstract

BackgroundRecent research has shown promising results for the therapeutic benefits of psychedelics. One popular view claims that these benefits are mediated by the subjective experiences induced by these substances. Based on this, we designed a virtual reality experience, Psyrreal, that mimics the phenomenological components of psychedelic experiences.AimsWe aimed to investigate the therapeutic efficacy of Psyrreal and psychedelic VR experiences in treating depressive symptoms as well as explore the effect of Psyrreal on subjective factors which have been suggested to mediate the therapeutic benefits of psychedelics.MethodsIn this open-label feasibility study, thirteen participants with mild-to-moderate depression underwent a 2-day therapeutic intervention implementing Psyrreal. Depressive symptoms were evaluated by the Emotional State Questionnaire (EST-Q2) at the start of the intervention and 2 weeks after. A thematic analysis of semi-structured interviews after Psyrreal was also conducted as an additional assessment of the method.ResultsA 2-day intervention implementing Psyrreal led to significant decreases in depressive symptoms at the 2-week follow-up (n = 10, p = 0.007, Hedges’ g = 1.046) measured by the Emotional State Questionnaire (EST-Q2). The analysis of semi-structured interviews suggests that Psyrreal could lead to insight and alterations in the sense of self in some people.ConclusionThis work proposes a novel method using virtual reality to augment the treatment of psychological disorders as well as to precisely investigate the mediating subjective factors of the therapeutic effects of psychedelic substances. Our preliminary results suggest that VR experiences combined with psychological support show potential in treating depressive symptoms and further research into similar methods is warranted.

Mystical experiences in virtual reality.

“…The present study is limited to self-report, subjective responses. In this respect, Kaup et al (2023) questioned the validity of the MEQ-30 when administered in the context of VR relating to the subjective nature of the questionnaire, possible difficulties understanding the questions, and possible demand effects. We share such concerns, particularly insofar as 5% of our participants reported a complete mystical experience in response to EC-I, an unexpected finding that seems to be an unlikely high prevalence.…”

“…Similar efforts were undertaken by Kaup et al (2023) who presented 11 participants with mild-to-moderate depressive symptoms with an unscripted, single-user virtual environment they titled "Psyreal." Psyreal was also designed to initially mimic a "real world" environment that is progressively altered primarily through the presentation of abstract shapes and geometrical patterns that were rated by a different group of users of psychedelics to be visually similar to their previous substance-induced experiences.…”

Safety, tolerability, and clinical and neural effects of single-dose psilocybin in obsessive–compulsive disorder: protocol for a randomized, double-blind, placebo-controlled, non-crossover trial

“…As mentioned, it may be hard to maintain blinding due to the unique effects of psilocybin. As such, future designs can consider non-pharmacological alternatives for the active control group, such as virtual reality-based simulations of psychedelic experiences ( 94 ). Additionally, it is not known whether other preparations of psilocybin (e.g., dried psilocybin-containing mushrooms, with additional alkaloids such as baeocystin) than the version used in this trial (i.e., synthetic psilocybin) would show the same proposed effects.…”

The mechanistic divide in psychedelic neuroscience: An unbridgeable gap?

“…To our knowledge, there are no psychedelic compounds that lack psychoplastogenic properties, but such compounds would be an extremely useful tool in resolving this controversy. Additionally, there may be non-pharmacological methods of inducing psychedelic-like states that may lack psychoplastogenic properties, e.g., altered breathing patterns, visual stimulation, sensory deprivation, and virtual reality, but it is currently unclear how such methods may or may not replicate key neurobiological changes that characterize the psychedelic experience [ [81] , [82] , [83] ].…”