Psychedelic-assisted therapy: a survey on the clinical methods of Swiss physicians

Background: -methamphetamine (MDMA). Objectives: The study provided an overview of PAT as currently provided in Switzerland under the regulatory framework of the Federal Office of Public Health (FOPH). Design: Swiss PAT practices were examined using an anonymous survey of physicians providing PAT. Questions included physicians' backgrounds, training, therapeutic orientation, treatment protocols, patient characteristics, and perceived benefits. Methods: Participants were recruited from PAT professional associations and the research team network. Forty-one physicians providing PAT under FOPH exemptions contributed to the survey. Results: Respondents used PAT primarily for depression, anxiety, post-traumatic stress disorder (PTSD), and chronic pain. Most physicians practiced in private practices, private outpatient clinics or shared practices (82%), with a minority in hospitals (18%). The most reported labels when providing PAT were body-oriented (61%), psychodynamic (59%), and eclectic (54%) approaches. Respondents provided PAT using psilocybin (85%), MDMA (71%), and LSD (65.9%). Choice of first substance was linked to diagnosis, with physicians preferring psilocybin for depression (54%) and substance use disorder (46%) and MDMA for PTSD (86%) and anxiety disorders (54%). A total of 90% reported always playing music during psychedelic sessions. Loss of orientation in time and space, feeling too cold, anxiety, and nausea where the most frequent adverse effects of PAT. 95% had emergency medication available, on average used during 2.4% of sessions. Challenges included legal constraints, high patient expectations, and financial barriers. Group therapy was common, with 9% reporting providing only group sessions, 42% providing both individual and group settings, and 47% providing only individual sessions. Only 9% reported never using co-sitters. Conclusion: This study offers valuable insights into the methods and experiences of physicians providing PAT in a legal clinical context, giving insight into the considerable variety of clinical methods. Cultural and regulatory differences may limit generalizability.