Pharmakotherapie, Psychotherapie oder „Superplacebos“?

The evaluation of the therapy of psychiatric illnesses with serotonergic drugs or classical psychedelics, such as psilocybin or lysergic acid diethylamide (LSD) has experienced a renaissance for ca. 10 years. Although the results of larger studies particularly on depression and substance use disorders are very promising, there are methodological and regulatory questions: how can psychedelics be tested according to modern methodological standards, when blinding in randomized clinical studies is practically impossible? Is it a “biological” therapy, which only needs psychological support for ensuring the safety of the patient, or a pharmacologically augmented psychotherapy? Can the therapy with psychedelics be sufficiently described at all with the two categories of pharmacotherapy and psychotherapy or must especially here a cultural anthropological descriptive dimension be introduced? This article gives a review of the state of the art against the background of these questions.