Uma Chatterjee - Psychedelics, PTSD, & Comorbid OCD: Considering the implications of comorbid OCD...

Psychedelic-assisted therapies for PTSD pose specific challenges in patients with comorbid Obsessive-Compulsive Disorder (OCD), which affects up to 40% of the PTSD population. Standard PTSD protocols often rely on exposure-based psychotherapies, which are contraindicated for OCD, as they can exacerbate symptoms if the required response prevention component is missing. Integrating OCD-specific screening, such as the Y-BOCS, and incorporating exposure and response prevention (ERP) principles are recommended to prevent adverse outcomes and improve the safety and efficacy of these treatments. Psychedelic psychotherapy creates an environment of physiological malleability that could amplify both beneficial and harmful therapeutic interactions. Because OCD is frequently misdiagnosed and mistreated, standard psychedelic protocols risk worsening symptoms by inadvertently reinforcing maladaptive cycles, unless providers are trained to recognize the interplay between trauma-focused work and obsessive-compulsive themes.