ADEPT is an open-label proof-of-concept study evaluating the safety and tolerability of psilocybin-assisted therapy in conjunction with Dialectical Behavior Therapy for participants with borderline personality disorder. Participants enrolled in the M Health Fairview Dialectical Behavior Therapy program will receive preparation therapy sessions, two supervised 25 mg psilocybin dosing sessions, integration therapy sessions, and a final follow-up visit. Participants will continue their usual DBT program during study participation. The study will primarily assess safety and tolerability, including adverse events, treatment-emergent adverse events, serious adverse events, suicidal ideation, challenging psychedelic experiences, psilocybin-related side effects, study retention, therapy session attendance, and assessment completion.
ADEPT is an open-label proof-of-concept study designed to assess the safety and tolerability of combining psilocybin-assisted therapy with Dialectical Behavior Therapy in participants with borderline personality disorder. The study will enroll up to 18 participants who have a confirmed DSM-5 diagnosis of borderline personality disorder and are enrolled in the M Health Fairview Dialectical Behavior Therapy program. Participants must have been enrolled in DBT for at least one month and must have consistent attendance in both group and individual therapy. The study intervention includes two 25 mg doses of psilocybin administered during supervised dosing visits. Three preparation therapy visits will occur before the first dosing visit. The first dosing visit will be followed by three integration therapy visits. A second psilocybin dosing visit will occur approximately 21 days later, followed by three additional integration therapy visits. Participants will complete a final follow-up visit at week 18, approximately 12 weeks after the second dosing visit. Participants will continue their usual DBT program while enrolled in the study. The M Health Fairview DBT program includes weekly individual therapy, group therapy skills development, and access to phone coaching. The primary focus of the study is safety and tolerability. Participants will be monitored during and after dosing, and adverse events, treatment-emergent adverse events, serious adverse events, suicidal ideation, challenging experiences, and psychedelic-related side effects will be assessed. Secondary outcomes will evaluate changes in borderline personality disorder symptoms, emotion regulation, depressive symptoms, quality of life, treatment credibility and expectancy, mystical experience, and continued participation in DBT after psilocybin-assisted therapy.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
18
Participants will receive two 25 mg doses of psilocybin during supervised dosing visits. Each dosing visit will include study therapist support for a minimum of 6 hours, with preparation and integration therapy sessions before and after dosing.
Participants will continue in the M Health Fairview Dialectical Behavior Therapy program while receiving psilocybin-assisted therapy. The study therapy sequence includes three preparation visits before the first dosing session, three integration visits after the first dosing session, a second dosing session, and three additional integration visits.
M Health Fairview DBT Program
Minneapolis, Minnesota, United States
M Physicians St. Louis Park Clinic
Saint Louis Park, Minnesota, United States
Incidence, Severity, and Frequency of Adverse Events
Safety and tolerability will be assessed by the incidence, severity, and frequency of adverse events, treatment-emergent adverse events, and serious adverse events during the study.
Time frame: Baseline through final study visit at week 18
Acute Suicidal Ideation After Psilocybin Dosing
Acute suicidal ideation will be assessed after each psilocybin dosing visit using the Modified Scale for Suicidal Ideation and related safety assessments.
Time frame: Within 24 hours after each dosing visit
Challenging Experiences After Psilocybin Dosing
Challenging experiences after psilocybin dosing will be assessed using the Challenging Experiences Questionnaire.
Time frame: Integration visit 24 hours after each dosing visit
Psilocybin-Related Side Effects
Psilocybin-related side effects will be assessed using the Swiss Psychedelic Side Effects Inventory.
Time frame: Integration visit 24 hours after each dosing visit
Percentage of Participants Who Complete the Study
Study retention will be assessed as the percentage of enrolled participants who complete the final study visit at week 18. Unit: percentage of participants
Time frame: Baseline through final study visit at week 18
Percentage of DBT Therapy Sessions Attended
Dialectical Behavior Therapy session attendance will be assessed as the percentage of scheduled DBT therapy sessions attended during study participation. Unit: Percentage of sessions
Time frame: Baseline through final study visit at week 18
Percentage of Study Assessments Completed
Assessment completion will be assessed as the percentage of scheduled study assessments completed during study participation. Unit: percentage of assessments
Time frame: Baseline through final study visit at week 18
Change in Zanarini Rating Scale Score
Borderline personality disorder symptoms will be assessed using the Zanarini Rating Scale. Change in score will be assessed from baseline to the final study visit at week 18. Higher scores indicate greater borderline personality disorder symptom severity. Unit: Points
Time frame: Baseline to final study visit at week 18
Change in Personality Inventory for DSM-5 Score
Borderline personality disorder symptoms will be assessed using the Zanarini Rating Scale, Personality Inventory for DSM-5, Inventory of Personality Organization, and Difficulties in Emotion Regulation Scale-16.
Time frame: Baseline to final study visit at week 18
Change in Difficulties in Emotion Regulation Scale-16 Score
Emotion regulation difficulties will be assessed using the Difficulties in Emotion Regulation Scale-16. Change in score will be assessed from baseline to the final study visit at week 18. Higher scores indicate greater emotion regulation difficulties. Unit: Points
Time frame: Baseline to final study visit at week 18
Change in Inventory of Personality Organization Score
Personality organization will be assessed using the Inventory of Personality Organization. Change in score will be assessed from baseline to the final study visit at week 18. Higher scores indicate greater impairment in personality organization. Unit: Points
Time frame: Baseline to final study visit at week 18
Change in Montgomery-Asberg Depression Rating Scale Score
Depressive symptoms will be assessed using the Montgomery-Asberg Depression Rating Scale and Quick Inventory of Depressive Symptomatology. Unit: Points
Time frame: Baseline, week 8 after the second dose, and 3 months after the last drug dose or at DBT exit
Change in Quick Inventory of Depressive Symptomatology Score
Depressive symptoms will be assessed using the Quick Inventory of Depressive Symptomatology. Change in score will be assessed from baseline to week 8 after the second dose and 3 months after the last drug dose or at DBT exit. Higher scores indicate greater depressive symptom severity. Unit: Points
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Time frame: Baseline, week 8 after the second dose, and 3 months after the last drug dose or at DBT exit
Change in Quality of Life Enjoyment and Satisfaction Questionnaire Short Form Score
Quality of life will be assessed using the Quality of Life Enjoyment and Satisfaction Questionnaire Short Form. Change in score will be assessed from baseline to the final study visit at week 18. Higher scores indicate greater quality of life enjoyment and satisfaction. Unit: points
Time frame: Baseline to final study visit at week 18
Credibility and Expectancy Questionnaire Credibility Score
Treatment credibility will be assessed using the Credibility and Expectancy Questionnaire. Scores will be assessed the day before the first dosing visit and the day before the second dosing visit. Higher scores indicate greater treatment credibility. Unit: Points
Time frame: Day before first dosing and day before second dosing
Credibility and Expectancy Questionnaire Expectancy Score
Treatment expectancy will be assessed using the Credibility and Expectancy Questionnaire. Scores will be assessed the day before the first dosing visit and the day before the second dosing visit. Higher scores indicate greater treatment expectancy. Unit: Points
Time frame: Day before first dosing and day before second dosing
Mystical Experience After Psilocybin Dosing
Mystical experience after psilocybin dosing will be assessed using the Mystical Experience Questionnaire. Higher scores indicate greater intensity of mystical-type experience. Unit: Points
Time frame: Integration visit immediately after each dosing visit
Rate of Continued Participation in Dialectical Behavior Therapy
Continued participation in Dialectical Behavior Therapy after psilocybin-assisted therapy will be assessed as the rate of DBT participation through the final study visit at week 18. Unit: percentage of scheduled DBT sessions attended
Time frame: Through final study visit at week 18