Despite their ill reputation, psychedelics such as Psilocybin, LSD, and MDMA (commonly known as Ecstasy) may be the missing puzzle piece to treating several mental disorders. Results from contemporary clinical trials testify for the drugs’ capacity in inducing positive, long-term alterations in mental health and well-being in both patients and healthy individuals, when taken under regulation and as a complement to psychotherapy.
The question is, as more states and cities in the United States legalize it, will the public accept the new role of these recreational drugs? Let us look at what we know so far.
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The belief in the therapeutic potential of psychedelics has been around for decades. But now more than ever, scientists are carrying out intensive investigations to allow for their use alongside psychotherapy, and results are promising. Their use in psychiatry can be attributed to a group of pioneering psychiatrists in the 1950s that demonstrated the powerful effects of LSD as an adjunct to therapy, in treating a gamut of conditions such as alcoholism, depression, schizophrenia, anxiety, personality disorders, and even sexual dysfunctions.
Towards the 1970s, research on the use of hallucinogens in psychiatry has yielded over 1,000 scientific papers that contained findings from 40,000 subjects and 6 international conferences. Many of these studies weren’t reliable as the methodology conducted was flawed relative to contemporary guidelines.
Nonetheless, the preliminary findings were intriguing enough to warrant further research into the matter. Unfortunately, that would become impossible as the use of psychedelics became a point of contention when LSD hit the streets in 1963, and psychedelics became notorious as drugs of abuse that are linked to the counterculture. Eventually, research using psychedelics was halted in the late 1960s due to political and societal pressures leaving many questions unexplored.
The current situation
Nowadays, scientists are once again proving the efficacy of psychedelics in treating mental illnesses. Recently, MDMA-assisted psychotherapy for individuals with severe PTSD was proven to be far more effective than present first-line pharmacological and behavioral therapies. These unprecedented results from the Phase 3 study led by Rick Doblin, founder and executive director of the Multidisciplinary Association for Psychedelic Studies, may be the cause for their FDA approval which is expected to come by 2023.
At Imperial College London, Centre for Psychedelic Research, researchers are conducting the most meticulous study to date on the healing effect of Psilocybin, the active ingredient in magic mushrooms, on depression. Their published results revealed that psilocybin reduces depressive symptoms rapidly and in greater magnitude in comparison to the FDA-approved antidepressant, Escitalopram. However, researchers did acknowledge the need for a larger and longer trial to establish their potency.
Additionally, the Center for Psychedelic and Consciousness Research at Johns Hopkins Bayview Medical Center in Baltimore, Maryland, released fascinating results in November 2020. Their study demonstrated that 71% of the patients suffering from major depressive disorder who underwent psychedelic-assisted psychotherapy showed a greater than 50% reduction in symptoms and more than half of the participants were in remission within 4 weeks.
How psychedelics work
Like the primary class of antidepressants, Selective Serotonin Reuptake Inhibitors (SSRIs), psychedelics act on serotonin receptors and enhance the brain’s neuroplasticity. Nonetheless, psychedelics have an additional effect best described by Franz Vollenweider, a psychiatrist and neurochemist at the University Hospital of Psychiatry in Zurich, Switzerland, he states that psychedelics “activate a therapeutic, dreamlike state, intensifying sensory perception, and memories pop up like little films.”. Therefore, the drug creates a receptive mental state and allows patients to be open to fresh ideas about how to view the past and the future, and this is where psychotherapy has a big role in breaking down false thought patterns that drive mental illnesses like depression and enforces positive ones.
As these long-stigmatized drugs emerge as alternatives for treating mental illnesses, and numerous states and cities in the U.S. continue their process of decriminalizing psychedelics for therapeutic purposes, it is very important to note that scientists are aware of how powerful these substances are. This is why intensive research is conducted to fully understand every facet of psychedelics to confront any side effects. Secondly, while the initial findings are promising, individuals are discouraged from self-medicating. These strong drugs are expected to be administered under the observation of trained psychotherapists and regulators. Therefore, psychedelics will be used solely for treatment purposes in a safe and well-regulated environment. If taken without supervision and dose regulation, these drugs could induce a lasting psychotic reaction.
Lastly, it is crucial for the public to comprehend the importance of these findings and their grave impact on the millions affected by these disorders. Depression is the cardinal contributor to a disability affecting more than 264 million individuals globally. Latest epidemiological studies demonstrate that the leading cause of death by suicide is clinical depression, which claims around 800,000 lives per year. And despite the rise in awareness of the detrimental effect, it has on its victims, depression largely remains an enigma. This is reflected in the unavailability of potent drugs for treating depression; even experts argue that the efficacy of antidepressants has been empirically exaggerated. As for PTSD, about 8 million people develop the disorder per year in the U.S. alone.
Similarly, PTSD has no cure and the only option available is psychotherapy for management or the use of antidepressants in an attempt to relieve the depressive symptoms. And as declared by the statistics, current antidepressants approved by the FDA are largely ineffective, in 40-60% of patients. Hence, there is no doubt that we are in dire need of a novel approach. Therefore, as scientists do their best to translate their research into reality to
help overcome these detrimental disorders, it is our duty to educate ourselves on the matter in order to view psychedelics for their new potential role, to overcome the stigma around them, and raise awareness in hopes that when the treatment is available, those needing help will seek it.