PSYCHEDELIC DRUGS AS PSYCHIATRIC TREATMENTS

PSYCHEDELIC DRUGS AS PSYCHIATRIC TREATMENTS

 

Psychedelic Drugs As Psychiatric TreatmentPsychedelic drugs, also known as hallucinogenic drugs or simply hallucinogens, are a group of substances that are usually used recreationally to change and enhance sensory perceptions, thought processes, and energy levels, and to facilitate spiritual experiences. They include chemicals, such as LSD, and plants, such as peyote

 

Types of Psychedelic Drugs

Psychedelic drugs are taken recreationally in ways including smoking, snorting, injecting, and drinking them. In contrast, most research studies dispense psychedelics in pill form to ensure their purity and to allow for consistent dosing, both gold standards for clinical tests of treatments and drugs. Pill forms are also much safer than smoking or injecting psychedelic drugs.

Well-known psychedelic medicines currently being investigated include psilocybin, LSD, MDMAketamine, and peyote.

 

Psilocybin (4-Phosphoryloxy-N,N-Dimethyltryptamine)

Psilocybin, sometimes referred to as “magic mushrooms,” comes from certain mushrooms found in the United States, Mexico, and South America.

 

 It’s considered the most researched psychedelic substance and is being explored as a treatment for depressioncancer-related distress, and different forms of addiction. ORDER MAGIC MUSHROOMS HERE

 

LSD (D-Lysergic Acid Diethylamide)

Colloquially known as “acid,” LSD is a clear or white material made from lysergic acid, which is found in a fungus that grows on grains like rye.

 

 Like psilocybin, LSD is being studied as a therapeutic agent for depression, cancer-related distress, and addiction, says Matthew W. Johnson, PhD, a professor of psychedelics and consciousness research in the department of psychiatry and behavioral sciences at Johns Hopkins University School of Medicine in Baltimore. BUY LSD HERE

MDMA (3,4-Methylenedioxymethamphetamine)

MDMA, often called “ecstasy” or “molly,” is a popular synthetic club drug that acts as a stimulant and hallucinogen. BUY MDMA CRYSTALS HERE

 

 Researchers are looking at MDMA as a potentially game-changing treatment for post-traumatic stress disorder (PTSD). BUY MDMA PILLS HERE

 

Ketamine

Ketamine, known on the street as “special K,” has traditionally been administered intravenously as a surgical anesthetic in humans and animals. It has also been used in liquid, powder, or pill form as a date-rape drug that when added to someone’s drink without their knowledge can cause confusion, memory loss, and other symptoms that render that person more vulnerable to sexual assault. BUY KETAMINE HERE

 

 In 2019, a nasal spray form of ketamine called esketamine won U.S. Food and Drug Administration (FDA) approval as medication for treatment-resistant depression.

 

Peyote (Mescaline)

Mescaline occurs naturally in a small cactus called peyote, but it can also be synthetically made.

 

 It’s being investigated as a possible treatment for depression, anxiety, and related conditions. BUY PEYOTE HERE

 

How Do Psychedelic Drugs Work in the Brain and Body?

All psychedelics produce a temporary altered state of consciousness, but researchers believe these experiences may generate lasting effects when it comes to treating mental health, says Dr. Johnson.

“There is evidence that the brain becomes more flexible or ‘plastic’ after a psychedelic,” says Johnson.

Kelley O’Donnell, MD, PhD, an assistant professor of psychiatry at the New York University (NYU) Grossman School of Medicine and a researcher at the NYU Langone Center for Psychedelic Medicine, puts it this way: Psychedelic drugs allow patients to access parts of themselves that are ordinarily inaccessible.

As Dr. O’Donnell explains, “The human brain is fundamentally a learning machine, and it derives its power from its ability to learn and recognize patterns and use those patterns to predict the future. It seems that psychedelics make that pattern much more flexible, so you have a window of opportunity to reopen a period of development, so even after the psychedelic experience, you can make choices and establish new patterns.

How each psychedelic drug affects the brain and body depends on the drug class to which it belongs.

Classic hallucinogens, such as psilocybin, LSD, and peyote, interfere with the brain chemical serotonin, which regulates your mood, senses, sleep, hunger, sexual behavior, and other functions.

 

Dissociative psychedelics, such as ketamine, affect the brain chemical glutamate, which regulates pain perception, emotion, learning, memory, and responses to your environment.

 

MDMA is an entactogen, which works by flooding the spaces between brain cells with serotonin, Johnson explains. 

 

What Research Says About Psychedelics as Mental Health Treatments

While the research on psychedelic medicine for mental illness is still considered new and emerging, some studies have shown compelling results.

Psilocybin

A study by Johnson and other researchers of 51 patients with life-threatening cancer diagnoses — who also had depression or anxiety — found that high-dose psilocybin improved symptoms and quality of life when given with psychological support. After six months, about 80 percent of participants continued to show clinically significant decreases in anxiety and depressed mood.

 

In a small later study, Johnson and his team reported that two doses of psilocybin, given with supportive psychotherapy, significantly reduced depressive symptoms among 15 adults with major depressive disorder (MDD) compared with 12 adults in a waitlist control group (meaning a group that received no treatment). More than half the study participants were in remission four weeks after treatment.

 

In a study published in April 2021, researchers compared the effects of psilocybin and a common antidepressant called Lexapro (escitalopram) among 59 people with depression. Thirty participants were randomly chosen to receive psilocybin and 29 to receive escitalopram. Ultimately, the researchers found no significant difference in antidepressant effects between psilocybin and escitalopram, but they noted that longer and larger studies were needed to confirm these findings.

 

Psilocybin may also be an effective addition to current treatments for quitting smoking, according to a pilot study coauthored by Johnson.

 

LSD

LSD-assisted psychotherapy — meaning a combined intervention of therapy and medication — may lessen feelings of anxiety among people with life-threatening illnesses who are anxious about their illnesses, according to a small study with 12 participants. Follow-up research with participants one year after treatment found that those decreases in anxiety had lasted.

 

A review of six clinical trials with 536 participants linked a single dose of LSD administered within treatment programs for alcohol use disorder to a decrease of alcohol misuse.

 

Ketamine and Esketamine

Intranasal esketamine, administered together with standard antidepressant treatment, significantly reduced depressive symptoms and suicidal thoughts among patients with depression and high suicide risk, a small 2018 study found.

 

In another 2018 study, ketamine administered with ongoing antidepressant treatment was found to significantly reduce suicidal thoughts and behaviors within 24 hours compared with midazolam, a different anesthetic medication, among people with depression who were at risk of suicide.

 

And in a March 2022 study, researchers found that among 537 people who received intravenous ketamine therapy in a clinical setting between 2016 and 2020, more than half of patients experienced improvement in their symptoms, and nearly 30 percent achieved remission. And 73 percent of people with suicidal thoughts and behaviors saw a decrease in these symptoms. The researchers noted that 8 percent of people experienced worsened depression after starting ketamine therapy, and 6 percent reported increased suicidal thoughts or behaviors.

 

MDMA

Some of the most compelling results for MDMA as a treatment for mental illness have come from clinical trials involving people with PTSD. In a study with 90 participants, investigators found that 67 percent of people treated with MDMA-assisted therapy no longer met the diagnostic criteria for PTSD 18 weeks after starting treatment.

The authors of the study concluded that, “MDMA-assisted therapy represents a potential breakthrough treatment that merits expedited clinical evaluation.”

 

Supportive Therapy Is Essential, Too

Although the research on psychedelic medicine is promising, it’s important to note that these studies involved very careful administration of these drugs in a clinical setting under the supervision of doctors. Currently available research consists of very small, short-term studies, many of which are performed in specific groups of patients (such as people with life-threatening illnesses, for instance). This means that the findings from these studies may not be applicable to everyone being considered for psychedelic therapies.

In addition, many studies also included supportive care in the form of psychotherapy.

“For clinical indications, psychotherapy appears to be necessary to support and facilitate change,” says Danovitch.

He adds that therapy protocols typically involve the following phases:

  • Assessment phase During this phase, a mental health professional and the patient set goals for therapy.
  • Preparation phase This phase is intended to get patients physically and emotionally ready for treatment.
  • Experience phase During this phase, health professionals monitor patients carefully as they take the medication.
  • Integration phase This phase focuses on helping patients reflect and learn from the experience after treatment with the psychedelic has ended.

O’Donnell says this type of support, including preparing the patient for what will happen when taking the medication, is vital for successful treatment.

“If someone has no idea what they’re in for and someone gives them a psychedelic, that can be a really traumatic experience,” O’Donnell says. “A lot of people have the idea that it’s a one-and-done and your life is transformed forever, and that’s really not the case. That takes it out of the context of a therapeutic relationship, which is so important.”

Benefits Of Using Psychedelic Drugs For Psychiatric Treatments

Below are some potential health benefits of psychedelic therapy:

Terminal illnesses

Facing a serious or deadly diagnosis can be scary, especially if a person feels anxiety about death itself or what might happen afterward. A handful of studies suggest that psychedelic therapy may ease this existential dread, as well as the anxiety and depression that accompany it.

A 2016 study of 29 people with cancer who had anxiety or depression related to their diagnosis compared those who got a single dose of psilocybin mushrooms to those who got a placebo. The psilocybin reduced cancer-related anxiety, hopelessness, and dread immediately after the dose. At 6.5 months, 60 to 80% of the psilocybin group continued to report improvements in depression and anxiety.

Another 2016 study of 51 people with life-threatening cancer arrived at similar conclusions. Participants either took a dose of psilocybin or a placebo-like low dose of psilocybin. The high-dose psilocybin group reported significant improvements across many domains of functioning, including improvements in mood and relationships.

These improvements persisted for 80% of participants when researchers followed up 6 months later.

In both studies, participants reported mystical experiences, or spiritualistic experiences. These may help a person glimpse death, feel like everything is connected, or better envision their version of the divine. These experiences, both studies found, mediated rates of anxiety and depression. This suggests mystical experiences may play a role in the mental health benefits of psychedelics.

Depression and anxiety

Psychedelic therapy may also ease symptoms of depression and anxiety in people not facing serious illnesses.

A 2020 reviewTrusted Source reported on 24 prior studies on psychedelic drugs to treat anxiety symptoms. It said 65% of studies reported a reduction in anxiety with psychedelics, though the studies were small and some had methodological flaws.

A 2021 study asked 164 people who reported experiencing a psychedelic experience to discuss their mental health symptoms. Participants reported significant reductions in depression, anxiety, and stress following the psychedelic experience. An analysis revealed that participants also had greater compassion and less frequent rumination.

However, because the study relied on self-reporting, it does not conclusively prove that psychedelic experiences can affect mental health. Rather, it suggests a mechanism through which psychedelics might improve mental health, which is in feeling greater self-compassion and less obsession with negative thoughts.

A 2017 study looked at people with treatment-resistant depression. Researchers gave 20 people with mostly severe depression two doses of psilocybin 7 days apart, then followed up with them for 6 months.

Researchers observed a significant reduction in symptoms for the first 5 weeks following treatment. At 5 weeks, nine participants had responded to treatment, and four had depression that was in remission. Participants were more likely to have improvements in their depression symptoms if they had quality psychedelic experiences during the drug dose.

Post-traumatic stress (PTSD)

The psychedelic effects of hallucinogenic drugs may help ease the effects of trauma, but research so far has produced mixed results.

A 2020 systematic review looked at four studies of MDMA and five studies of ketamine for the treatment of trauma. The evidence supporting ketamine alone was very low, while the evidence for ketamine with psychotherapy was low. Researchers found moderate evidence supporting the effectiveness of MDMA.

Another 2020 study followed gay male survivors of the AIDS pandemic who reported feeling demoralized. Participants attended eight to 10 group therapy sessions, and got one dose of psilocybin. At 3 months, researchers found clinically significant reductions in participants’ symptoms of demoralization.

Addiction

An emerging body of research suggests that psychedelic therapy may help ease some symptoms of addiction. Addiction and other mental health symptomsTrusted Source, such as depression, commonly occur together, which may help explain the benefits. Perhaps by reducing other mental health symptoms, psychedelics make it easier to quit abusing substances.

A 2015 proof-of-concept study recruited 10 volunteers with alcohol addiction to undergo psilocybin therapy along with a type of psychotherapy called motivational enhancement therapy. In the first four weeks, during which participants only received psychotherapy, alcohol use did not decrease. After taking psilocybin, though, participants drank significantly less.

Participants who had intense psychedelic experiences were more likely to quit drinking.

A 2016 study suggests psilocybin might also help people quit smoking. Researchers recruited 15 volunteers to receive both psilocybin and a cognitive-behavioral therapy-based quit-smoking program.

A year later, 67% had successfully quit smoking, and at 16 months, 16% remained non-smokers. These are significantly higher success rates than doctors typically see either with other medication or with therapy alone.

Ibogaine is another plant compound that early research suggests may prove beneficial in treating extreme addiction. Learn more about it here.

Eating disorders

The mystical and psychedelic experiences a person has with psychedelic therapy may shift their body image away from unhealthy thoughts, potentially easing symptoms of eating disorders.

A 2020 systematic review reports on people who underwent psychedelic therapy for eating disorders, several of whom said their experiences while under the influence of drugs offered them new insights that encouraged them to embrace healthier habits.

People with eating disorders often have other mental health symptoms, so psychedelic therapy might ease the symptoms that lead to disordered eating. A 2020 study of 28 people with a history of eating disorders found that psychedelics significantly reduced participants’ reported depression symptoms.

Risks

Psychedelic drugs induce powerful changes in consciousness that can cause serious side effects. These may includeTrusted Source:

  • Psychosis: This is a break from reality that may be more likely in people with conditions known to cause psychosis.
  • Fear: Some people hallucinate things that terrify them, cause them to believe they are dying, or even that induce trauma and flashbacks.
  • Cardiovascular issues: Psychedelics can elevate the heart rate and blood pressure, so people with a history of heart disease should discuss their history with a provider before trying psychedelics.

It is very important to note, however, that despite these risks, most studies report few or no negative reactions.

Side Effects

Some of the most common side effects of psychedelics include:

 

  • Altered sense of time, such as feeling that time is passing by slowly
  • Anxiety or fear
  • Fast heart rate
  • Increased blood pressure
  • Mild headaches
  • Nausea
  • Intensified sensory experiences, such as seeing colors that are brighter than usual

Johnson adds, “A risk for anybody is a panic reaction during a ‘bad trip.’ But the potential for harms from this are mitigated through monitoring and a safe environment in medical trials.”

Some psychedelic medicines can be addictive. More research is needed to determine how addictive they might be when administered in clinical settings, as well as the best ways to reduce the risk of addiction.

 

 

Which Psychedelic Drugs Are FDA-Approved for Use?

Currently, Spravato (esketamine) is FDA-approved for treatment-resistant depression. It’s administered as a nasal spray by a health professional.

 

Though esketamine is a psychedelic medicine, the drug’s prescribing information lists hallucinogenic experiences as a side effect rather than a mechanism of action, or how the drug works.

 

 “With the typical way esketamine is used, folks are told to ignore the psychedelic effects as a side effect, which is the opposite of true psychedelic therapy where one is encouraged to pay attention to the altered state of consciousness and try to learn from it,” says Johnson.
Some doctors prescribe ketamine — which is FDA-approved as a general anesthetic — “off-label” for depression. This means it’s not yet FDA-approved for depression, but some health professionals deem the medication appropriate for certain patients. Some physicians provide ketamine for depression at specialized clinics throughout the United States.

 

Additionally, the FDA has granted breakthrough therapy designations to psilocybin for MDD and MDMA for PTSD.

 

 This designation accelerates their pathway to FDA approval. But these medicines aren’t legally available to the public yet and can only be used as part of a clinical trial.

 

 

Contraindications: Who Should Not Use Psychedelics?

People with a history of mania, severe heart disease, or psychotic disorders such as schizophrenia should not be considered for psychedelic therapy, Johnson says.

Individuals prescribed psychedelic therapies should always be clinically monitored and should never try to take the drugs on their own. “It is important to have supervision anytime someone consumes anything that dramatically alters perceptions of reality,” says Danovitch. 

 

The Future of Psychedelic Medicine for Mental Illness

The recent surge in psychedelics research will likely continue gaining steam.

“It’s receiving attention because of very large effects for very difficult to treat disorders — effects that often dwarf our best existing medications,” Johnson says. “That, combined with the fact that we are at peak levels of mental health trouble as a society and we’re pretty desperate for breakthrough changes. This shows good promise of being a game-changer,” he adds.

Still, Johnson and others say more extensive, rigorous studies need to be done before psychedelic drugs can be considered a mainstream therapy.

And although studies are showing positive results, there are still many unknowns, such as the ways these drugs will be administered if they become FDA-approved. “There are so many questions we have to study that we don’t know the answers to,” O’Donnell notes.

O’Donnell says she envisions specialized psychedelic clinics popping up in areas around the country where patients will receive guidance, support, and psychotherapy along with psychedelic treatment.

While the future of psychedelic therapy offers exciting possibilities, O’Donnell emphasizes that overcoming mental health disorders is a process that often takes time and hard work.

“Changing one’s life isn’t something that happens in an instant. It’s something we have to commit to and live out,” O’Donnell says. “Psychedelics give us an opportunity to settle into a new pattern, but we still have to choose that pattern and establish it consciously. There’s a real responsibility, and it can be a lifelong journey.”

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