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In recent years, an increasing number of clinical investigations and research studies are taking place on the use of psychedelic substances as standalone or adjunct therapy for a range of illnesses such as post-traumatic stress disorder (PTSD), anxiety, depression, addictions such as alcohol dependence, as well as potentially treating the effects of Alzheimer’s disease.
Some of the research findings have been so promising that at the end of 2019 Johns Hopkins investigators launched the Center for Psychedelic and Consciousness Research.
The center, believed to be the first such research center in the country and the largest of its kind in the world, will focus on how psychedelic substances impact brain function and mood in both healthy individuals and those affected by conditions such as Alzheimer’s disease and anorexia nervosa.
What are Psychedelics?
According to an article published in the Canadian Medical Association Journal “psychedelic drugs” include a range of substances with different pharmacological profiles that all have strong effects on a person’s conscious experience.
As it stands currently, the only FDA-approved drug for psychedelic therapy is Ketamine to treat adults with treatment-resistant depression and depressive symptoms in adults with major depressive disorder (MDD) with suicidal thoughts or actions. While intravenous administration is the most effective, it is also approved as a nasal spray in the form of esketamine and sold under the brand name Spravato.
The approval of Ketamine is significant as it may serve as a guide for the approval of future psychedelic therapy medications by paying less attention to the hallucinogenic effects of the drug and focusing on the unique way it acts on the brain.
Two psychedelic substances which have received an increasing amount of attention during recent times are methylenedioxymethamphetamine, also known as MDMA, and Psilocybin. MDMA is commonly known as “Ecstasy” or “Molly”. However those substances sold on the street are often combined with other harmful chemicals. Pure MDMA is within a category of psychedelics known as entactogens which act primarily as a serotonin-releasing agent and has effects that somewhat overlap but are substantially distinct from classic psychedelics. Psilocybin is under the category of a “classic psychedelic” and is a tryptamine derivative that enhances serotonin levels in the central nervous system and is found in various species of mushrooms more commonly known as “Magic Mushrooms.”
Ketamine and Dissociative Therapy for Depression
Ketamine has shown promising potential with its benefits for dissociative therapy in treating depression, PTSD, and other mental health concerns. In 2014, a study published in the Journal of Affective Disorders found that dissociative symptoms, as measured by the Clinician-Administered Dissociative States Scale (CADSS), were significantly associated with antidepressant improvement at both 230 minutes after the infusion and even a full week following the infusion.
Researchers also note that the path of improvement following a ketamine infusion is important. Patients with treatment-resistant depression usually receive an intravenous ketamine infusion that lasts more than 40 minutes and up to one hour. Antidepressant effects and improvements for other symptoms such as anxiety and suicidal ideation in response to a single ketamine infusion usually occur within a few hours and continue to have lasting effects, according to a 2006 study published in JAMA Psychiatry. The researchers went on to say:
“To our knowledge, there has never been a report of any other drug or somatic treatment…that results in such a dramatic rapid and prolonged response with a single administration.”
What is Next for Psychedelic Therapy?
An increasing amount of interest by the scientific community in psychedelic medicine is generating new knowledge about substances that have been used by humans throughout history for therapeutic, cultural, and ceremonial purposes. It won’t be long before the research into the therapeutic use of psychedelic drugs becomes commonplace enough for its integration into medical school teachings. There is a substantial need for more scientific evidence concerning the relative risks and harms of psychedelic drugs — which is absent in the current scheduling classifications from the Drug Enforcement Administration’s (DEA) Diversion Control Division. These current categorizations are largely outdated and are more of a reflection of adverse outcomes from uncontrolled recreational use rather than supervised clinical settings.
Additionally, medical school literature needs to include knowledge about the potential therapeutic uses of psychedelic substances as patients who familiarize themselves with the most up-to-date clinical trials are likely to ask their health care providers about the potential for their own treatment. Consequently, as evidence accumulates on the therapeutic value of psychedelic substances, there will soon be a need for specialized clinical training for health care professionals to meet the increasing demand for these breakthrough therapies.
Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4592297/
https://www.psychologytoday.com/us/basics/psychedelic-assisted-therapy
https://www.beingpatient.com/could-psychedelics-help-treat-alzheimers/
