Psychedelics and their role in treatment of mental health disorders

Psychedelics such as LSD, magic mushrooms, mescaline etc. have garnered renewed interest in the scientific world because of the possible role they could play in mental health problems. Ketamine remains the only hallucinogen at present that is used clinically as an anesthetic agent. The others are all classified under banned drugs.

There have been numerous studies in the recent times where these drugs have been tried in treatment of mental health disorders such as addictions, depression, post-traumatic stress disorder etc. these agents have shown promise in persons in whom most of the conventional therapy has failed.

As a next big step, researchers at Imperial College London are now all set to start major clinical trials to see if any of these psychedelic or hallucinogenic drugs can be actually helpful in treatment of depression when compared to a standard drug used for treatment of depression. In their trial the team of researchers would compare magic mushroom compound psilocybin and a SSRI (selective serotonin reuptake inhibitors) antidepressant, escitalopram. The trial is expected to run for at least 2 years. Dr Robin Carhart-Harris, study leader said that there is a “revolutionary potential” of these psychedelic drugs and this is not an exaggeration.

The team of researchers explains that these hallucinogenic drugs have been in scientific interest for the last few decades. They were initially used in the 1950s and 60s for some of the mental health problems before they fell into disrepute mainly because of the abuse liability, recreational use and risk of dependence and addiction. Over a thousand studies had been conducted during that time. Soon fear of moral degeneration and overdosage related risks took over and these drugs were made illegal in America in 1968. The United Nations too convened on the status on 1971 that stopped scientific research on these drugs. Member states made these drugs illegal and classified them as Schedule 1 drugs or drugs that have no known medicinal benefits. This sealed their fates even in scientific research. Next few decades saw no research on these drugs. It is only recently that there is renewal of interest in the psychedelics especially in PTSD and depression that is refractory to standard treatments.

According to experts, in the mid-2000s these drugs underwent a “scientific renaissance” after Johns Hopkins University in the US started work on them. Magic mushroom compound psilocybin was being studied in 1990s mainly because laws governing its use in research were not as stringent as with others. Psilocybin showed that there was a reduction in symptoms of depression in 80 percent of the patients with terminal cancers who suffered from depression. This agent could also help people quit smoking more effectively than currently used therapy. Dr Carhart-Harris has been working with psychedelics for the last five decades and more and he and his team last year found that psilocybin can help “reset” the brains of people with depression and help cases of “untreatable depression”. His paper published in the journal Scientific Reports showed that two areas of the brain including the amygdala and a network of neurons are affected. The amygdala helps an individual to process emotions and feelings while the network of neurons help coordinate different parts of the brain. Dr Carhart-Harris says that it could be that the psilocybin can “heat up” and “reset” the brain to remove the rigidly held “self destructive patterns of thought”. Along with cognitive behavioral therapy, he explained, the brain could be “recalibrated”.

Some of the problems with the use of these psychedelics are the fear and anxiety bad trips may cause. There may be a sense of losing control that might trigger anxiety and even psychotic breaks, warn experts. During the trials pure, medical-grade drugs would be used under strict medical supervision and support and it is hoped that the negative effects may be lesser. One of the major problems with the use of these drugs is the temporary nature of their efficacy. They seem to lose their ability to provide relief after continued use say experts.

Up until now the studies conducted pitted the effects of psychedelics against placebo. This latest trial would be the first to try it against an established antidepressant, say researchers. Dr James Rucker, a clinical lecturer at the Institute of Psychiatry at King's College London, is soon to start his study to establish the safety of psilocybin. Once the drug is established to be safe, it could go on to become licensed and finally be prescribed by doctors.  According to Dr. Rucker, this could take at least five years or longer to happen.

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