Could psychedelic drugs treat depression and addiction problems?

Originally appeared at: “SEEKING persons committed to spiritual development to participate in a research study of mystical experience, meditation and spiritual practice,” an advertisement reads. It asks for volunteers with an “active interest” in exploring their spiritual lives to take part in a study analysing the effects of the entheogen, psilocybin – the psychoactive substance found in ‘magic mushrooms’ – on self-exploration and personal meaning. With phrases like “God-evoking substances” and “non-ordinary states of consciousness” sprinkled throughout the advertisement, one could be forgiven for thinking famous 1960s guru Timothy Leary was alive and well. However, the ad was actually published under the respected Johns Hopkins University School of Medicine banner. The study, backed by the US Food and Drug Administration (FDA), is one of a growing number of experimental studies to throw the limelight back onto the use of psychedelics for psychiatric treatment, after governments stopped sanctioned research in response to concerns over widespread recreational use in the free-wheeling 1960s. In a press release issued by Johns Hopkins University in Maryland, USA, the study’s lead researcher, Professor Roland Griffiths, from the university’s department of psychiatry and behavioural science, said earlier research had hinted psychedelics may aid psychotherapy and addiction treatment.1 However, with media headlines constantly warning of the dangers associated with psychedelics, will they ever be routinely used, and what are the risks? So far, studies on psilocybin, MDMA (ecstasy) and LSD have reported tantalising benefits from treating depression in patients with cancer, to post-traumatic stress disorder (PTSD) in rape victims and war veterans. The Johns Hopkins study in 36 adults found 58% of volunteers who received a 30 mg dose of psilocybin rated the experience among the five most personally meaningful experiences of their lives compared to controls receiving methylphenidate (Concerta), a treatment for ADHD.2 Over a year later, 64% of participants also indicated psilocybin, which affects the brain’s serotonin receptors, increased their sense of wellbeing or life satisfaction.2 PROFOUND BENEFITS An ongoing study has also shown psilocybin is effective in reducing anxiety and depression in patients with advanced cancer. A recent New York Times article reported profound benefits in one of the study’s participants, Dr Clark Martin, a 65-year-old retired clinical psychologist who had been unable to escape depression after receiving chemotherapy for kidney cancer.3 Nothing seemed to work, not even antidepressants, until he tried psilocybin for the first time and lay down on a couch listening to classical music.3 “Imagine you fall off a boat in the open ocean, and you turn around, and the boat is gone. And then the water’s gone. And then you’re gone,” he recalls of the experience.3 Over a year later, Dr Martin credits psilocybin with helping him overcome his depression and transforming his relationship with his daughter and friends. The Multidisciplinary Association for Psychedelic Studies (MAPS), a non-profit organisation based in Santa Cruz, California, has also funded two studies in the US and Switzerland to investigate whether MDMA-assisted psychotherapy can treat PTSD. The US study in 21 rape victims and war veterans with PTSD compared an MDMA dose of 125 mg, followed by a booster dose of 62.5 mg, with placebo. Randolph Hencken, MAPS director of communication and marketing, says the results showed MDMA was superior to traditional PTSD treatments with mood stabilising medications and psychotherapy. “Our results were phenomenal, about 70% to 80% of their scores on… their PTSD scale came down to the point where they didn’t have PTSD anymore,” he says. Dan Lubman, professor of addiction studies at Monash University and director of the Turning Point Alcohol & Drug Centre in Melbourne, says MDMA increases the brain’s oxytocin levels, promoting social closeness, and possibly allowing patients with PTSD to process the trauma. “By using drugs that potentially allow you a new way in to access those memories… there might be an opportunity to process them in a different way and… you might be able to deal with the trauma better and move on,” he says. In an effort to bring psychedelics into the mainstream, MAPS has more studies in the pipeline in the US, Canada, Spain, Jordan and Israel on the use of MDMA, primarily in war veterans with PTSD. On its website, MAPS boldly proclaims it aims to make MDMA into a government-approved prescription medicine for PTSD within 10 years. PSYCHIATRISTS Sceptical However, some psychiatrists like Louise Newman, professor of developmental psychiatry and psychology at Monash University in Melbourne, remain sceptical, saying it’s far too early to say these psychedelic drugs would be used in routine practice. She warns of the dangers associated with psychedelic drugs, saying they can trigger extreme reactions, including depersonalisation in patients with underlying vulnerabilities. “There certainly have been reports of people on psychedelic drugs becoming quite confused and psychotic and even harming themselves and putting themselves at risk, so it really is quite serious,” says Professor Newman, who is also president of the Royal Australian and New Zealand College of Psychiatrists. Findings from the psilocybin study back this, showing two participants compared the experience to being in a war and three indicated they never wished to repeat a similar experience again.2 Professor Griffiths says while psychedelics such as psilocybin are not physically toxic or addictive, they can trigger latent schizophrenia and, during the drug experience, cause paranoia and extreme anxiety.1 “It is not difficult to imagine such stresses leading to dangerous or inappropriate behaviours, which may constitute the substance’s most prominent risk,” he says.1 However, he adds that these behaviours were managed through a short course of psychological preparation and monitoring throughout the drug session.1 Mr Hencken remains impervious to the criticism. “I think that we have something that could be a viable option for many people,” he states. While it’s viability remains to be seen, there is little doubt its path to marketing will be a tough one, with much stigma attached to such a course of treatment. But Mr Hencken is optimistic, believing his association’s MDMA regime will pass the stringent FDA process. “As far as we are concerned… we will get through [the FDA],” he says. “Hopefully, the reality is, what we have is not a political game, it’s a science game.” 1. Griffiths psilocybin Q&A – John Hopkins Medicine 2. J Psychopharmacol 2008 22: 621-632. 3. New York Times published April 11, 2010 An article that discusses the renewed interest in psychedelics for relieving depression, anxiety and PTSD. It discusses the potential of psilocybin for helping relieve depression and MDMA’s potential in helping PTSD patients. It includes a section about the dangers of using these substances and what skeptics in the field are concerned with.