How psychedelic drugs treat mental illness differently than traditional medicine?

Renewed investigations are being conducted on the use of psychedelic substances for treating diseases like depression, anxiety, addiction, and post-traumatic stress disorder; in clinical research settings worldwide. A majority of the psychedelic substances are categorized as “drugs of abuse” with no recognized medical use since the termination of a research period from the 1950s to the early 1970s.


However, to assess the basic psychopharmacological properties and therapeutic efficacy of these drugs as adjuncts to existing psychotherapeutic approaches, controlled clinical searches have recently been conducted. The materialization of a paradigm that recognizes the importance of setting (the physical environment), the therapeutic clinician-patient relationship, and the importance of set (psychological expectations) as critical elements for realizing positive outcomes and facilitating healing experiences is central to this revival. It is understood that hallucinogenic drugs are nuanced, complex substances, and under the right circumstances can even treat anxiety, depression, and other mental and physical health issues. Doctors and researchers are beginning to offer psychedelic drugs therapeutically, although most of them lie in the legal gray area.


Psychedelic drugs include a range of substances that have substantial effects on conscious experience with varying pharmacological profiles, for example - LSD and psilocybin (the classic psychedelics). These exert primary activity as agonists at the 5-HT2A receptor. Entactogens (the second category, for example, MDMA) are primarily serotonin-releasing agents. LSD (lysergic acid diethylamide) was viewed as a likely productive drug for treating analytical psychotherapy when first developed in the 1940s. There has been a revival of curiosity in LSD and other various hallucinogenic drugs for the treatment of psychiatric disorders over the past decade.


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The studies conducted on the use of psychedelic drugs for therapeutic purposes show that there have been some essential limitations like inconsistent measures, poor research design, and small sample size, making it difficult to draw definitive conclusions. Before recommending these drugs for public use, carrying out higher-quality, longer-term studies, especially careful randomized controlled trials, become extremely important.


LSD, MDMA, Ketamine, and Psilocybin are the main psychedelics currently being examined for specific therapeutic purposes. Although some studies indicate that these substances could have a powerful capacity to treat mental health issues that have resisted traditional drugs, there is a lot that is still unknown about them and their potential adverse effects. Studies have shown that psychedelics have shown great promise as treatments for a wide range of issues, including OCD, anxiety, depression, PTSD, and addiction. For example, Ketamine (a dissociative drug traditionally used as an anesthetic), has been used as a treatment for depression, with research finding a 60%-70% success rate for severe and treatment-resistant depression.


Experiments on the hallucinogenic substance in magic mushrooms (Psilocybin) have generally focused on anxiety and depression. Psilocybin-assisted therapy sessions reduced anxiety and improved mood in 80 percent of people with advanced-stage cancer six months post-treatment, according to a critical study published in 2016 in the Journal of Psychopharmacology. Another hallucinogen, LSD, has been tested on individuals with life-threatening illnesses and, when used as an aid during psychotherapy, has been found to reduce anxiety.

MDMA or methylenedioxymethamphetamine, belongs to the second class of hallucinogenic substances (the entactogens), and acts mainly as a serotonin-releasing agent and has impacts that overlap but are distinct from conventional psychedelics; as a result, clinicians have employed MDMA (the main ingredient in molly and ecstasy that is responsible for feelings of excitation and euphoria) as an addition to therapy sessions. According to a study, a significant reduction in symptoms was experienced by first responders and veterans with severe PTSD. The FDA has recently approved a phase 3 clinical trial of MDMA-assisted psychotherapy for post-traumatic stress disorder (PTSD).


Mental health conditions vary according to an individual’s personality, brain chemistry, and life experiences; thus, disorders like anxiety, depression, and PTSD can sometimes be very resistant to conventional treatments. Psychedelics may help by ‘rebooting the brain’ in these cases. According to Lipi Roy, director of addiction medicine and community engagement at the addiction treatment center Urban Recovery, each of these psychedelic drugs contains a psychoactive component that tips the chemical balance to a more therapeutic setting. However, this does not assure that the drugs are going to work for everyone, and the potential for misuse and diversion still stays relatively high.


Most psychedelic drugs are legally scheduled and classified as having a high potential for abuse, limited or no medical purpose, and a lack of accepted safety for use under medical supervision. These substances’ potential health risks include a predisposition to psychotic disorders or precipitation of psychotic breaks in a patient with these disorders. Therefore, people with a family history of psychosis or bipolar disorder are typically excluded from contemporary psychedelic research.


Hallucinogen Persisting Perception Disorder (HPPD), sometimes known as ‘flashbacks,’ are a further risk associated with psychedelic drugs. Drugs like Ketamine can cause feelings of depersonalization (feeling like you are outside of your body, looking in) and dissociation (feeling out of touch with reality). It can also lead to confusion, rapid heartbeat, and high blood pressure. You should also inform any potential psychedelic therapy provider about any medications you’re on, or any health conditions that you have because these psychedelics could catalyze certain risks. Psychedelics can also aggravate mental health issues like bipolar disorder and psychosis, so if you have a history of these conditions, definitely bring it up with your physician.


The clinical protocols for contemporary psychedelic research incorporate some common elements to maximize potential therapeutic benefits and minimize risks, drawing on lessons learned from the earlier psychedelic research era. Development in understanding the human brain and its effective relationship with mind and consciousness would be considerably advanced by further determining how psychedelic drugs work neuropharmacologically, concerning basic neuroscience research.

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