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In years gone by, psychedelics have evoked an easy-going, carefree moment in time, ca...
In years gone by, psychedelics have evoked an easy-going, carefree moment in time, calling to mind scenes of hippie counterculture and swirly neon patterns.
Today, however, psychedelics aren’t about free love and world peace. No, this time round, the new wave is serious in considering the scientific and therapeutic benefits of mind-altering drugs, such as psilocybin, MDMA, and ayahuasca.
In fact, as a growing number of scholars at renowned institutions are researching the effects of psychedelics on mental health with promising results, a wave of investment is flowing into the research area.
Even though most of the drugs in question are still illegal, more than $3 billion has been raised on the promise that psychedelics could be the magic cure for mental health conditions ranging from depression to drug addiction.
So, with the fitting quest of expanding our minds, today we’re looking into the ‘psychedelic renaissance’ to understand if they really have a place in the world of Life Sciences and if they could be what the growing mental health crisis has been waiting for.
Psychedelics, also known as hallucinogens, are a class of psychoactive substances that can alter an individual’s perception, mood, and cognitive patterns.
They often induce a profound change in consciousness and are most well-known for their ability to produce vivid sensory experiences, such as visual hallucinations and altered states of awareness.
Truthfully, psychedelics have been used for centuries in various cultural and religious contexts, but due to their properties, they’ve more recently been adopted by the Life Sciences industry to explore the potential therapeutic benefits in treating mental health disorders, such as depression, anxiety, PTSD, and addiction.
As seen in the Netflix docu-series, How To Change Your Mind, psychedelics have a long, complex, and controversial history as a means of medicine.
While they date back centuries in various cultures around the globe, in the Western world of medicine, it was the mid-20th century when they were first taken seriously for their therapeutic uses.
Throughout the 50s and 60s, LSD and other drugs in the psychedelic family were studied for their effects on mental illness and addiction. And although promising results were reported, growing recreational use and increasing concerns about their safety meant that research into their therapeutic potential was soon shut down.
Now, decades on, there’s been a resurgence in exploring the use of psychedelic drugs as medicine. In fact, with promising results from numerous clinical trials, in 2021, the FDA designated psilocybin as a breakthrough therapy for treatment-resistant depression.
That means that the agency recognizes the potential of the therapy to address an unmet medical need and can accelerate the famously slow-moving process of drug development and review – a huge step forward.
Did you know that 5% of adults suffer from depression, and up to 30% of those suffering from the condition don’t respond to treatment with antidepressants?
For this reason, there’s an urgent need to expand the range of approved therapies available. And now, researchers might have found a cure with none other than magic mushrooms!
Psilocybin, the active compound found in magic mushrooms, changes the brain’s response to serotonin. When our livers break it down, it causes an altered state of consciousness and perception, and after being used in several clinical trials, results show it can rapidly relieve depression.
For example, one study by John Hopkins found that psychedelic treatment with psilocybin, in conjunction with supportive psychotherapy, relieved major depressive disorder symptoms in adults that could last up to a year.
In the study, 27 participants aged 21-75 with a history of major depressive disorder (MDD) and who had experienced persistent depressive symptoms for approximately two years prior to the research were randomized into two groups. The first group was treated immediately, while the second group was administered psilocybin after an eight-week waiting period.
Over two weeks, all participants received a first dose of 20mg of psilocybin and a second dose of 30mg. The results found that both study groups experienced a decline in depression after the treatment, which remained low one, three, six, and twelve months afterward.
To judge depression symptoms, the Hamilton Depression Rating Scale was used, which is a typical depression assessment tool. A score of 24 or above indicates severe depression, 17-23 moderate depression, 8-16 mild depression, and 7 or less no depression.
On average, participants scores decreased from 22.8 pre-treatment to 9.7 after one week of treatment, 8.9 after four weeks, 9.3 after three months, 7 after six months, and 7.7 after twelve months. What’s more, 58% of participants were considered to be in remission twelve months after the treatment, meaning they no longer qualified as being depressed.
Another double-blind, randomized trial took 59 depression patients and split them into two groups. One group was administered psilocybin while the other took the existing antidepressant, escitalopram.
The trial was then further examined using fMRI brain scans, comparing the results with other fMRI findings from a separate clinical trial. The results discovered that just one day after the first dose of psilocybin, fMRI measures revealed an overall increase in connectivity between the brain’s various networks, which are typically reduced in those with severe depression.
In comparison, the brains of the participants taking escitalopram showed no change in connectivity between brain networks six weeks after treatment began. Furthermore, psilocybin had the greatest effect on overall wellbeing, with 70% of patients showing clinical response compared to only 48% of those treated with escitalopram.
On top of that, 57% of patients in the psilocybin group were considered in remission at six weeks, compared to just 28% of the escitalopram group.
Both of these studies suggest that psilocybin not only produces significant and instant effects on depression, but it also has duration, which standard antidepressants do not – they usually need to be taken for long stretches of time to have an effect.
Therefore, psilocybin shows promise as a depression therapy, being an ideal treatment option for patients who don’t respond to existing antidepressants and moving us closer to expanding depression treatments on the market.
PTSD, or post-traumatic stress disorder, is an exceedingly common yet debilitating condition that affects the lives of hundreds of millions of people around the world.
The condition can have some severe social and economic side effects on those affected, and at the moment, current treatments are considered only moderately effective, with 40-60% of patients not responding to FDA-approved PTSD therapies.
What’s more, poor PTSD treatment outcomes are often associated with comorbid conditions, such as childhood trauma, alcohol and substance abuse, depression, suicidal ideation, and dissociation.
But today, new research indicates that MDMA-assisted psychotherapy can significantly reduce symptoms of anxiety disorders, including PTSD.
MDMA, more commonly known as ecstasy, is typically a party drug. It induces a release of serotonin and, more recently, has been shown to increase the ability to process traumatic events and improve social behavior, with a Phase III clinical trial finding that MDMA-assisted therapy successfully reduced the symptoms of patients with severe PTSD.
The trial in question began with 91 participants who were reflective of the demographics of those living with PTSD in the US, with ethnic minorities representing more than half of the patient population. They were then split into two randomized groups. The first group received an 80-120mg dose of MDMA alongside psychotherapy, followed by a supplemental half-dose of 40-60mg. The second group received psychotherapy and a placebo drug in place of MDMA.
Across the 15 separate study sites, MDMA significantly reduced the symptoms of PTSD in comparison to the placebo drug. What’s more, it was found that MDMA didn’t trigger any adverse events, such as drug abuse or suicidality, even in those with comorbidities, which only goes to show that MDMA-assisted therapy could be a highly effective treatment for individuals suffering from severe PTSD or for those who do not respond to the currently available FDA-approved PTSD treatments.
Back in January this year, Amy Emerson, CEO of MPS PBC, who conducted the study, commented, “The Phase III confirmatory results support the development of MDMA-assisted therapy as a potential new breakthrough therapy to treat individuals with PTSD – a patient population that is often left to suffer for years. Now, with two positive Phase III trials complete, we can add this important data to the new drug application, which we expect to submit in the third quarter of this year.”
Addiction is an epidemic of its own, with an estimated 35 million people affected by drug use disorders, tobacco killing 8 million people annually, and 3 million deaths per year a result of harmful use of alcohol.
So, how do we overcome addiction? Well, a growing number of studies are suggesting that tripping on ayahuasca might just be the way!
Ayahuasca is a highly potent plant-based psychedelic brew that contains the psychoactive ingredient DMT. It’s only really available in the Amazon basin, where it naturally grows, and for centuries, South Americans have joined ayahuasca ceremonies conducted by spiritual leaders known as Shamans to use the plants’ properties to treat both spiritual and physical ailments.
But now, modern medicine is researching ayahuasca’s therapeutic benefits to overcome substance use disorders. For example, one study examined the psychedelic brew’s effects on individuals suffering from drug addiction and unresolved grief.
Throughout the study, all participants received a dose of ayahuasca in a ceremonial setting, followed by counseling and group therapy. Then, at one, six, and twelve months after the ceremony, the participants were followed up to assess any changes in their substance use and emotional wellbeing.
Overall, the results showed significant improvements in depression, anxiety, and substance use – particularly for alcohol and cocaine. In the twelve-month follow-up, 58% of participants reported complete abstinence from drugs and alcohol, and all participants reported improved emotional wellbeing and decreased grief symptoms.
Similarly, another study in Brazil saw 159 individuals suffering from substance use disorders, including alcohol, tobacco, and cocaine, undergo a one-day ayahuasca-assisted therapy session. This included a dose of ayahuasca, individual psychotherapy, and group therapy.
The results of this study found significant declines in substance use in the twelve months following ayahuasca-assisted therapy. In fact, just 16.4% of participants reported using substances at the twelve-month follow-up compared to 100% before the trial. What’s more, the results also showed improvements in mental health outcomes, including anxiety and depression.
It’s fair to say that both of these studies proved promising preliminary evidence for the potential therapeutic benefits of ayahuasca on substance use disorders and associated psychological distress. That said, it’s important to note that they also have limitations, such as small sample sizes and a lack of control groups.
With ayahuasca being an extremely powerful psychedelic drug, more research is definitely needed to ensure the safety of ayahuasca-assisted therapy and explore its underlying effects.
OCD, or obsessive-compulsive disorder, is a psychiatric disorder whereby people have recurring obsessive thoughts, urges, images, and fears that cause them to act compulsively and repetitively. It can severely impact people’s daily tasks, often making it extremely difficult to leave their homes, go grocery shopping, interact with others, or meet work-based demands.
Despite OCD affecting around 2% of the population and being classed by the World Health Organisation as one of the ten most debilitating illnesses to live with, it remains a complex condition to understand. To this day, there are still arguments over whether it’s an anxiety-based condition or a distress-derived disorder, meaning there’s no comprehensive definition nor an agreed-upon treatment.
At present, FDA-approved OCD treatments include SSRI medication (selective serotonin reuptake inhibitors, a widely used form of antidepressant) and cognitive behavioral therapy (CBT), as well as transcranial magnetic stimulation (TMS, a non-invasive treatment that exerts a series of short magnetic pulses to stimulate nerve cells in areas of the brain known to be associated with major depression).
But, with SSRIs only achieving a modest remission rate for sufferers of chronic OCD and many OCD patients considered treatment-resistant, researchers are turning their attention to less conventional options, including the magic mushroom compound, psilocybin.
The very first study to treat OCD with psilocybin was conducted back in 2006. At the time, nine patients received psilocybin up to four times each, with doses ranging from ‘very low’ to ‘frankly hallucinogenic’.
The results found that all nine participants showed immediate improvement in their OCD symptoms following at least one session, as well as improved mood and anxiety levels. On top of that, it was reported that the psychedelic drug was proven safe and well-tolerated.
Up until now, that widely cited study has stood as the only modern investigation into the effects of psilocybin on OCD symptoms. However, today, a Phase II double-blind placebo-controlled study is currently underway at Yale (in collaboration with Ceruvia Life Sciences). The trial aims to determine the efficacy and safety of synthetic psilocybin on OCD patients.
What’s more, Francisco Moreno, the University of Arizona professor of psychiatry who led the 2006 study, is beginning another trial (initially postponed due to COVID-19) also looking into the effects of psilocybin on OCD. In this instance, the team of researchers will look at fMRI brain scans to determine the impact of psilocybin on brain connectivity.
So, while we must patiently wait for more clinical trial results to truly understand if psilocybin could be a breakthrough treatment for OCD, experts in the field seem to have high hopes. That’s because evidence from the National Institute on Drug Abuse reports that the magic mushroom compound can produce perceptual changes, altering a person’s awareness of their surroundings, thoughts, and feelings.
Psychedelics have long been found to increase brain connectivity and neuroplasticity, contributing to their therapeutic effects, as mentioned in the studies above. However, many unanswered questions remain, meaning more research is needed to fully understand the long-term effects and potential risks and identify optimal dosing and administration protocols.
It’s also worth noting that all the above-mentioned studies were conducted in highly controlled research settings, so it’s not yet clear how these therapies will work in real-life settings.
With that said, the study of psychedelics in Life Sciences is undoubtedly a growing area of research, with the promising potential of improving mental health treatments. Do you think 2023 will be the year psychedelic medicine becomes mainstream? We’d love to hear your thoughts!
If you’re interested in reading more on alternative therapies, take a look at the 5 Ways Life Sciences is Utilising CBD as Treatment.