Can that really be true? You may be wondering how that could happen given the problems that occurred with the misuse of LSD and magic mushrooms (psilocybin) by the youth culture in the 1960s. They were finally banned in the U.S. altogether in 1970 so there could be no further studies until recent years.
Psychedelics are serotonin specific agents, the same neurotransmitter that is involved in commonly used antidepressants such as Prozac or Zoloft but that’s where the similarity ends. When was the last time someone told you about their mystical transformative journey on Prozac? There has been a re-emergence of legitimate research showing a robust 50% remission rate of anxiety and depression after one single microdose of psilocybin that resembles a cure rather than the usual need to repeat doses over time. There is also a paradigm shift in using the psychedelic to catalyze the change process in therapy by helping people relax and revise biased beliefs and feel reconnected with nature, people, spirit and a sense of purpose in life. Some researchers believe the clinical benefit is not about the psychedelic itself, but the associated spiritual experience that has such an impact on a person for the rest of their lives. The use of psychedelics has been used by indigenous cultures for centuries with similar benefits and with more recent studies we are entering a psychedelic renaissance.
The truth is psychiatry is need desperate need of new treatments. Depressive disorders now comprise the world’s second greatest public health problem and mood disorders are implicated in three-quarters of suicides. Twenty two U.S. military veterans kill themselves every day. The current antidepressants only have a 10-20% advantage over placebo when an effective treatment should be closer to 50% or more. Psychedelics may offer a much more effective treatment than any traditional antidepressant with a few other benefits: good safety profile, non-addictive, rapid and enduring positive effects, reduction of suicidality, reduction of Obsessive-Compulsive Disorder symptoms, decreased end of life distress, and reduction in active addictions. There is an extremely low risk of psychosis and for that reason anyone with a personal or family history of psychosis is not a good candidate. Also, there is a 5% risk of visual misperceptions (“flashbacks” or HPPD, Hallucinogen-Persisting Perception Disorder) and from a risk standpoint that is not a small percentage and needs to be understood when consenting to treatment.
We are now in the era of rapid acting antidepressants and there is already off label use of ketamine which is not a serotonin agent but is an anesthetic with psychedelic qualities that reverses the negative effects of chronic stress with cellular resilience. Ketamine has some drawbacks including the need for repeated doses over time to maintain benefits, side effects (nausea, vertigo, dissociation, dizziness, headache) and high expense. We also don’t know the long term effects of ketamine such as tolerance or neurotoxicity. The FDA review for intranasal ketamine will be completed in the Spring 2019. Meanwhile, the VA is conducting ketamine studies for chronic Post Traumatic Stress Disorder in U.S. veterans. As for the other psychedelics such as psilocybin and MDMA (Ecstasy) more studies are planned: one study will compare psilocybin to Lexapro and another psilocybin study for treatment resistant depression will be performed at six U.S. sites. There could FDA approval for a psychedelic (either MDMA or psilocybin) as early as 2021. Can’t wait that long? You could try to volunteer for a psilocybin trial that is taking place in multiple sites across the U.S. Or you could go abroad where psychedelics are legal such as Jamaica or Mexico but you still may want to wait until the treatment is fine-tuned.