Which Drugs are Leading the Psychedelic Revolution?
Before we start, we would like to remind you that Paracelsus Recovery does not endorse the consumption of illegal substances. If you take psychedelics of any sort without professional guidance and expert support they pose a danger to your health.
The Covid-19 vaccination may have been the most talked about scientific breakthrough of the past couple of years, but other medical advances have been made that also have the potential to dramatically improve lives. One of them is the ability of psychedelic drugs to treat mental health conditions.
Psychedelics (such as LSD, DMT and magic mushrooms) are hallucinogenic substances that alter our perception of time and change how we relate to our emotions, other people, and our external reality — otherwise known as a trip. Researchers in the 50s and 60s were excited by mounting scientific evidence of their effectiveness in treating personality disorders, depression, anxiety and addiction. But as recreational usage soared, the US Drug Enforcement Administration (DEA) categorised all psychedelics as Schedule I drugs, putting a halt to research.
However in 2019 Imperial College in London launched the world’s first formal research centre looking into the possible benefits of psychedelics for mental health care. Other schools across the world have followed in Imperial’s footsteps. And throughout 2021, a number of studies reinforced the potential of mind-altering substances in combination with therapy.
As their impact on neuroscience and psychiatry grows, we take a closer look at four psychedelics and the role they could play in treatment.
Major depressive disorder is a serious public health concern affecting more than 300 million individuals worldwide. Pharmaceutical therapies have long been available, but their efficacy remains limited. More and more patients are presenting with treatment-resistant depression (TRD), a form of depression that responds poorly to more than 20 different groups of medications.
In November, the biotech mental health company Compass Pathways announced it had successfully treated major depressive disorder using COMP360 psilocybin (the active compound in magic mushrooms). In their study, 233 patients were introduced to different dosages of psilocybin under a controlled environment, with psychiatric specialists assisting them through the psilocybin trip. Just one single dose of the psychedelic in conjunction with psychological support generated a significant reduction in depression that lasted up to 12 weeks.
This evidence is now academically documented and is being peer-reviewed by other scientists. The results are impressive. In fact, the US Food and Drug Administration (FDA) designated psilocybin as a breakthrough therapy in 2018, and in 2021 Compass Pathways began the largest study of psilocybin ever conducted. Consequently, we are now on the brink of major scientific advances in the use of psilocybin as an effective treatment for TRD.
Ketamine was first discovered in Belgium and received FDA approval in 1970 as an anaesthetic for animals and humans. Commonly known as a horse tranquiliser, ketamine is also a class A drug with many recreational users. But studies also show it can be highly effective in reducing suicidal ideation in those suffering from depression.
In one study, individuals at risk of taking their own life who received a ketamine injection reported, “not feeling suicidal for months.” And we are beginning to notice more and more correlations between ketamine intake and reduced depressive symptoms.
Unlike conventional antidepressants which increase serotonin levels, ketamine works on a different neurotransmitter. Known as glutamate, these chemicals play a key role in regulating our moods. Interestingly, the glutamate nerve pathway has traditionally not been associated with depression, which is why anti-depression treatments have always focused on serotonin and norepinephrine pathways instead.
But researchers at the Karolinska Institute of Sweden have found that “elevated glutamate has been linked to stress, depression and other mood disorders.” Ketamine works against these effects, by stimulating AMPA receptors which can indirectly inhibit the presynaptic release of glutamate.
In 2019, the FDA approved a Spravatro (ketamine) nasal spray in conjunction with an oral antidepressant for the treatment of resistant depression in adults. Even more promisingly, in March 2021, the UK’s first ever ketamine-assisted psychotherapy clinic opened in Bristol.
Ibogaine is a natural psychoactive substance extracted from the roots of a West African shrub belonging to the Apocynaceae family of plants. Around three million followers of the Bwiti religion, scattered across West-Central Africa, use ibogaine for spiritual celebrations and healing rituals.
Interest in ibogaine as a treatment for opioid addiction emerged in the 60s, following several amateur experiments with the drug. For example, in 1962, a 19-year-old heroin addict called Howard Lotsof experimented with ibogaine and was amazed to find it essentially wiped out his addiction. He then organised over 20 of his own drug experiments with substance-dependent friends. All were freed of both their heroin addiction and the physical withdrawal symptoms.
But it is a potentially dangerous drug and FDA and EU approved clinical trials in the 90s were halted due to safety concerns in 1993. But as opioid use continues to spiral upwards across the globe, radical new treatments are needed and ibogaine could become a powerful tool in tackling the growing crisis.
In 2021, for the first time ever, pharmaceutical companies began to invest in ibogaine research and clinical trials. Although health and safety concerns mean research needs to proceed with caution, ibogaine is finally being taken seriously.
In New Zealand, it is legal by prescription, making it easier for academics to study ibogaine. In an observational study following eleven people fighting drug dependence, eight who completed the programme have completely stopped using opioids. Although the mechanism behind this success is still not fully understood, the active metabolite noribogaine is believed to reset brain neural connections and halt signals of physical and psychological cravings.
MDMA, also known as ecstasy or Molly, is not a drug you would necessarily expect to see in a mental health research article. Wildly popular on the nightclub scene, MDMA is not only an amphetamine stimulant but also a psycho-hallucinogenic product similar to LSD.
Anatomically, MDMA stimulates the release of serotonin hormone, leading to enhanced trust and reduced fear. When administered in a controlled setting, MDMA helps people maintain a complete alert state of consciousness.
This state of elevated emotional engagement has proved to be an effective treatment for people with post-traumatic stress disorder (PTSD).
Although some PTSD patients respond positively to talking psychotherapy, others find it extremely distressing to discuss traumatic events. MDMA can help them to engage with their therapists and recall troubling events, before mindfully resolving them.
Tackling the mental health crisis
The development of psychotropic drugs, such as the four discussed here, is still in its infancy partly because of our limited understanding of the complex human brain. There is a long way to go before they enter the medical mainstream, but with each new discovery the mental health benefits of psychedelics are becoming clearer and our attitude towards them is shifting.
As we move on from the pandemic and seek to address the mental health crisis it has left in its wake in every corner of the globe, they may soon become a vital and widely accepted treatment.
At Paracelsus Recovery, our treatment ideology is grounded in our core principles of empathy, pragmatism and care. We will design a comprehensive and fully-individualised treatment programme tailored to your unique needs.
We work exclusively with ultra-high-net-worth individuals whose mental health challenges often go unnoticed due to the misconception that financial security ensures mental stability. We only treat one client at any given time, provide the strictest confidentiality, and our international team of highly qualified professionals works with the client 24/7.
We recognise that the pandemic has been a difficult time for many UHNW individuals. Because we are a treatment centre, we can stay open to support our clients regardless of wider restrictions. Alternatively, we can send our team to you and/or provide a fully-virtual treatment programme.
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