Psychedelics for Anxiety, Depression, and PTSD, Part 1

Ecstacy a/k/a Molly, Author DEA, Source https://www.dea.gov, (PD as work product of federal govt.)

“I am more convinced than ever that psychiatric medications, over the long term, cause net harm.  I wish that weren’t the case, but the evidence just keeps mounting that these drugs, on the whole, worsen long-term outcomes…The inventor of frontal lobotomy…was awarded a Nobel Prize for inventing that surgery, which today we understand as a mutilation.”

-Award-winning science author and journalist, Robert Whitaker [1][2]

Recently, a number of drug trials have been conducted re-assessing the effectiveness of psychedelics for anxiety, depression, and post-traumatic stress disorder (PTSD).

While the results of these trials have been heralded as providing new treatment options for tenacious illnesses, there are serious dangers associated with psychedelics.

Serotonin

Psychedelics act on receptors in the brain for serotonin, a neurotransmitter that effects mood.

There is some thinking that psychedelics enhance the brain’s capacity to form and reorganize synaptic connections, especially following injury [3A].  But this hypothesis needs further research.

In the therapeutic setting, psychedelics cause a receptive, dream-like state during which memories are readily accessible [3B].  The theory is that this state opens the door to fresh ideas the therapist can introduce.

Unsupervised use is not recommended.

Magic Mushroom

A small study on 59 adults reported in the New England Journal of Medicine that psilocybin (known on the street as “magic mushroom”) worked as well as the commonly used anti-depressant escitalopram (the generic form of Lexapro), over a period of 6 weeks [4].

Participants were given the psilocybin dose in a physician’s office where they could be monitored until any short-term effects had worn off.  Long-term effects were not evaluated.

Ecstasy a/k/a Molly

Ecstacy or MDMA (a derivate of methamphetamine, known on the street as “Molly”), coupled with talk therapy, was found to provide patients suffering from severe PTSD relief [5][6].  Two-thirds of participants achieved full remission at one year or more.

MDMA is now being explored as a treatment for eating disorders concurrent (comorbid) with PTSD [7].  The combination of MDMA with psychotherapy is, also, being considered for the treatment of anxiety and alcoholism [8][9].  Because MDMA is amphetamine-derived, however, it poses the risk of abuse [3C].

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[1]  Scientific American, “Has the Drug-Based Approach to Mental Health Failed?” by John Horgan , 10/17/20, https://www.scientificamerican.com/article/has-the-drug-based-approach-to-mental-illness-failed/.

[2]  Wikipedia, Robert Whitaker (author), https://en.wikipedia.org/wiki/Robert_Whitaker_(author)#Awards_and_honors.

[3A, 3B, and 3C]  Nature, “How ecstasy and psilocybin are shaking up psychiatry” by Paul Tullis, 1/27/21,   https://www.nature.com/articles/d41586-021-00187-9.

[4]  NBC News, “Psychedelic drug worked for depression as well as common anti-depressant, small trial finds” by Kaitlin Sullivan, 4/14/21, https://www.nbcnews.com/health/mental-health/psychedelic-drug-worked-depression-well-common-antidepressant-small-trial-finds-n1264093.

[5]  NY Times, “A Psychedelic Drug Passes a Big Test for PTSD Treatment” by Rachel Nuwer,  5/3/21, https://www.nytimes.com/2021/05/03/health/mdma-approval.html. 

[6]  National Institutes of Health (NIH), National Library of Medicine, “The safety and efficacy of ±3,4-methylenedioxymethamphetamine-assisted psychotherapy in subjects with chronic, treatment-resistant posttraumatic stress disorder: the first randomized controlled pilot study” by Michael Mithoefer, et al, Journal of Psychopharmacology, April 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3122379/.

[7]  National Institutes of Health (NIH), National Library of Medicine, “The potential use of N-methyl-3,4-methylenedioxyamphetamine (MDMA) assisted psychotherapy in the treatment of eating disorders comorbid with PTSD” by  Timothy Brewerton, et al, Medical Hypotheses January 2021, https://pubmed.ncbi.nlm.nih.gov/33203569/.

[8]  National Institutes of Health (NIH), National Library of Medicine, “MDMA-assisted psychotherapy for treatment of anxiety and other psychological distress related to life-threatening illnesses: a randomized pilot study” by Philip Wolfson, et al, Science Reporter, 11/24/20, https://pubmed.ncbi.nlm.nih.gov/33235285/.

[9]  National Institutes of Health, National Library of Medicine, “First study of safety and tolerability of 3, 4-methylenedioxy methamphetamine (MDMA)-assisted psychotherapy in patients with alcohol use disorder:  preliminary data on the first four participants” by Ben Sessa, et al, BMJ Case Reports 7/15/19, https://pubmed.ncbi.nlm.nih.gov/31308191/.

LSD and Cannabis will be addressed next week,
in Part 2 of this series.

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