Psychedelics in the Treatment of Mental Health

Written By Rebecca Cohen

Experiments with psychoactive substances began in the 19th century in France using hashish, chloroform, ether, opium, and nightshades (Luauté, 2021). In the 1920s, the studies moved on to mescaline (Bentall, 1990) and in 1943, after seeing positive results, research on LSD began (Stoll, 1947). History exhibits several different reasons for the halt of psychedelic research in the 1970s, including the war on drugs, stricter pharmacological regulations, and a lack of funding for research (Hall, 2021).

Ketamine

Most of the ketamine research over the years has been focused on depressive disorders. According to a meta-analysis of nine studies, Fond et al. (2014) explains that there was a drastic decrease in the intensity of Major Depressive Disorder (MDD) scale scores after ketamine administration. Suicidal ideation has also been shown to decrease as a result of the treatment.

There is a small set of studies in ketamine research that show an increase in positive, negative, and total symptoms of Schizophrenia when using a specific infusion method. In a systematic review and meta-analysis by Beck, Hindley, and Borgan (2020), there is evidence that, in those studies, there is a greater number of positive than negative symptoms in Schizophrenia. The only exception to this is Schizophreniform, a disorder related to Schizophrenia, which shows increased psychotic symptoms after administration of ketamine.

Lastly, a systematic review and meta-analysis written by Whittaker et al. (2021) gave insights into the treatment of Social Anxiety Disorder, Generalized Anxiety Disorder (GAD), Post-Traumatic Stress Disorder (PTSD), and Obsessive-Compulsive Disorder (OCD) with ketamine. Results indicate that four of the six studies showed improved anxiety and fear ratings. The effects of this treatment can be prolonged with therapeutic maintenance.

Psilocybin

Psilocybin is a Schedule I illegal substance, so research is limited. The research that is published focuses on end-of-life, chronic, or terminal illness anxiety and depression symptoms, as well as other depression and anxiety symptoms. A meta-analysis by Yu et al. (2022) looked at five studies examining end-of-life anxieties. They report that, from these studies, symptoms of end-of-life anxiety decreased after psilocybin administration, and the improvement was maintained up to six months post-treatment. This study denies negative physical side effects; however, more trials need to be conducted before this is a clinically sound form of treatment.

MDMA

MDMA is also illegal, but research is more on the forefront than Psilocybin. The Multidisciplinary Association for Psychedelic Studies (MAPS) is currently doing trials on MDMA. Results show an 88% decrease in PTSD symptoms, including decreased feelings of fear, increased feelings of well-being, increased sociability, and increased interpersonal trust (MAPS, 2023). MAPS is also working on studies to examine how anxiety disorders and eating disorders may be impacted by MDMA treatment.

LSD

Research on LSD treatment is also limited, but there is some out there. A systematic review of LSD studies shows mixed results in the treatment of Alcohol Use Disorder, depression and anxiety, Psychosomatic diseases, Heroin Use Disorder, and anxiety associated with life-threatening illnesses. Due to complications with the structure of the studies, it is difficult to make strong conclusions about LSD treatment. However, the analysis concluded that “LSD is revealed as a potential therapeutic agent in psychiatry; the evidence to date is strongest for the use of LSD in the treatment of alcoholism” (Fuentes et al., 2020).

Risks of Psychedelic Treatment:

  • Addiction or higher chances of substance abuse

  • Potential for a lack of long-term effects

  • Increase in Schizophreniform symptoms

  • Insufficient research on the treatment of Schizophrenia to determine the risks

  • Small sample sizes

  • Many psychedelic drugs are illegal, limiting research

Benefits of Psychedelic Treatment:

  • Short-term substance assistance

  • Decrease in symptoms of some disorders

  • Best results when used alongside psychotherapy

Sources

Written by McKell Barrett

Published on October 25, 2023

Rebecca Cohen
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