The therapeutic potential of psychedelics
New research into psychedelic drugs has shown promise in helping to address specific mental disorders
By Margaux Chekroun
Photo courtesy of Freestocks via Unsplash.
The most widely studied psychedelic substances are lysergic acid diethylamide (LSD) and psilocybin. LSD was first synthesised in 1938 by chemist Albert Hoffmann from lysergic acid, a chemical deriving from ergot fungus. Psilocybin is similarly linked to fungi, as it is a naturally occurring chemical found across many species of fungi. Both of these substances are classed as hallucinogens. Symptoms following the ingestion of those drugs can vary but often include perturbation of the senses and illusions of perception. What we call a “bad trip” usually refers to a psychotic crisis occurring after the ingestion of those substances. These crises are characterised by the overactivation of the thalamus and under activation of the cortex. On the other hand, the mystical experience sometimes described after ingestion of those drugs corresponds to a higher activity in the cortex and lower activity in the amygdala.
Psychedelics suffer from a bad reputation as they have been widely used recreationally and can be linked to different counterculture movements and the largely unknown long term health impacts of suffering “bad trips”. This led to a subsequent ban by the United Nation in 1971. However, in the nineties, some research studies were authorised, and since then, medical research investigating the potential therapeutic effects of psychedelics is growing and gives us a more precise vision of the capacities of these drugs.
Indeed, lately it has been shown that LSD and psilocybin present very low addiction and physiologic risks. For instance, overdoses have hardly been documented in scientific literature as they remain very rare with those substances. The main risks are in fact due to the environment and setting in which people can consume psychedelics. Indeed, unsupervised and in bad conditions, the ingestion of such drugs can lead to an increase in impulsive acts that can endanger one’s life. However, it has been shown that when ingested in a medical setting with a supervisor, such as in psychedelic assisted psychotherapy, the result can suggest a positive impact on the treatment of different mental disorders. Many studies have shown that repeated, low doses of LSD can help reduce depression and anxiety. Similarly, a study conducted in 2021 demonstrated the reduction of the intensity of depressive symptoms associated with the use of psilocybin. Addiction can also be treated with psychedelics, as a meta-analysis study highlighted in 2012. A link was discovered between a single dose of LSD, and a decrease in alcohol consumption in individuals suffering from alcoholism. Another study in 2006 demonstrated the effect of LSD and psilocybin on cluster headache, as it seemed to stop the attacks and to increase the remission period.
The way LSD and psilocybin can have such effects has been observed through brain imaging and highlighted the hyperconnectivity of neuronal networks that do not usually communicate following ingestion. On the other hand, neurones which are usually connected are desynchronised, leading to an increase in neuronal plasticity, allowing the brain to “reset” and reorganise to mitigate the troubles it suffers from, whether they are psychiatric issues such as depression or even neurological issues such as cluster headache. Current studies also focus on patients suffering from life-threatening cancer and having to face the end of their lives. For instance, a study from a John Hopkins research group evidenced in 2016 that symptoms of death-related anxiety, depressed mood and general anxiety were reduced following the ingestion of psilocybin. Additionally, several months after treatment, increased levels of optimism, and a general positive attitude towards living were recorded.
Even though it cannot be argued that psychedelics such as LSD and psilocybin have positive effects on several different psychiatric conditions, research stays complicated because of the legal status of those substances. Indeed, the United Nations Convention on Psychotropic Substances from 1971, puts LSD and psilocybin in Schedule I of Controlled Substances. This means that nowadays, even though we have made significant advances in scientific understanding, these drugs are still claimed to create a serious risk to public health. Furthermore, their therapeutic value is not acknowledged by the Commission on Narcotic Drugs. This makes research a lot more difficult to conduct as many authorisations are always needed, and researchers in general are less likely to investigate substances that have such restricted access. This occurs while at the same time, more addictive and health damaging substances such as tobacco or alcohol are legalised in most countries.
However, the ingestion of psychedelics can also present risks especially if not consumed in a clinical setting. For instance, risks of triggering crises in people affected by schizophrenia are present. Hallucinogen persisting perception disorder can also occur and leave people with long lasting perception distortions after the ingestion of a hallucinogenic drug.
Finally, in the future we hope that research gives us a more precise vision of the potential treatments in which psychedelic drugs could be used, and hopefully get their therapeutic value recognised, to enable a better and wider access for patients that could benefit from those treatments.