Psychedelic Therapy: Transforming Mental Health Care

Different Types of Psychedelics

Psychedelic-assisted therapy utilizes various substances, each with its unique characteristics and effects. The following are commonly used psychedelics in clinical studies.

Psilocybin

Psilocybin is a naturally occurring compound found in certain species of mushrooms. The common name for this species is “magic mushrooms.” When ingested, psilocybin is converted to psilocin and interacts with serotonin receptors in the brain, leading to altered perceptions and hallucinations.

Psilocybin studies have found that 71% of individuals with major depressive disorder who received two doses of psilocybin responded to treatment, and half entered remission. Any type of safety issues, such as mental health complications, were lacking in the case studies, with less than 0.1% experiencing adverse effects.

The studies also showed that individuals had a low likelihood of misusing psychedelics, and the mushrooms don’t have addictive properties like other types of substances.

Psilocybin therapy has also shown great potential in alleviating anxiety symptoms. Research has demonstrated that a single dose of psilocybin can lead to significant and long-lasting reductions in anxiety and improved quality of life.

Ketamine

Ketamine is an anesthetic that has recently gained attention for its potential antidepressant effects. Ketamine produces a dissociative state in the individual and can cause euphoric sensations. Even at low doses, ketamine produces profound changes in perception and consciousness.

It is primarily used in clinical settings for the treatment of treatment-resistant depression. Clinicians administer ketamine in microdoses within a controlled setting that allows physicians to better monitor the patients.

Ketamine is administered via IV infusions. Esketamine can be used as a nasal spray.

The effects of ketamine have been described as immediate, with patients reporting reduced depression symptoms in under 24 hours after the initial dose. Benefits are rapid, but since ketamine treatments typically have only been studied for up to six weeks, long-term effects have not yet been demonstrated. However, in clinical settings, ketamine therapy has been observed as being an effective barrier to suicide.

MDMA

MDMA, also known as ecstasy, is a synthetic hallucinogenic that primarily affects a person’s mood. MDMA is often referred to as ecstasy because a person will feel a close connection with others. People who use MDMA may feel more energized and have distorted feelings about reality.

Studies on MDMA-assisted psychotherapy for PTSD have shown promising results. The therapy involves a combination of psychotherapy sessions and MDMA administration, creating a safe and supportive environment for patients to process traumatic experiences.

During a clinical trial in 2021, researchers evaluated 90 test subjects with severe PTSD that had occurred for years.

Participants were required to complete a 12-week program where researchers gave either MDMA or a placebo. After the study, 67% of the MDMA group no longer qualified for a PTSD diagnosis compared to 32% of the placebo group.

LSD

Lysergic acid diethylamide (LSD) is a potent hallucinogenic substance that alters sensory perception, cognition, and mood. The effect of using LSD is known as “tripping.”

LSD-assisted therapy involves the use of the drug in a therapeutic setting. LSD therapy sessions are typically conducted under the guidance of trained therapists, allowing patients to explore their emotions, thoughts, and memories in a potentially transformative way.

Research suggests that LSD-guided therapy can be effective in treating various mental health conditions, including anxiety, depression, and addiction.

DMT

Dimethyltryptamine (DMT) is a naturally occurring compound in certain plants and animals and is also available in synthetic form. DMT provides short-acting psychedelic experiences but is very powerful.

Various cultures have used DMT for hundreds of years, with one of the active ingredients being ayahuasca. DMT is being evaluated for mental health purposes since its effects can include:

• A heightened spiritual and emotional experience
• Feelings of intense happiness
• An ability to unlock hidden memories

Latest Research and Studies on Psychedelics To Treat Mental Health

Studies on animal and human subjects have proven that psychedelics can produce long-term behavioral effects. The compounds can have a direct impact on depression, anxiety, and other psychiatric disorders. Neuroimaging studies performed during clinical trials have demonstrated that psychedelics can alter functional connectivity in the brain, including decreasing connectivity within the DMN.

However, the therapeutic effects of psychedelics are not yet well understood. More studies are needed to know how different psychedelics affect the brain. Researchers also need further proof of the drug’s addictive potential to confirm that it’s low enough for therapeutic use.

One challenge of clinical research is the well-known, highly perceptible effects of these compounds. Outcomes are being impacted because of how test subjects perceive the drugs are affecting their mental state. There are high expectations when participants know that psychedelics are part of the clinical trial protocol.

Therefore, the reported therapeutic benefits may not be accurate. Since psychedelics have such powerful effects, even in double-blind studies, it’s apparent to subjects and investigators who have received the study drug and who have received the placebo.

However, since psychedelics have demonstrated such potential, the FDA has granted breakthrough therapy designations to psilocybin-assisted psychotherapy for major depressive disorder and treatment-resistant depression and to MDMA-assisted psychotherapy for PTSD. This procedure helps fast-track the approval process.

Ongoing and future research aims to explore the use of psychedelics for a broader range of mental health conditions, including bipolar disorder, personality disorders, and early-stage Alzheimer’s disease.

Is Psychedelic Therapy Legal?

LSD, MDMA, psilocybin, and DMT are all classified as Schedule I Substances by the U.S. Drug Enforcement Agency. The designation makes these psychedelics illegal at the federal level.

In the U.S., psychedelic-assisted therapy is still in the clinical trial stage. Individuals would need to enroll in a trial to access this form of treatment. The outcomes of these trials will potentially pave the way for legal use in clinical settings.

Ketamine is classified as Schedule III, having less potential for misuse than Schedule I, and is federally legal for use by registered medical practitioners.

Several states and cities are pushing to legalize psychedelics for therapeutic purposes. Oregon was the first state to legalize psilocybin therapy. Colorado soon followed and also legalized magic mushrooms. California, New Jersey, and Connecticut have introduced bills to legalize psilocybin for medical or recreational use.

How Long Do the Effects of Psychedelics Last?

The duration of psychedelic effects varies depending on the substance and how much the patient ingests. For instance, the effects of magic mushrooms can last between four and six hours. Meanwhile, LSD trips can range from eight to 12 hours.

Notably, clinical studies are evaluating more than just the short-term effects. Clinical trials help determine if psychedelics can alter behaviors for weeks, months, or even years.

How Is Psychedelic Therapy Conducted?

Psychedelic therapy follows a structured process to ensure patient safety and maximize benefits.

Consultation

An initial consultation must occur before any therapy is considered. During the session, a trained mental health professional reviews the individual’s mental health history and gauges their current state of mind. The consultation helps determine whether psychedelic therapy is an appropriate treatment for the individual. The provider may choose to meet with the candidate multiple times before deciding on psychedelics as a course of treatment.

Discussing Safety Protocols

Safety is one of the most critical considerations in psychedelic therapy. Since most therapies are still in the clinical trial phase, individuals must fully understand the potential risks and benefits of psychedelic substances. Patients must sign an informed consent document as part of their process before receiving any dissociative medication.

Administration

Within clinical settings, the patient ingests the psychedelic substance, typically administered orally in the form of capsules or tablets (or in the case of ketamine via IV infusion or nasal spray). The dosage is determined based on the individual’s mental health needs and the specific hallucinogenic being used.

Professional Observations

Typically, there are two to three sessions where the patient is administered the psychedelic substance under the guidance and supervision of a trained therapist. After being given the study drug, patients receive close monitoring. Trained professionals are on hand to provide a safe space for individuals who are experiencing the powerful effects of hallucinogens.

Integration

Taking a psychedelic is only one part of the process. Patients must also meet with therapists to reflect on their experiences while on the psychedelic. The mental health professional will want to encourage the patient to talk about any insights gained during the experience. It’s vital to apply whatever they learned during the psychedelic experience to their everyday life.

Ongoing Therapy

Psychedelic therapy isn’t a one-time treatment. Patients will need additional resources to support accountability, growth, and healing. Options may include ongoing psychotherapy appointments or supplemental medication.

The Importance of Professional Support

Psychedelic drug therapy must be conducted under the guidance of trained professionals. The following are some of the top reasons why patients should never attempt to take these substances without the support of a trained mental health professional.

Potential for Bad Trip and Injury

Psychedelic experiences can be intense. Without proper support, individuals may risk experiencing a “bad trip.” Patients could experience panic, feelings of intense fear, and heightened anxiety. Physical symptoms, such as nausea and vomiting, may also occur after taking a psychedelic.

Get More Out of the Experience

Trained professionals can provide guidance to help individuals make the most of their experiences. A therapist can suggest ways to process any insights the patient may experience and note any effects the individual may not recall while “tripping.”

Contamination Risks With Illegal Substances

If a person illegally obtains psychedelics for use as a mental health treatment, there’s a chance that the drugs can be contaminated with other substances. Without any regulations, individuals may end up ingesting dangerous drugs, such as methamphetamine and fentanyl.

How Therapies Can Support the Psychedelic Experience

Psychedelic-assisted psychotherapy (PAP) refers to the use of psychedelic drugs in combination with psychotherapy. PAP is still considered a novel treatment model. Its main objective is to have the psychedelic substance and psychotherapy work together to create prompt and long-lasting psychological and behavioral changes.

The goal is to have PAP work even for treatment-resistant conditions like PTSD and depression.

Cognitive behavioral therapy (CBT) may also be useful alongside psychedelics. Through CBT, professionals focus on changing negative thought patterns and behaviors. When combined with psychedelic treatments, CBT can provide additional support.

Microdosing vs. Tripping

One part of using psychedelics for therapy is understanding the difference between microdosing and tripping. For microdosing, patients take small doses of psychedelics on a regular schedule. A standard microdosing schedule is to ingest a psychedelic every few days. Microdosing aims to use the substances without bringing on a whole psychedelic experience.

On the other hand, “tripping” refers to taking a full dose of a psychedelic substance. The person will then likely experience the typical psychedelic effects.

What To Expect During a Psychedelic Experience

Every psychedelic experience is unique, and individuals will likely have varying reactions. However, the following are some everyday events often seen during psychedelic treatment therapies.

Hallucinations

Psychedelics can cause different types of hallucinations. These hallucinations can range from very subtle distortions to vivid experiences. Individuals may see or hear things that aren’t there.

Out-of-Body Experience

Some individuals may have an out-of-body experience. During an out-of-body experience, the person will feel a sense of separation from their physical body, as if they are free to explore the world at a higher level of expanded consciousness.

Dissolving of Ego

Psychedelics can temporarily lead to what’s known as the “dissolution of ego.” During this experience, the person loses what is considered their ordinary sense of self. When this occurs, the individual can gain a better understanding of themself almost as a third-party observer.

Sense of “Oneness”

Many individuals report feeling a profound sense of interconnectedness with something greater than themselves. This oneness may be with the universe, humanity, or a spiritual entity.

Sixth Senses

During a psychedelic therapy experience, individuals may feel as if they almost have a sixth sense. For instance, users may report effects like “hearing colors.” The person may also feel as if they are reliving memories they had long suppressed.