New research explores whether psychedelic drugs, taken under strict medical supervision, can help treat post-traumatic stress disorder, chronic pain, depression and obsessive-compulsive disorder. SciLine interviewed Dr. Jennifer Mitchell-professor in the Department of Neurology and Psychiatry & Behavioral Sciences at the School of Medicine at the University of California, San Francisco-to discuss what scientists have found so far about the effectiveness of these drugs to treat the disease. disorders and how they can be treated safely.
The Conversation has collaborated with SciLine to bring you highlights from the discussion, edited for brevity and clarity.
What are psychedelic drugs and how do they work?
Psychedelic means “manifestation of the mind”, suggesting that the compound helps people to discover subjects that may otherwise be hidden from the conscious mind.
This is a slightly different term from hallucinogen, which you use almost interchangeably with the term psychedelic.
A hallucinogen by definition is something that makes you see, hear, smell something that you are not used to, so you can imagine there is a lot of overlap between psychedelics and hallucinogens.
What types of psychedelic drugs are researchers studying for potential therapeutic uses?
The two drugs most studied at this time are MDMA and psilocybin.
MDMA is being evaluated mainly for the treatment of post-traumatic stress disorder, and psilocybin mainly for the treatment of resistant depression and major depressive disorder.
MDMA is the furthest along because there is phase 3 data (data from late-stage research) and a possible new drug application will be submitted to the FDA later this year.
LSD is also being evaluated for a number of different indications, particularly obsessive-compulsive disorder.
Then some of the heavier hitters are now being tested on healthy control populations, including drugs like mescaline and ayahuasca.
What have scientists discovered about whether these drugs are effective in treating health problems like PTSD or chronic pain?
Medicines so far seem to be quite effective. I think one key, though, is that it’s usually published in conjunction with some form of psychotherapy.
So, it’s important to remember that when we look at the results of some of these new trials that these are not self-administered drugs. You don’t take a bottle of pills and take them twice a day like you do, an antidepressant. This is done in a certain way.
What is involved in therapeutic treatment using these drugs?
Usually, before taking the drug, the subject participates in several preparatory sessions so that they know a little about what will happen on the day of the experimental session.
Then the subjects came to a room that looked very much like a comfortable living room, and they spent the whole day there. The medicine is usually given in the morning. For psilocybin, you’re looking at a six-hour dosing session, and for MDMA, an eight-hour dosing session.
You are in the company of a group of trained providers: therapists, psychedelic facilitators, psychiatrists and clinical research coordinators.
What are the potential risks of using psychedelic drugs for therapeutic purposes?
One concern we have is cardiovascular risk, so we are careful in some of our current clinical trials to evaluate cardiovascular burden, including the risk of heart attack, during and after the experiment. This evaluation includes tracking the heart rate and blood pressure of the participants.
In addition, researchers are concerned about suicidality, in part because this is a treatment-resistant population to begin with, so there is concern that it may become unstable – with psychedelics, or simply with tapering. other meds to be part of the psychedelic trial-that we can open the risk of suicidality.
Finally, I think the FDA has been concerned about the potential for psychedelics to be addictive, so we have been following study participants to make sure they are not engaging in drug-seeking or taking drugs outside of the study.
What do we know about the safety of taking psychedelics outside of a clinical context?
I’ve all heard stories from the ’60s and ’70s of people taking psychedelics and having very bad experiences. What we know now is that the environment in which you take your psychedelic is the most important. It is not appropriate at this time to try to take some of these substances or replicate some of these protocols yourself without supervision.
Watch the full interview to hear more about psychedelic drugs.
SciLine is a free service based on the nonprofit American Association for the Advancement of Science that helps journalists include scientific evidence and experts in news stories.
Jennifer Mitchell, Professor of Neurology, University of California, San Francisco
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