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TESTING THE BOUNDARIES OF PSYCHEDELIC MEDICINE

Psychedelics are winning scientists and clinicians over because of their potential for improving mental health.2 Most research these days is done with psilocybin, with some centers also focusing on LSD and other psychedelics, as well as MDMA for the treatment of PTSD. Psilocybin in particular is exciting because of its favorable safety profile and capacity to improve symptoms in multiple disorders.3 Not that this property is unique to psychedelics: SSRIs, for example, are used to treat both depression and anxiety.4 But psychedelics seem to have an unusually broad range of uses. Scientists want to know just how broad it really is.

So far, initial evidence from clinical trials supports psychedelic-assisted therapy for mood disorders, PTSD, and alcohol and nicotine dependence.5,6 Scientists are continuously building on this research, their sights set on getting the regulatory green light for psychedelic therapy in the next five years – if further trials confirm its efficacy. Worldwide, eighteen Phase 2 and 3 clinical trials for these diagnoses are currently ongoing, with several more in the works. The MIND Foundation, in collaboration with Charité Universitätsmedizin Berlin and the Central Institute for Mental Health Mannheim, will also conduct a large study on psilocybin therapy for depression beginning next year.

Meanwhile, research is expanding to other mental health conditions. At its Center for Psychedelic & Consciousness Research, Johns Hopkins University has expanded its studies with psilocybin to include eating disorders. Imperial College London, also boasting a Centre for Psychedelic Research, plans to do the same. Beyond that, research teams at Yale and the University of Arizona are testing whether psilocybin is effective against obsessive-compulsive disorder.

Scientists also hope that psychedelics might help people overpower addictions beyond alcohol and nicotine. The University of Alabama is finishing up a study investigating psilocybin for cocaine addiction, and the University of Wisconsin will soon do the same for opioid use disorder.

Clinical research is also taking some more surprising turns. One notable avenue is the treatment of cluster headaches and migraines, with clinical trials running at Yale, in Basel, and in Copenhagen. The Beckley Foundation has also sponsored a recent trial in which a low dose of LSD decreased pain perception.29 And researchers at Imperial College London have proposed using psilocybin as a last resort for chronic coma patients, although their theory has yet to be tested.7

HOW TO CHANGE YOUR ABILITY TO CHANGE

Beyond knowing that psychedelics may treat certain disorders, it’s also important to know why.

Researchers have recently examined whether specific aspects of a trip make psychedelic therapy more likely to work. One crucial phenomenon appears to be the mystical experience (now an official scientific term!). Mystical experiences are characterized by feelings of ecstasy, oneness and unity, and transcendence of time and space. They are also known for being both saturated with meaning and difficult to put into words.8 Recent studies suggest that these kinds of experiences are important – perhaps even essential – for fruitful psychedelic therapy.9

At the physical level, psychedelics may promote neuroplasticity – that is, the brain’s ability to form new connections and restructure itself.10 In rats, most psychedelics promote several components of neuroplasticity in the pre-frontal cortex, and they’re more potent and quicker potent at it than nearly any other substance.11 In humans, scientists think augmented neuroplasticity may explain psychedelics’ long-term effects, and they’re busy trying to verify it.12,13 (If this sounds interesting, check out our blog post on neuroplasticity.)

Psychedelics may also work by counteracting inflammation in the brain, which is out of control in certain psychiatric disorders.14 According to Dr. Stephen Ross at NYU, reducing inflammation could also have uses beyond improving mental health. Drugs which enhance neuroplasticity and dampen neuroinflammation could be uniquely suited to treat Alzheimer’s disease and other neurodegenerative disorders. There is no evidence for this right now, but since Alzheimer’s can’t yet be cured or slowed down, it may be worth a try. Scientists at Johns Hopkins are conducting a study on psilocybin treatment for depression in Alzheimer’s disease, with plans to also measure changes in cognitive ability. And researchers at Yale have recently shown that LSD microdoses of up to 20µg are safe for older adults, opening the door for further clinical trials.14

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