Psychedelics have come a long way from the days when LSD was part and parcel of Vietnam anti war protests. To be fair, there was already research into health benefits of psychedelics as far back as the 1950s. Unfortunately, much of the research was of poor quality and what good research that there was got shut down as psychedelics develop a stigma that took decades to overcome. Today it has become clear that psychedelics have therapeutic value for the treatment of depression, anxiety, and even post-traumatic stress disorder provided that they are used appropriately and in the correct setting. We look at two types of psychedelic use, precise doses of pharmaceutical grade psychedelics coupled with professional psychotherapy and naturalistic use.
Psychedelics MDMA and Psilocybin for Treatment of PTSD and Depression
Two psychedelic medicines are now undergoing therapeutic trials with the goal of FDA approval and use in professional treatment of depression and post-traumatic stress disorder. These drugs are used in relatively low doses and pharmaceutical grade which means they have no additives or impurities and the patient gets exactly what the doctor orders. They are used in just one or two doses as adjuncts to psychotherapy and have been shown to be safe and effective. Early study results show benefits lasting for as long as five years. This is virtually amazing considering that the alternative has been constant use of standard antidepressants in daily doses for months or even years. These medicines reduce the anxiety and stress that people feel when bringing up old, painful, frightening memories. Because a patient can now access such memories, they are able to confront old fears, put past events in perspective, and, very commonly, overcome their depression or post-traumatic stress disorder. These folks do not use such drugs on a constant basis and never use them outside of a carefully controlled treatment setting.
Naturalistic Use of Psychedelics
Psychedelics are used outside of the strict treatment settings required by the FDA to ensure safety and efficacy for human medicines. This is a naturistic use. Information about such use comes from surveys and suggests that results are obtained similar to what is seen in formal clinical trials for depression and anxiety as well an improved sense of well-being and the sorts of transformative states historically sought by psychedelic users. A recently reported survey covered 2,500 people who has used psychedelics at least once. About 12% reported negative effects ranging from extremely mild to severe. The vast majority reported reduction of depression and anxiety to the degree that it had been present in their lives and that reduction appeared to correlate highly with positive spiritual effects of taking the drug in question.
How Useful Is This Information?
This sort of survey information is useful in directing further research but is not valid in ascertaining safety or efficacy of psychedelics for treating conditions like PTSD, depression, drug abuse, or chronic anxiety. It is helpful to know that over a wide range of occasional users there are only about 12% who reported any mentionable side effects and that the vast majority of side effects were not dangerous. One concern is that those in the survey did not use pharmaceutical grade medicines and, as such, could have been taking drugs of varying strength, with or without added impurities. It is altogether possible that many of the reported side effects were not from the drug the person thought they were taking but from something that was added.
Of the people who answered the survey the most frequent number of uses was one. Thus, we are looking at a use profile similar to that used in current FDA studies. The relatively low incidence of severe or repeated side effects is reassuring in that it indicates that repeated use, if required, would not be especially dangerous. In their discussion of results the authors of the study noted diminishing returns from repeated use of psychedelics. Thus, while taking more than one dose may not be dangerous, continual dosing is likely to be less and less effective. Unlike with standard antidepressants psychedelics will not be useful as long-term modifiers of mood but rather, as is being tested now, as short term adjuncts to professional psychotherapy.