A seismic shift is taking place in the field of psychiatry. We are at the start of an era in which psychiatric medicines do not just cover over symptoms of mental health problems or temporarily suppress them. How psychedelics are changing psychiatry is this. As an era of psychedelic medicines arrives it brings with it the promise of changing the brain itself in order to cure mental health problems. We have written about how MDMA and psilocybin have achieved breakthrough drug status for their ability to help in treatment of depression and post-traumatic stress disorder. What especially has the psychiatric community excited is that they appear to do this by altering individual brain cells and “rewiring” the brain in the process.
Research Into Psychedelic Medicines
There are two levels of research into psychedelic medicines going on today. One is to identify psychedelics that can be used for medicines and to confirm that they are useful and safe. This is what is happening with MDMA and psilocybin as they pass through FDA clinical trials. The are also studies going on for LSD, ayahuasca, and other psychedelics for treatment of depression, PTSD, and substance abuse disorders especially. These studies are looking for practical uses of psychedelics and studying their safety as medications for humans.
Additionally, there is basic research going on to understand at the very basic level what psychedelics do in the brain and how they do it. This, especially, is what has the psychiatrists excited today.
Psychedelics “Rewire” the Brain
This kind of research relies heavily on animal studies such as giving the drugs to mice or rats and dissecting and studying their brains afterward. What researchers have found is psilocybin, for example, alters the dendrites or branch structures that extend from nerve cells and connect with other nerve cells. This changes the ability of the cell to connect with and communicate with adjacent cells. These are physical changes and totally different from how standard drugs work where they facilitate or block nerve connections but do not make any physical changes.
Researchers have found that new bumps or protrusions of dendrites called dendritic spines form within a day after mice are given psilocybin. There is about a 10% increase in these protrusions which allows cells to cross connect with other cells at a higher rate or level. Furthermore, the increase in connections lasts for months after just one dose of the psychedelic drug. What is of interest to clinicians is that these changes might help explain why taking just one dose of psilocybin or MDMA helps bring about improvements in depression or PTSD that last for months and even years. Researchers talk about improving brain plasticity which in turn helps the brain adapt and learn. Clinical research has shown that psychedelics improve brain plasticity and now basic research has provided clues as to why this happens.
Explanations for “One and Done” Treatments With Psychedelics
When research subjects with depression anxiety, or post-traumatic stress disorder receive a psychedelic medicine like MDMA or psilocybin as an adjunct to coaching or psychotherapy they commonly only need one dose and one session to see improvements that last up to many years. This is in contrast to standard antidepressants that have been used in the same manner to help make talk therapy more effective. The antidepressants need to be taken daily for weeks, months, or even years to help. This is because their effects are temporary in blocking for facilitating brain connections. The permanent or semipermanent effects of psychedelics appear to come from physical changes in the brain and its connections which is why researchers talk about “rewiring.”
Although only psilocybin and MDMA have progressed to clinical tests with the likelihood of being approved for treating humans, both LSD and ayahuasca have been shown to also produce long term effects consistent with brain rewiring.
Psychedelic Side Effects and Usefulness as Medicines
A promising aspect of using psychedelic medicines is that they do not need to be taken constantly. Thus, the typical problems of psychiatric drugs that they sedate or otherwise bother people are less of an issue. However, psychedelic medicines can cause hallucinations which can be quite disturbing to many people. As such it is important that psychedelics only be used in controlled settings with a trained therapist or coach as a guide.
