First-line therapy for mood disorders and stress-related illnesses still depends on neurotransmitting systems, despite decades of study. This approach has made very little progress since the initial invention of inhibitors of monoamine oxidase in the 1950s. Most antidepressants have improved in terms of safety and tolerability, although many patients won't fully recover. However, as these therapies are not "cures" and do not permanently alter the underlying neurobiology, they certainly need to be repeated in order to have an impact. Although the introduction of cognitive-behavioral therapies for certain anxiety and stress-related diseases has also contributed to some progress, these therapies are only modestly successful, leaving a significant number of patients still symptomatic. Over the course of 46 months, 43% of individuals who had undergone CBT had improved, indicating at least a 50% reduction in depressive symptoms, as opposed to 27% of those who stayed with their normal treatment alone. The potential of psychedelics and psychedelic-assisted therapy to treat mood and anxiety disorders, trauma and psychosomatic illnesses, and drug use disorders has received a lot of media and research attention in recent years. A range of factors has raised the possibility of using psychedelic-assisted psychotherapy to treat anxiety problems. First, psychedelic-assisted psychotherapy for certain anxiety disorders has been the subject of some research. The use of psychedelic-assisted psychotherapy is made possible by studies looking at other mental disorders, such as mood disorders, trauma- and stress-related disorders, and disorders related to stress and trauma, which have shown decreases in psychological factors that collectively may also be present in anxiety disorders. Finally, there is growing neuroscientific and clinical evidence that psychedelics have therapeutic potential. A systematic review showed that 20% of patients treated with psychedelics saw "dramatic improvement," in their clinical conditions 41.9% experienced "moderate improvement," and 22.6% exhibited no change. The therapeutic process of psychedelic-assisted treatment can alter brain circuitry and cognitive constructs linked to disease across a wide range of conditions.
Psychedelic Drugs as Reemerging Treatments for Anxiety Disorders
Psychedelics, such as psilocybin and LSD, have shown promising results as potential treatments for anxiety disorders in recent studies. These substances have been found to produce profound and enduring changes in mood, cognition, and behavior, which may make them useful for treating conditions such as post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and generalized anxiety disorder (GAD).
Challenges and risks
One of the main challenges in using psychedelics as a treatment for anxiety disorders is their legal status. Many of these substances are classified as Schedule I drugs around the world, which makes it difficult for researchers to conduct clinical trials and for patients to access treatment. In recent years, there has been a growing movement to decriminalize and even legalize psychedelics for medical use, which could help to overcome this barrier. Another challenge is the potential for adverse effects. While psychedelics are generally considered safe when used in controlled settings, there is a risk of adverse reactions, particularly in people with pre-existing mental health conditions or in those who take these substances in uncontrolled settings. Additionally, some people may have intense and overwhelming experiences while under the influence of these substances, which could exacerbate anxiety or other mental health conditions. Another challenge in psychedelic research is that the mechanisms of action of psychedelics are not yet fully understood, and more research is needed to determine how these substances produce their therapeutic effects. This includes understanding the neural mechanisms involved, as well as the psychological and spiritual experiences that can occur during a psychedelic experience. Despite these challenges, the potential benefits of using psychedelics as a treatment for anxiety disorders are significant. For example, a recent study found that a single dose of psilocybin significantly reduced anxiety and depression in people with life-threatening cancer. These benefits persisted during the 6-month follow-up, with nearly 80% of patients continuing to exhibit clinically significant reductions in anxiety and depressive mood. Other studies have found that psilocybin can increase feelings of empathy and reduce social anxiety in healthy volunteers. Overall, the use of psychedelics as a treatment for anxiety disorders is developing, with significant possibilities and challenges. While more research is needed to fully understand these substances' potential benefits and risks, early results suggest that they may hold promise as alternative treatments for people with anxiety disorders who have not responded to traditional therapies.
Clinical Trials of Psychedelic Compounds
Psychedelic drugs, such as LSD, psilocybin, and MDMA, have been the subject of a growing number of clinical studies in recent years. Here are some key findings from these studies.
Psilocybin treatment
Psilocybin treatment has shown promise in treating depression and anxiety. In one study, a single dose of psilocybin led to significant reductions in symptoms of major depressive disorder and anxiety in patients with life-threatening cancer. As previously mentioned, a study found that a single dose of psilocybin reduced the symptoms of 80% participants 6 months post treatment. Another study found that psilocybin reduced symptoms of depression and anxiety in patients with treatment-resistant depression.
MDMA
MDMA has shown promise in treating PTSD. In several clinical trials, MDMA-assisted psychotherapy has been found to be effective in reducing symptoms of PTSD after 1 to 2 months in patients who have not responded to traditional treatments. The FDA issued MDMA a breakthrough therapy designation in 2017 to MAPS, which is also preparing a small trial on MDMA-assisted therapy for anxiety and eating disorders. MAPS is using MDMA to treat post-traumatic stress disorder (PTSD).
LSD
LSD has been studied for its potential to treat cluster headaches. While more research is needed, early studies have shown that LSD may be effective in reducing the frequency and severity of cluster headaches.
Ketamine and Esketamine
The FDA authorized ketamine, a Category III substance, as an anesthetic in 1970. Vivid visions and "mystical and peak" experiences are just a few of the psychedelic effects it may produce. Ketamine can be given intravenously, intramuscularly, or orally, or it can be taken orally as a powder, lozenge, or nasal spray. Esketamine, a ketamine derivative, is FDA-approved as a nasal spray to treat depression that is otherwise resistant to therapy. The esketamine spray, also known as Spravato, must be used in a licensed physician's office or clinic under close supervision.
Psychedelic Assisted Psychotherapy
Early applications of psychedelic drugs were founded on modern, psychoanalytically based knowledge of mental disease and concentrated on the belief that psychedelic drugs might be used in psychotherapy to lessen ego barriers. Known as psycholytic treatment, this approach aimed to use the drug experience to improve a psychodynamic understanding of patients' problems by repeatedly administering low to moderate doses of psychedelics, often lysergic acid diethylamide (LSD), during therapy sessions. A significant amount of preparation was required for psychedelic-assisted psychotherapy, including lengthy therapy sessions prior to a single, high-dose drug session. A series of integration therapy sessions then followed, during which the client was encouraged to interpret what happened during the psychedelic experience. The use of ensuring a calming atmosphere and décor, frequently with the accompaniment of melodies and eyeshades to emphasize an internally focused experience, was added to the classic psychedelic alone session, which was always presided over by a therapist but with emphasis on the patient's internal experience (nondirective). Setting (a relaxed, nonclinical environment) and set (the patient's thoughts or expectations brought to the session) received particular consideration. This approach has been substantially maintained today, and practically all clinical studies conducted in the modern age have used it to some extent. The psychedelic drugs-administering sessions typically maintain this nondirective, psychedelic psychotherapy model, despite the possibility that some protocols may integrate the psychedelic drug-assisted therapy sessions into already-existing organized data programs, such as programs based on cognitive-behavioral therapy or motivational therapy.
Overall psychedelic therapy
Psychedelic therapy has been found to increase feelings of well-being, empathy, and spirituality. In one study, psilocybin was found to increase feelings of well-being and life satisfaction, while another study found that psilocybin increased feelings of empathy and interpersonal closeness. LSD has been found to increase feelings of spirituality and connectedness. Psychedelic compounds can induce mystical experiences. Studies have found that psilocybin and LSD can induce mystical experiences, which are characterized by feelings of unity, transcendence, and ineffability. It is worth noting that these studies are still in their early stages, and more research is needed to fully understand the full potential benefits and risks of psychedelic compounds. Additionally, the use of these compounds in a therapeutic setting should only be done under the guidance of trained professionals.
Mental health care and psychedelic therapy
Anxiety and treatment-resistant depression in cases of life-threatening illness
As she draws closer to an unexpected death, Anne Baldeschwiler, 57, who has metastatic advanced cancer, is battling cancer-related anxiety and depression. She claims, "I don't want to be fearful, worried, or apprehensive, especially when I pass." She is aware that her condition will not respond to any therapy. She is, however, battling to access experimental psilocybin-assisted therapy, which prior studies have shown helps reduce anxiety and depression for cancer patients with terminal diseases. The federal Right to Try statute should already make psilocybin and MDMA accessible to eligible patients. According to the 2023 law, patients with life-threatening diseases who have used up all available treatment choices may access medications that have been through Phase 1 testing. Phase 1 testing means that the initial stage of clinical research is trials in which medications are tested on people, but have not yet received FDA approval.
Obsessive-compulsive disorder
In the field of psychiatry, it is uncommon to find a therapy that can dramatically and instantly reduce long-lasting symptoms in a patient. When administered in an environment of interpersonal support by a skilled professional, psilocybin therapy is not only secure but also has the potential to quickly and significantly reduce overall OCD symptoms and generally enhance the quality of life. This type of psychedelic therapy offers a paradigm change in the way obsessive-compulsive disorder and other mental disorders and health issues like depression and addiction are treated. If psilocybin proves to be safe and effective in ongoing trials, it may improve our capacity to create fresh treatments for OCD patients.
Addiction disorders
Alcohol dependence and use were dramatically reduced from the start of the open research on psilocybin in 10 patients with alcoholism to the follow-up at 36 weeks. 80% of participants in a psilocybin open research with 15 patients who had treatment-resistant tobacco/nicotine addiction were abstaining after six months. The objective metrics of smoking cessation verified this.
Seven-Item Generalized Anxiety Disorder Scale
A seven-item test called the Generalized Anxiety Disorder Assessment (GAD-7) is used to assess or evaluate the severity and acute effects of a generalized anxiety disorder (GAD). Each question asks the respondent to rate how severe their symptoms have been throughout the last two weeks. "Not at all," "a few days," "more than half the days," and "almost every day" are all acceptable responses. You can access the test*** here***.
Finding a professional
The majority of the world still forbids the use of magic mushrooms and other psychedelics, and several countries have decriminalized it. The state of Oregon has legalized the use of psilocybin for physical and mental health purposes if you are US based. Australia legalized the medical use of psychedelics for treating mental health conditions in an extremely controlled setting. And while it is possible to do psychedelic therapy in some countries of Europe, the formal therapy protocol still doesn't exist. There are still many limitations in place, such as the fact that only therapists and other qualified experts are permitted to cultivate magic mushrooms and extract or make psilocybin, but this is still a significant improvement. Finding a therapist that uses mushrooms in therapy may be a bit difficult, but you do have possibilities. A beneficial first step could be to look through therapist directories for those that provide psilocybin or other psychedelic drugs for therapy. Our Psychedelic Integration List can be used to locate a local expert who offers psychedelic-assisted therapy near you.
Conclusion
Experts are optimistic that interest in psychedelic medicine and treatment is on the rise thanks to bigger FDA funds and increased research. It will take time and education for psychedelic therapy to dispel the stigma that surrounds both psychedelic substances and mental health. To increase accessibility, the therapy will also need the support of medical experts, insurance providers, and state and federal regulatory agencies. Although psychedelic drugs and treatments face many obstacles, the abundance of recent discoveries and developments provide both trauma-informed medicine and those struggling with serious mental health issues hope for a more embodied existence.
Vivien Freeflow · 3/13/2023
