The post A Cure for the Common – and Not So Common – Blues? appeared first on Psychedelia.
By Andrew Ward
Psychedelic science has been breaking through at an increasing rate in recent years, with public stocks and prominent institutions, including Johns Hopkins University, all entering the fray. Leading organizations are also helping add updated lab studies to a space lacking in insights due to federal prohibitions.
Bolstered by lab studies and ample anecdotes, some believe that psychedelic treatments can create a paradigm shift in how depression and other mental health conditions are addressed.
“The concept of medication-assisted psychotherapy represents a revolution in how mental health care is normally delivered in the mainstream, where medication and psychotherapy if offered at all, are split,” says Dr. Scott Fisher, MD, advisory board member of psychedelics firm Iter Investments. Fisher’s psychedelic endeavor is one of many analyzing the space and the potential various effects psychedelic substances have on depression, noting the spiritual, existential and philosophical realizations a person can experience when undergoing treatment.
Researchers, investors, and activists across the globe are optimistic about the future of psychedelic treatments. As progress marches forward, they also note ongoing hurdles created by various state and federal regulations. However, as psychedelic treatments gain credibility through public support and lab data, lawmakers could change policies surrounding psychedelics, depression, and other medical treatments.
Psychedelics Moves Forward
Researchers and business leaders in the space note the ample potential presented in various psychedelic compounds.
Dr. Stephen Dahmer, MD, chief medical officer at Goodness Growth Holdings, says research moves forward despite ongoing social stigmatization and regulations against psychedelics research. He credits the surge in research to increased public interest coupled with additional access to funding. While optimistic, he notes that modern research requires further study to verify initial findings.
“Historical research dates back thousands of years, depending on the substance, yet the number of studies, as well as participating patients in psychedelic research, is still very limited,” Dahmer says.
As research grows, so too does the list of psychedelic compounds to analyze. Dr. Jahan Marcu, Ph.D., is a founding partner at psychedelics advisory firm Marcu and Arora and the editor-in-chief of the American Journal of Endocannabinoid Medicine. Marcu notes the promise in treating mood-related disorders with various serotonergic psychedelics, like psilocybin and LSD, that interact with serotonin receptors. At the same time, a world of compounds continues to present potential.
“This field is expanding and looking at all sorts of minor and major compounds,” Marcu says.
Overall, Marcu believes there has been an “explosion” of research in recent years, noting several pre-clinical observational trials studying effects on mood. He cites findings from several prominent U.K. researchers, including the psychologist and neuroscientist Robin Carhart-Harris, highlighting their 2016 paper on the psychological effects of LSD as one pivotal study. In the analysis, researchers concluded that their findings “reinforce the view that psychedelics elicit psychosis-like symptoms acutely yet improve psychological wellbeing in the mid to long term.”
Marcu also points to a 2016 double-blind study from the Johns Hopkins University School of Medicine, which found that psilocybin could reduce depression and anxiety symptoms in patients who have life-threatening cancer.
Dr. Douglas Cook, MD, chief medical officer at psychedelic-based wellness clinic Dimensions Health Centres in Toronto, says there is “growing evidence that psychedelics can improve outcomes for patients with depression.”
Regarding psilocybin, he cites an April 2021 paper by Carhart-Harris in the New England Journal of Medicine, presenting Phase 2 trials of psilocybin versus Escitalopram-based treatments on depression.
“This study arose from prior work by the same group demonstrating improvements in depression outcomes using psilocybin,” Cook says.
In addition to psilocybin, ketamine and ayahuasca have shown potential in producing anti-depressant effects, according to Cook.
Dr. Parag Bhatt, Ph.D., director of science for Silo Wellness, also highlighted the Carhart-Harris studies. Bhatt delves into the Phase 2 research, noting that the trial produced no significant stats on treatment between the two drugs.
“However, secondary outcomes reported as a reduction in QIDS-SR-16 score reduction by greater than 50%, trended towards favoring the psilocybin group,” reports Bhatt.
He also touched on potential treatments beyond psilocybin, highlighting DMT and the ayahuasca-based open-label trials conducted by the University of São Paulo’s Rafael Faria Sanches. Results include a 2019 analysis, which saw significant reductions in depression and anxiety according to the Hamilton Rating Scale for Depression and Montgomery-Asberg Depression scale.
“It should be noted that in these trials, participants were measured for their baseline to be used as a control compared to one dose ayahuasca treatment,” Bhatt adds.
Anecdotal Evidence
The rise in lab studies joins scores of anecdotal evidence, including from leaders in the emerging space. Daniel Goldberg, co-founder and partner of investment fund Palo Santo, says it’s an understatement to say that most professionals in the psychedelics space have been “positively affected from our personal experience with the medicine.”
Goldberg had his first MDMA experience at 46, calling it “an incredibly positive session that absolutely changed my life,” giving him “a sense of wonder, awe and hopefulness.”
Bhatt says he’s used psychedelics in various dosages, beginning in graduate school, to manage his depression, anxiety and attention deficits.
“The combination of macro and microdoses has allowed me to change my perspective on my current situation and adapt for a better future,” he says. Bhatt eventually found a regimen of four days on microdosing, then two days off.
“I have found more enjoyment in life, a greater drive for my future and greater resilience in the face of obstacles that would normally have left me crippled,” he says.
Today, he feels less of a need for what he calls “a maintenance microdose,” taking more days off between applications. Despite the less frequent use, Bhatt reports feeling a fueled “passion for understanding the neuropsychopharmacology of these compounds so that others may benefit from these misunderstood molecules.”
Regulations Hinder Research
Most researchers in the space appear optimistic over the lab progress made in recent years. Several also noted that such progress would have almost assuredly been accelerated were it not for ongoing federal prohibitions on research and analysis. Like cannabis, the rise of support for psychedelics among the general public has not yet resulted in a shift in their federal drug classification. Until a revision arrives, regulations could hinder insights on how psychedelic treatment may affect depression symptoms.
Fisher notes that psilocybin, LSD, MDMA, DMT, ayahuasca and mescaline all remain on the DEA’s Schedule I list of controlled substances, the most restricted group in the federal rubric. The Schedule I classification is reserved for drugs “with a high potential of abuse” and “no currently accepted medical use.”
Just as with cannabis, this classification seemingly becomes more tenuous with each passing day, but the status quo has been in place for decades. In 2016, a report conducted by several New York City medical centers and schools noted that strict regulations, social stigmas and legal consequences surrounding Schedule I substances led to a void in studies covering the drugs. The report stated that such impediments might lead to barriers when developing medications surrounding chronic pain relief and harm reduction.
And despite the emergence of legitimate psychedelics businesses, not much has changed since the 2016 report was released.
“The added restrictions by the federal government placed on research done on Schedule I drugs certainly presents many challenges, which slow efforts being made to test the safety and effectiveness of these potentially life-saving treatments,” Fisher says.
Dahmer likened psychedelics’ legal circumstances to cannabis reform, noting research prohibitions limit both burgeoning spaces.
“Expanded research will not only support potential breakthroughs in brain disease knowledge but minimize potential harms due to increased general use,” he states.
While most sources highlighted the pain points associated with the status quo, Palo Santo’s Goldberg took a different approach, saying the U.S. Food and Drug Administration “has been very supportive of psychedelics.”
Goldberg believes the United States will legalize psychedelics through a medicalization path before cannabis achieves federal reform.
“It looks like you will be able to work with MDMA, legally, under the supervision of a therapist, within the next couple of years,” he predicts, adding that he believes psilocybin will receive its approval soon after MDMA.
There is hope that the continued public interest and progressing psychedelics reform will lead to additional breakthroughs in research and accessibility in the years ahead. The U.S. has seen a shift in local regulations in recent years, with laws passing in Oregon and Washington, D.C., among other municipalities. With more states and cities taking up efforts, there is some belief that the U.S. Department of Justice could allow state psychedelic laws to provide some level of protection from federal enforcement, similar to how the 2013 Cole Memo gave cover to state-legal cannabis enterprises. For now, that largely remains speculative.
Until any reform arrives, researchers and patients will have to base their decisions on scant research and substantial anecdotal feedback.
Andrew Ward is a Brooklyn-based freelance journalist, author and branding specialist. He is the author of Cannabis Jobs (2019) and The Art of Marijuana Etiquette (2021). Working primarily in the cannabis space, Ward also covers psychedelics, politics, business and whatever else is interesting. His work has been published by High Times, Business Insider, Benzinga and many others.