Can Psilocybin or MDMA Treat Depression and Anxiety?

You may have seen there is a lot of talk, hype and research surrounding psychedelic medicine.

Have you seen the ads pop up in your social media feeds magic mushrooms to treat depression or so-called healing.

Retreats?

Now, psychedelic medicine to treat mental illness covers a lot of different drugs and claims people to treat a lot of different conditions.

But the stories we hear all sounds something like this.

The effects after the first treatment were profound.

I would have said a 60% reduction in my symptoms immediately.

I felt a mighty change had occurred.

Believe it or not, some doctors and scientists actually feel that psychedelic medicine can drastically change the way we treat depression, anxiety, PTSD, OCD and other mental health conditions.

But it can get pretty weird.

And there are some real safety concerns.

So what is psychedelic medicine?

Psychedelic medicine specifically involves a number of hours of focused psychotherapy leading up to an all day treatment session that involves a psychedelic experience and then followed by a number of hours of aftercare.

These are pretty peculiar and profound experiences that people also often report, encountering deep personal insights during or after these experiences, as well as an increase in psychological flexibility or cognitive flexibility, and an increase in your capacity for changing the way that you think about things in your in your life and in your world.

For example, in the bigger research studies on PTSD and depression, here's generally what happens.

So one has a few drug therapy sessions, maybe two or three, which lasts several hours while sitting with a therapist or a peer therapist.

And these are a few weeks apart.

And in between, these people have normal therapy sessions without any of the drugs.

I like that.

It sounds like you're taking these drugs under guidance.

Psychedelics include synthetic human made chemicals like LSD or MDMA, also known as Ecstasy or Marley psychedelics.

Also include mind altering plants like the roots and branches that are boiled into a brew called ayahuasca.

Then you've got fungi like magic mushrooms and the actives psychoactive component in these mushrooms is what's called psilocybin.

Some big psychedelic therapy research studies use psilocybin to treat depression Other studies use MDMA to treat post-traumatic stress disorder.

We'll get to those studies in a minute.

But first, I want to point out that even though there's a lot of talk about psychedelic therapy, this stuff is not new.

Way before the drugs were maybe legal psychedelics, mainly LSD and psilocybin, were the focus of some serious medical research.

In the 5060s and seventies.

There were more than a thousand published studies between 1950 and 1965 an estimated 40,000 people were given LSD by their doctors, therapists or scientific researchers.

They may videos like this.

This is a glass of water.

Colorless, tasteless.

It contains 102 gamma of LSD.

25 Scientists found these drugs, did all sorts of interesting things to people.

Everything is in color.

And I can feel the air.

I can.

I can see that.

I can see all a molecule.

In some cases, like treating alcoholism, they seem to help.

But research back in those days was primitive and mostly wasn't focused on treating specific conditions.

Just like a curtain or a spiderweb or can you see it?

It's right here in front of me right now.

And then before psychedelics could actually become validated in medical therapy.

Regular people, not doctors and patients, got a hold of drugs like LSD and psilocybin and begin to use them for their own particular reasons, like going on a spiritual journey or having a lot of fun.

LSD is a really groovy way to find.

Out more about the things around you.

Oh, say it helps me understand the whole world better.

LSD helps you to understand your own mind.

Things got pretty messy and.

The bad trip.

Instant insanity.

Often a never, never land of no return.

Now LSD and psilocybin were banned by the federal government in 1970 and MDMA ecstasy was banned in 1985.

But in the 1990s and picking up steam in the 2000s.

A handful of scientists got permission to restart their research.

There have now been several studies with psilocybin to treat depression or severe anxiety.

And the results mostly look really promising in the biggest study which included patients who were not helped by antidepressants.

A single dose of psilocybin combined with therapy was nearly four times more likely to make depression go away as compared to placebo.

Another trial directly compared psilocybin therapy with antidepressants and the psilocybin patients did better.

But it's important to point out in that big study with 233 patients, 11 who got psilocybin had serious adverse reactions compared to just one in the control group that included suicidal behavior and self-injury in the weeks after treatment.

So this is not Risk-Free.

Even more so outside of the studies.

So we conducted a large Internet survey of individuals who reported having had a bad trip or challenging experience with psilocybin mushrooms.

More than 3000 individuals overall responded.

Of all of those reports, over 10% of individuals reported at one point or another, putting themselves or others at personal risk of harm.

A slightly smaller percentage of individuals reported experiencing psychological trauma that they then felt the need to to seek therapy for a small number of individuals reported to the emergency room because of psychological or psychiatric distress.

And these are all real, very real risks of taking these drugs, especially in uncontrolled environments.

Of all the psychedelic studies, MDMA is the furthest along.

A group called MAPS is close to wrapping up a Phase three trial with nearly 100 patients who have moderate or severe PTSD.

Now, phase three is the last step before the FDA will decide whether to approve the treatment.

And so far, what's been made public looks good.

MDMA has been called an intact agent or pathogen which kind of alludes to the acute effects of MDMA in really increasing emotionality and empathy and emotional connectedness and social connectedness.

MDMA is unique in that it produces very powerful subjective effects, very powerful emotional effects.

But during the effects of MDMA, people can still really readily engage in talk therapy.

But it's also very early.

The long term data isn't in yet.

On one hand, the publication from the Phase three trial reported no serious adverse events but some of the subjects have said very publicly that the treatment actually made them worse.

So there are still big questions.

But the FDA could approve MDMA assisted therapy as soon as 20, 23.

And this wouldn't be a take home treatment, even if it's approved.

It would be administered by a therapist in a controlled setting and the FDA could still put all sorts of conditions on it.

In addition to depression, psilocybin is also being tested to treat severe anxiety in patients who have or used to have a life threatening illness.

That's how Dr. Anthony Bhatt got interested.

He's a palliative care doctor in Seattle.

That means that he treats patients at the end of their life.

I feel like I've sat with so many people who have advanced cancer who ended up making decisions out of fear and terror.

And honestly, those decisions, you know, a lot of them didn't turn out well.

And so I was really looking for something different.

I wanted to try psilocybin myself because I thought, you know, if somebody asked me what it's like.

I wouldn't be able to recommend it without really knowing myself whether or not it was really worth worth, worth it.

Can you tell us more what that experience was like and what kind of insight you may have gotten from actually taking it?

I realized from taking psychedelics for the first time was that actually the work of dying is about letting things go And it's about feeling your relationship to the rest of the universe.

And I know it sounds pretty sixties kind of wacky, but I really did have this kind of oceanic ego dissolving experience that really helped me see another dimension to the world, you know, the world we live in that I hadn't learned about in medical school.

That was very different than the material view of the human body.

And the human psyche.

Whoa.

It was big, I'll tell you.

And now you have a current research project that has a lot of attention where you're giving psilocybin to doctors and nurses who may be suffering burnout or other mental illness related to the pandemic.

Can you tell us about that specific study?

For many years, I've been thinking and feeling about how do you keep doing this work?

Right.

Because it's really hard.

It's it's you are exposed to a great deal of human suffering and how do you actually handle yourself so that you don't just end up saying the same things over and over, you know, like a little like kind of like a robot.

And I think it's kind of a mixture of depression and burnout and PTSD, honestly.

And then I realize, whoa, it's it's kind of the same existential crisis that people with a life threatening illness are facing.

And so that gave me the idea to design a study about psilocybin assisted therapy for doctors and nurses with symptoms of depression and burnout.

While this is like making me enlightened but also emotional in so many ways, I had a patient yesterday who had COVID, and she's like telling me, Oh, why don't you let me die?

Just don't do anything to let me live.

Like, let me go.

And although I was working with the palliative care nurse practitioner and we were doing the normal steps of like you know, the medications and the anti-anxiety and all those things, I just wanted her to be happier.

I didn't know how to fix that emotion.

Well, I'm hoping that we can get some really robust scientific data about how does this really work for people.

We want to understand that process, and then we want to understand what might happen if people have a couple of sessions of psychotherapy an experience with psilocybin or placebo, and then follow up psychotherapy.

And for now, all psychedelic drugs are still illegal.

However, that landscape is already changing.

In 20, 20, the state of Oregon took a page out of the medical cannabis book and said Psilocybin therapy will be legal They're still finalizing the rules and regulations, though.

Meanwhile, a few cities, including Washington, D.C., Oakland and Denver, have decriminalized psilocybin altogether.

So the research has a ways to go, and we're here for it.

If you want to learn more, check out the links in our bio.

Does this seem helpful?

A tad bit crazy?

Or do you have a story to share?

Tell us what you think in the comments and hit us up at PBS's Vitals.

See you next time.