Over the past 5 years of so, I've been hearing a lot about psychedelic assisted psychotherapy. At first my mind thought of the 1960's counterculture, lava lamps, and the fear of "drugs" that existed in my community growing up. As I read more though, I was won over by the stories of peoples healing journeys, the amazing research and some of the exciting ideas coming out of this field. This is a brief blog introducing some of the molecules of interest in Psychedelic- assisted Therapy (PAT). As we dive into the substances pivotal to this therapy, we'll examine not only their potential therapeutic benefits but also the specifics of the studies conducted and the mechanisms of action behind these medicines. In future blogs I'll go more in depth on these molecules and what PAT looks like.
Psychedelics: A Brief Introduction
Psychedelics are substances capable of inducing profound alterations in perception, mood, and thought. Historically associated with spiritual experiences and psychotherapeutic practices (think Woodstock), these substances are now being rigorously studied for their potential in treating various mental health issues.
Psychedelic Substances of Interest
Psilocybin
Research Procedure: Studies on psilocybin often involve controlled, supervised sessions where participants receive a set dose of the substance. These sessions are typically accompanied by psychological support both during and after the experience.
Mechanism of Action: Psilocybin acts primarily by stimulating serotonin receptors in the brain, particularly the 5-HT2A receptor, which leads to altered consciousness and potentially therapeutic effects.
Therapeutic Potential: Johns Hopkins Medicine research suggests significant benefits in treating depression and anxiety. More about their research can be found here.
MDMA
Research Procedure: MDMA-assisted therapy for PTSD usually involves a combination of psychotherapy sessions and MDMA administration in a controlled setting. Participants undergo preparatory and integration sessions alongside the MDMA sessions.
Mechanism of Action: MDMA increases the release of neurotransmitters like serotonin, dopamine, and norepinephrine, which enhances mood and emotional response. It also reduces the activity in the amygdala, which is involved in fear responses, making it easier for individuals to process traumatic memories.
Therapeutic Potential: Nature has published promising results on MDMA's effectiveness in PTSD treatment. Further details can be accessed here.
Ketamine
Research Procedure: Ketamine treatment for depression often involves intravenous administration in a clinical setting, monitored by medical professionals. The treatment includes multiple sessions over a specific period.
Mechanism of Action: Ketamine acts on the NMDA receptors in the brain. It's thought to increase the levels of glutamate, a neurotransmitter, between neurons. This triggers changes in the communication patterns of neurons, leading to improved mood and thought patterns.
Therapeutic Potential: The Mayo Clinic provides insights into ketamine's efficacy in treating treatment-resistant depression, available here.
Legality and Context
The legal status of these substances is evolving. Psilocybin and MDMA are currently Schedule I drugs in the United States, indicating no accepted medical use and a high potential for abuse. However, there's a growing movement towards reclassifying these for medicinal use. Ketamine, already legal in medical settings, is used under strict medical supervision.
Closing Thoughts
Psychedelic therapy represents a significant shift in treating mental health disorders. The combination of these substances with psychotherapeutic support offers a new horizon in treatment. As a therapist, while I don't directly administer psychedelic-assisted therapy, I am keenly interested in helping clients integrate their experiences from such treatments. This field is rapidly evolving, and the potential for these substances to bring about profound therapeutic transformations is immense. For those interested in exploring this therapy or looking for guidance post-therapy, feel free to reach out for a thoughtful conversation.
I would also recommend reading Michael Pollan's book How to Change Your Mind if you're interested in learning more.
*This post was written in collaboration with generative AI.