Recently, there have been a number of reports and studies exploring the potential therapeutic applications of currently illicit drugs. Cannabis is breaking down barriers in the treatment of certain types of epilepsy in the UK and a marketing application for an intranasal esketamine spray has been submitted to the EMA for treatment-resistant major depressive disorder.
Currently available antidepressants, such as SSRIs, are used collectively to treat major depressive disorder, anxiety and other mood disorders. They have been shown to lack substantial efficacy in all patient populations and are renowned for having a delayed onset of action (Penn and Tracy, 2012). Working in the area of mental health at CHC, coupled with an interest to find out more, we ventured further into a current avenue of research that looked more and more curious…
Research suggests that psilocybin, the active compound in the psychedelic and so called ‘magic’ mushrooms, is showing a lot of promise in the treatment of mood disorders. In a study led by Carhart-Harris, clinically significant results (defined as a greater than 50% reduction in depressive symptoms) were achieved when psilocybin was administered to patients with treatment-resistant depression (Carhart-Harris et al., 2017). Another study looked at the effect psilocybin had on depression and anxiety symptoms in patients with life threatening cancer (Griffiths et al., 2016). Similarly, it was shown to lead to significant reductions of death anxiety and depression which was even sustained at 6-month follow-up.
Effects of psilocybin are reported to induce a ‘dissolution of the ego’ and ‘loss of self’ (Carhart-Harris et al., 2017). This is proposed to be a result of a disruption of brain networks that effectively ‘reset’ the brain and encourage ‘cross-talk’ activity between different regions through interactions with serotonin receptors in the brain (see diagram). The ensuing therapeutic effect is said to have effects that allow anxieties that come with original perspectives and outlooks on life to be released, allowing a sense of emotional freedom.
Further, Ayahuasca; a naturally occurring hallucinogen used traditionally by indigenous people of the Amazon, has a similar pharmacological profile to psilocybin. Studies have shown that it increases blood flow to brain areas that regulate mood, leading to a relief of depressive symptoms (Palhano-Fontes et al., 2018).
Of course, there is the need to conduct robust clinical trials to explore the benefits of these illicit drugs, but with the promise and progress ketamine, cannabis and now magic mushrooms have made, it will be interesting to see whether these get EMA and FDA approved and the potential that they may have in treating other problematic neurological disorders.
Increase in ‘cross-talk’ activity between brain regions in a person on psilocybin (b) compared to someone who is not (a).
Carhart-Harris, R., Bolstridge, M., Day, C., Rucker, J., Watts, R., Erritzoe, D., Kaelen, M., Giribaldi, B., Bloomfield, M., Pilling, S., Rickard, J., Forbes, B., Feilding, A., Taylor, D., Curran, H. and Nutt, D. (2017). Psilocybin with psychological support for treatment-resistant depression: six-month follow-up. Psychopharmacology, 235(2), pp.399-408.
Griffiths, R., Johnson, M., Carducci, M., Umbricht, A., Richards, W., Richards, B., Cosimano, M. and Klinedinst, M. (2016). Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial. Journal of Psychopharmacology, 30(12), pp.1181-1197.
Palhano-Fontes, F., Barreto, D., Onias, H., Andrade, K., Novaes, M., Pessoa, J., Mota-Rolim, S., Osório, F., Sanches, R., dos Santos, R., Tófoli, L., de Oliveira Silveira, G., Yonamine, M., Riba, J., Santos, F., Silva-Junior, A., Alchieri, J., Galvão-Coelho, N., Lobão-Soares, B., Hallak, J., Arcoverde, E., Maia-de-Oliveira, J. and Araújo, D. (2018). Rapid antidepressant effects of the psychedelic ayahuasca in treatment-resistant depression: a randomized placebo-controlled trial. Psychological Medicine, pp.1-9.
Penn, E. and Tracy, D. (2012). The drugs don’t work? antidepressants and the current and future pharmacological management of depression. Therapeutic Advances in Psychopharmacology, 2(5), pp.179-188.
Roseman, L., Nutt, D. and Carhart-Harris, R. (2018). Quality of Acute Psychedelic Experience Predicts Therapeutic Efficacy of Psilocybin for Treatment-Resistant Depression. Frontiers in Pharmacology, 8.