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Psychedelics and their potential in the treatment of mental illness


What are psychedelics?

Psychedelics are psychoactive substances that induce changes in consciousness, perception, affect mood and energy levels. It is no coincidence that they are classified as hallucinogens - psychedelics can cause people to hallucinate, seeing or hearing things that do not exist or perceiving them in a distorted way.

Many psychedelic drugs are natural in origin - derived from plants and fungi, some of which have been used for thousands of years in traditional or religious rituals. There are also synthetic psychedelics made in the laboratory. The history of synthetic psychedelics began in 1938 when Albert Hoffman synthesised substance number 25 from the lysergic acid derivative group (LSD-25) in the laboratories of the pharmaceutical company Sandoz. 

Psychedelics reached their greatest popularity in the 1960s and early 1970s. Drugs like LSD were part of the hippie subculture in Western Europe and the United States. In recent years, there has been growing interest in the potential of psychedelic and dissociative drugs to treat a variety of health problems, including addictions or mental disorders. 

Types of psychedelics

There are different types of psychedelics, the basic division being into natural and synthetic psychedelics. 

Most psychedelic drugs can be classified into one of these three groups: 

  • tryptamines (DMT, psilocybin)
  • phenethylamines (mescaline)
  • lysergamides (LSD)

The best known are undoubtedly LSD, mescaline, psilocybin and DMT.

LSD

LSD (lysergic acid diethylamide) is a semi-synthetic drug produced from a substance contained in ergot, a parasitic fungus that attacks rye, wheat and barley. Synthesising lysergic acid diethylamide is quite challenging, with only a few well-equipped laboratories in the world dedicated to it by experienced chemists.


 


Mescaline

Mescaline is a psychoactive substance found in some species of cacti, such as the San Pedro cactus, the Mexican peyote and the cactus known as the Peruvian torch. The protruding tops of these cacti are cut off and chewed or made into a tea. It is originally a natural drug, but mescaline can also be produced synthetically. 

Psilocybin

Psilocybin is a psychedelic substance found in various species of mushrooms (nicknamed "magic mushrooms"). It belongs to the tryptamine group. Psilocybin is biologically inactive on its own, but is rapidly converted in the body to psilocin, which has mind-altering effects. These effects are similar to LSD, mescaline and DMT. 

DMT

DMT is a substance found naturally in a number of plants, probably the most famous of which is the ayahuasca plant (Banisteriopsis caapi). The substance became popular in the 1960s and was classified as a controlled substance in the 1970s due to its potential for abuse, potentially dangerous effects and possible psychological dependence. DMT is also produced in small amounts by the human (mammalian) body, found primarily in the pineal gland (part of the mesenchyme).

How do psychedelics work?

Most psychedelics, including LSD, mescaline, psilocybin and DMT, affect the serotonin system in the brain. The therapeutic effects of these substances, according to research to date, are based primarily on their action on the serotonin receptor 5HT2A and, to a lesser extent, on the 5HT1A and 5HT2C receptors. Psychedelics are therefore also referred to as serotonergic hallucinogens. 

Serotonin 5-HT receptors are located in the central and peripheral nervous system. These receptors mediate emotion and mood, anxiety, aggression, cognition, sex, learning, memory, appetite and other biological, neurological and neuropsychiatric processes.

Substances that act on 5HT2A receptors also increase glutamate release, thereby affecting the amygdala, hippocampus and prefrontal cortex. These three brain structures play a key role in emotion processing, learning and memory. Modulation or activation of these areas can affect our responses to stressful situations. Increasing glutamate in these brain regions stimulates the synthesis of brain-derived neurotrophic factor (BDNF), thereby improving the brain's neuroplasticity. BDNF is a protein that ensures the functionality of existing brain cells and the production of new ones. 

Effects of psychedelics

The intensity and nature of the effects of psychedelic drugs can be difficult to predict and depends on many factors. These include the amount of the substance ingested and its potency (concentration and strength), the environment, age, gender, sensitivity, mood, expectations and the mindset of the individual.

We know that psychedelics can induce:

  • changes in sensory perception (especially visual)
  • changes in cognitive processes 
    • introspection
    • self-awareness
    • mystical experiences
    • changes in the passage of time
  • mood changes 
    • blissful state
    • euphoria
    • joy
    • fear

People feel strong emotions, from intense happiness to fear, anxiety and confusion, some see vivid colors, shapes and experience vivid memories. 

Psychedelics carry a risk of adverse health effects such as headaches, nausea or changes in heart rhythm. A psychedelic experience called a 'bad trip' may also occur, characterised by transient anxiety and psychotic symptoms, confusion, dissociation and depersonalisation. 

Illegally produced or processed drugs may be contaminated with fentanyl or other dangerous substances that cause serious health problems and, in extreme cases, death.

People who use drugs may have impaired thought processes and perception, which is often associated with unusual or dangerous behaviour and injuries that can occur under the influence of psychedelics.


 


Psychedelics as a therapeutic tool 

In some cultures, herbal psychedelics have been used for hundreds or thousands of years for holistic healing. They attracted the interest of psychologists and psychiatrists in the 1950s. At that time, some thought that it could "serve as a new tool for shortening psychotherapy". A meta-analysis of 19 studies of psychedelics for mood disorders published between 1949 and 1973 found that 79% of patients showed "clinically recognized improvement" after treatment. 

In the early 1970s, however, psychedelic drugs were banned, due to political pressure and also because of concerns about their potential dangers and uncontrolled use. Rules related to their production, handling and use were tightened, and major scientific programmes were restricted.

Since the early 1990s, research has begun to resume and the popularity of psychedelics has steadily increased since then. 

The importance of psychedelics and their use in therapy 

There are an increasing number of people with mood and anxiety disorders around the world. In the West, in particular, the use of psychedelic drugs as a therapeutic tool is attracting increasing interest. Conventional psychotic drugs and antidepressants are not always the ideal solution due to unpleasant side effects. 

Natural therapeutic alternatives, such as psychedelic drugs, could in the future represent an effective alternative to medication. It seems that DMT, LSD and psilocybin may be helpful in:

  • anxiety
  • mood disorders
  • neurodegenerative disorders
  • problems caused by alcohol and tobacco use

Psychedelics have a very low risk of dependence (addiction), a low likelihood of neurological deficits and no associated persistent physiological or psychological problems during or after use. In addition to these characteristics, psychedelics usually have negligible side effects compared to commonly prescribed antidepressants and work more quickly than commonly prescribed antidepressants (which may take several weeks to take effect). They can produce positive, long-lasting effects after just one dose/therapy session. 

How is psychedelic "treatment" carried out?

The process of psychedelic therapy differs from therapy with conventional psychiatric drugs. While conventional drugs are usually taken unsupervised, in psychedelic therapy the drug is administered in a therapy session. The therapists prepare the patient for the experience beforehand and help the patient integrate the knowledge from the experience afterwards. After ingesting the drug, the patient wears eye shades and listens to music to help them focus on the psychedelic experience. The therapist intervenes (interrupts the therapy) only if side effects such as anxiety or disorientation occur.

Psilocybin in therapy

Psilocybin is currently the most studied psychedelic drug, and many studies confirm that it is a promising adjunct to psychotherapy in the treatment of pain and inflammation, anxiety, cluster headaches, and other disorders such as:

  • major depressive disorder
  • post-traumatic stress disorder
  • generalised anxiety disorder
  • obsessive-compulsive disorder
  • severe existential depression

A clinical study published in 2016 examined the effects of psilocybin in 51 patients who had been diagnosed with life-threatening cancer and at the same time these patients were exhibiting symptoms of depression and/or anxiety. Participants themselves, staff and community observers assessed mood, attitudes and behaviour throughout the study. High doses of psilocybin resulted in large decreases in assessed indicators of depressed mood and anxiety, and increases in indicators of quality of life, meaning in life, and optimism, and decreases in death anxiety. At six-month follow-up, these changes were sustained and approximately 80% of participants continued to show clinically significant decreases in depressed mood and anxiety.

DMT (ayahuasca) and effect on depression

Tryptamine psychedelics such as DMT (and hence 5-MeO-DMT) and psilocybin are very similar in chemical structure to serotonin. Some studies suggest that endogenous DMT has anxiolytic effects and may induce a calm and relaxed mental state through interaction with trace amine receptors.

The antidepressant and anxiolytic properties of DMT have been described in an open study examining hospitalized patients with a current depressive episode. The study evaluated the effects of a single dose of ayahuasca (a hallucinogenic beverage from South American plants containing DMT). The resulting measurements showed a statistically significant reduction in depressive scores after administration of ayahuasca. Other controlled studies have also confirmed the potential of ayahuasca in treating depression, anxiety, and panic-like episodes and hopelessness. In addition to treating mood and anxiety disorders, ayahuasca may also have the potential to treat substance dependence and prevent relapse. 

However, some studies conducted in the past have also suggested that endogenous DMT is a 'schizotoxin', i.e. that it could play a role in the development of psychosis and schizophrenia. However, this has not yet been conclusively confirmed (or refuted). 

The LSD controversy

LSD and its effect on behavioural and personality changes and the decline of psychiatric symptoms in various diseases has been the subject of research since the 1950s. The substance has been used in the treatment of anxiety, depression, psychosomatic illnesses and addiction. However, most studies have not been carried out to current standards and it took several decades before interest in the use of LSD in psychiatry was revived. Evidence to date suggests that LSD achieves the best results in the treatment of alcoholism. Further research is needed to confirm the effects and to assess the potential risks.

LSD remains one of the most stigmatised and legally restricted substances among psychoactive substances. According to the UN Convention, it is still included in the list of illegal and most tightly regulated psychotropic substances, which limits its use in research and complicates its use as a therapeutic tool in medicine. 


 


Conclusion

Psychedelic drugs have considerable potential for treating some mental disorders and addictions according to existing research and available information, but this does not mean that they are without risk. In order to be fully integrated into modern health care, they face various challenges and limitations. This will not be without further research and clinical trials, but also legislative changes to allow the legal and safe therapeutic use of these substances. It is necessary to develop therapeutic procedures, resolve ethical issues and resolve funding options so that therapy is available to all those who need it and for whom it is suitable. However, it is very likely that this form of therapy will become more widespread.

Until that happens, there is no choice but to address psychological disorders using the classic approaches of pharmacotherapy and psychotherapy. It is also possible to seek out specialist clinics that use psychedelics in the treatment of mental illness. In the Czech Republic, such a facility is Psyon, which focuses on ketamine-assisted psychotherapy.

If you do not trust substances with psychotropic effects, you can try CBD (cannabidiol), a natural and legal cannabinoid from the cannabis plant that does not affect consciousness and perception. Several studies have already confirmed that CBD can help regulate mood and alleviate symptoms of anxiety and depression. CBD oils and drops, capsules and CBD vape pens are particularly popular.

 

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Author: Canatura

Photo: Shutterstock

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