Can psychedelic drugs such as psilocybin, the active ingredient in magic mushrooms, Ayahuasca, an Amazonian brew, or MDMA, the active ingredient in the party drug Ecstasy help people who are addicted, anxious or depressed? That’s the question increasingly asked by researchers who are testing these psychedelic drugs in small numbers of patients to see if they bring any relief.
As the article nicely points out, mental health problems like addiction or depression are thought of as chronic, lifelong diseases, but what if that’s an ineffective approach for many people? What if anxious or depressed people were, instead, treated by a small number of episodes of profoundly perspective-altering drugs, which rewires one’s underlying personal philosophy and brings relief that way? Would this not represent a dramatic paradigm-crushing approach to treating mental illness?
While the story raises these questions in an intriguing fashion, details on the research are fleeting and there’s not enough context to give readers a balanced view of the issues involved. As the story points out, early results suggest that these substances might be worth substantial increases in research in treating mental illnesses. But the current evidence base is characterized by tiny numbers of subjects and is almost anecdotal in nature, so a bit more caution about the likelihood of a “paradigm shift” in this area would have been welcome.
Editor’s note: Two ratings in this review — see the “Independent Sources” and “Availability” criteria — have been changed from Not Satisfactory to Satisfactory and the star score has been changed from 2 to 3 stars. See the specific criteria, as well as the comments section, for an explanation of the changes.
There are many people who have addictions, are uncontrollably anxious or suffer severe depression who are not well served by the current armamentarium of conventional prescription drugs and so increased research on a range of psychoactive substances derived from plants or fungi seem a promising area of research. Assurances that such research can be done in controlled, monitored situations by competent scientists may help revamp an area of drug therapy that was up to now written off as dangerous, addictive and generally pushed to the margins of society.
Not discussed at all. Presumably without patentable drugs derived from these substances, they could be very economical, yet we have no idea if the substances used in these experiments underwent substantial processing or packaging which, of course, would all affect cost.
Unfortunately the details on the various studies cited are few and far between, though the links to the actual studies are helpful for those wishing to dig deeper. Because of the lack of quantification of benefits permeates the piece, it can only rate as Not Satisfactory.
Obviously the harm potential of these drugs is probably what gave them a bad reputation in the first place–particularly in their potential for abuse–so it would have been useful to hear which adverse effects were experienced by these users in these small experiments. It was good that the story stipulated that the drugs were used under controlled and supervised conditions, and so the obvious question arises: is that how these drugs would be used in the wider population, and if not, would that not alter the harm/benefit potential of the drug?
As we circle back to re-evaluating these drugs, focusing on one specific area (anxiety/depression), it seems a little too easy to forget they are powerful drugs that affect multiple chemical and who knows what other systems in the brain. Informed consent documents for future studies will be tricky.
We learn that the studies were small, done under strictly controlled situations, and usually involved patients with specific conditions. But there’s no specific caution about the limitations of the existing research, or the fact that the “paradigm shift” suggested by the article might not pan out. And details about the studies are spotty. Some of the claims pertaining to ayahuasca, for example, seem to be based on an interview with an ethnobotanist book author whose evidence mainly consists of anecdotes such as:
“One time I accompanied a friend who was addicted to antidepressants for 30 years down to Peru, and then he came out a free man and isn’t depressed anymore.”
The story mainly argues for more research, a point that we can agree with, but overall it seems a bit unbalanced in favor of the possibilities without sufficient acknowledgment of the potential that the research might go nowhere.
No obvious disease mongering.
The only expert quoted is the author of the Canadian Medical Association Journal review article that seems to be the news hook for the story. It would have been interesting to hear a second opinion.
Editor’s note: This review originally stated that that there was no independent source quoted, which is incorrect. The story quotes Dr. Charles Grob who was not involved with the review article that’s the launching point for the story. The rating has been changed to Satisfactory.
There is also no information about the potential conflicts around such research, and even though such conflicts may be unlikely given the source of drugs studied, a sentence to confirm the independence of the research would have raised the credibility of the article.
Although it mentions that mental health problems are often treated with drugs like serotonin-specific reuptake inhibitors, it doesn’t discuss how the psychedelic drugs compare to those drugs or each other, or other types of non-drug therapy. We’ll give the benefit of the doubt here, though we wished for more detail.
Magic mushrooms and MDMA may be ‘available’ in our society, but hardly through channels that one would consider reliable or trustworthy. While we might want more details on how to obtain these substances, in the interests of public service, it may be just as well that the story didn’t delve into this issue too far.
The story establishes that what is ‘novel’ here is the research, as we know many of these substances have been around for decades, or in the case of the Ayahuasca, probably thousands of years. There’s especially some novelty in studying the drugs’ usefulness in treating anxiety in terminal patients. But otherwise, the idea of quick fixes in the forms of pills containing psychoactive substances for these serious and chronic problems is not all that new.
This shows no hallmarks of having been generated by, or dependent upon, a news release.