Psychedelic drug may help brain to treat depression
key takeaways
- New research shows that psilocybin improves depressive symptoms associated with emotional avoidance and rumination.
- Brain scans of people with depression showed that two doses of psilocybin strengthened inactive areas of the brain, allowing flexible thinking and fewer negative thinking patterns.
- The antidepressant effect of psilocybin lasts for at least three weeks.
Mounting evidence suggests that psychedelics such as psilocybin are effective in treating depression, and scientists may finally understand why. researchers found that psilocybin works differently than conventional antidepressants, stimulating and reprogramming brain pathways that are less active in depressed brains.
By rewiring the brain, the antidepressant effects of psychedelics lasted for weeks after the initial treatment.
Findings published in the journal nature medicine, There are suggestions that psilocybin may help treat people whose depression has not responded to traditional antidepressants such as selective serotonin reuptake inhibitors (SSRIs).
Strengthening connections with other areas of the brain can help with depression and other mental conditions that have fixed patterns of thinking. It may also eliminate the need to take daily medication as one to two doses was enough to help with symptoms.
“You won’t need to dose indefinitely or frequently,” says David Merrill MD, PhD, a psychiatrist and director of the Pacific Brain Health Center of the Pacific Neuroscience Institute at Providence St. John’s Health Center, who was not involved in the study. told Verywell. “In trials, they are showing a lasting antidepressant effect with two doses, even when you are not [actively] using them. This is in contrast to antidepressants which show benefit only as long as you take them.”
While psychedelics are not slated to replace antidepressants anytime soon, it supports the push toward reducing hallucinations for medicinal use across the United States.
Past Evidence of Psilocybin Effectiveness
In recent years, scientists have discovered the benefits of psilocybin for the treatment of depression. A small 2020 study from Johns Hopkins Medicine showed that combining two doses of psilocybin with psychotherapy for one month reduced depressive symptoms. Half of the patients with major depression also recovered. When the researchers followed up with the same patients, they found that the antidepressant effects of psilocybin continued for a year after the second dose.
How psilocybin fares compared to other antidepressants is poorly understood. Study 1 April 2021 The New England Journal of Medicine suggested that while psilocybin helped people with severe depression reach remission sooner, there was no significant difference in antidepressant effect between psilocybin and the SSRI Lexapro (escitalopram).
While not published in a journal, Compass Pathway, a company involved in psilocybin-assisted mental health therapy, also released phase 2 clinical data showing that a single dose of psilocybin significantly reduced depressive symptoms for up to three months. gave.
Merrill said current data is establishing evidence for which treatments will work best for different patient populations. “Hopefully, psilocybin will be one of the options in various interventions,” Merrill said. “Some people may not have the need for a major psychedelic experience or may be at risk of psychosis with the psilocybin journey. But [for others]Combining psychotherapy with psilocybin appears to produce better results than simply giving psychedelics as a drug.”
Psilocybin rewires the brain to promote fluid thinking
Scientists enrolled people with varying levels of depression who recently participated in one of two psychedelic trials. In the first trial, 16 people with treatment-resistant depression knew they were taking psilocybin. People were given a lower dose (10 mg) and then a higher dose (25 mg) of psilocybin one week later.
The second trial involved people with major depressive disorder who were told they would receive psilocybin but were unaware of the dosage. People were randomly selected to receive either 25 mg of psilocybin or Lexapro that served as a placebo. Twenty-one people received the placebo. During the trials, all participants received psychotherapy.
The research team took brain scans of each trial participant before and after treatment. In the pre-treatment scan, the participants’ brains showed a certain pattern of thinking. The brain connection prompted a rigid thought pattern, characterized by repeated thoughts on the same thoughts and being highly self-centered. Because a depressed brain encourages rumination, it is difficult for people to change their thought processes.
People taking psilocybin reported better outcomes in depression severity after both trials. Researchers observed improvements in cognition and being more emotionally open. Researchers observed changes in people’s depressive symptoms three weeks after they followed their second dose. Meanwhile, those who were given the SSRI antidepressant showed temporary improvement before reverting to a rigid pattern of thinking.
Psilocybin was associated with changes in brain connectivity. The results suggest that psilocybin may affect the brain differently from conventional SSRIs.
“Basically the brain is connected in a more functional way,” Merrill said. “This is a remarkable study and I was struck by the mild antidepressant effect from SSRIs and no change in brain network organizations from these antidepressants.”
The study authors propose that psilocybin works to reduce high cognitive brain regions that are overactive in depression and promote stronger connections in other disconnected brain regions. Promoting connectivity throughout the brain has made it easier for people with depression to have flexible thinking and change their mindset.
“This study is arguably going to be the real game-changer of the psychedelic experience because it is qualitatively different from antidepressants,” Merrill said. “And this is part of the solid evidence that psilocybin may be a different approach to treating major mental illness because of its positive effects on the brain.”
Researchers speculate that psilocybin disrupts the function of 5-HT2A receptors, which become overactive in depressed brains. By blocking connections, psilocybin may give the brain an opportunity to make other connections.
“In previous studies, we saw a similar effect in the brain when people were scanned on psychedelics, but here we’re seeing it weeks after treatment for depression, which suggests a carry-over of rapid drug action, Robin Carhart-Harris, PhD, director of the Neuroscape Psychedelics Division at the University of California, San Francisco and senior author of the study, said in a press release.
what does it mean to you
Psilocybin shows great promise in being an effective treatment for depression. But it can be risky to self-medicate. If you or a loved one is experiencing depression, you may want to consider checking if you qualify for the psilocybin clinical trial. Researchers are professionally trained and can monitor you during treatment.
more research is needed
The study findings indicate that psilocybin has great potential, but has some limitations. The trials were highly controlled meaning that the researchers created a trial design that limited other external variables that could affect the results.
But in the real world, it is possible that other factors may affect the effectiveness of psilocybin such as a person’s previous history of psychedelics or comorbidities.
The study was also conducted on a small sample size, making the data prone to variability and bias when performing statistical analyses. It is possible that the benefits of psilocybin are affecting people with severe depression the most and adding more people with less severe depression to the mix may make the benefits less significant.
Merrill said he would be interested to see how psilocybin would affect older adults—about one-third of those with treatment-resistant depression more likely to be older—and younger people whose brains are still developing.
“We’re still in early research and we’re still studying the effects,” Merrill said. “It is not federally legalized, but we are hopeful that we are moving toward more widespread, accessible and safe clinical use.”
Merrill expects psilocybin to be approved by the FDA for the treatment of depression within the next one to three years.
But currently, psilocybin is not legal, and Merrill discourages people from self-medicating with psilocybin or other psychedelics because it increases the risk of “bad travel” and other safety issues with supplements.
