Over the past few years, psychedelic assisted therapies have become a more mainstream discussion. Having first been considered back in the 1950s, they were quickly put to the side due to backlash from the government against the stigma of psychedelics like LSD (Gardner et al., 2019). Back then, there was a large “counter cultural movement” and the groups of people apart of this movement frequently used many psychedelics (Gardner et al., 2019). As a result, the government started a campaign against psychedelics, using the media to convince the population that these drugs could cause chromosomal damage and alter the minds of the users (Gardner et al., 2019). During this time, Nixon signed the Controlled Substances Act and placed psychedelics like LSD and psilocybin as schedule 1 drugs, meaning that they had high risk for abuse and had no foreseeable medical use (Gardner et al., 2019). Of course, we now know that this was an overreaction, as was the entire war on drugs which began around this time.
As we have begun to become more open minded about the potential use of “illicit” drugs for therapeutic treatments, it begs the question, what exactly is psychedelic assisted therapy? Psychedelic assisted therapy is the use of psychedelics (to no surprise) to help treat disorders such as depression, anxiety, and PTSD, and it isn’t anything new (Gardner et al., 2019; Luoma et al., 2020; Schenberg, 2018; Vargas et al., 2020). Psychedelics have been used for therapeutic purposes for a long time, in many religious practices and traditional healing practices (Gardner et al., 2019). Today, psychedelic assisted therapies start with a therapist who is a mental health professional. They typically start with a few sessions before the actual drug session to build a base, these are called preparatory psychotherapy sessions (Schenberg, 2018). After these preparatory sessions, then the drug is introduced. Sometimes only one drug session is needed and sometimes upwards of twelve sessions are needed (Schenberg, 2018). Ultimately, it’s dependent on both the drug in use as well as the patient’s reaction to the drug. After the drug session, there are follow up sessions, called integrative psychotherapy sessions, where the therapist “integrates” the findings and feelings from the drug sessions with the patient (Schenberg, 2018). The whole process of psychedelic therapy is extremely controlled, with the patient always being monitored while under the influence of the drug and the primary concern always being with the wellbeing of the patient.
So what exactly are psychedelics doing during these sessions and are they effective? Many psychedelics are found to block 5-HT2A receptors in the neocortex with a large amount of 5-HT2A receptors existing in the prefrontal cortex (Celada et al., 2004; Gardner et al., 2019). These receptors are associated with serotonin reuptake inhibitors, the same route as many SSRIs or “selective serotonin reuptake inhibitors” which are used for treating depression (Celada et al., 2004). In fact, blocking of 5-HT2A receptors has been shown to aid SSRIs’ effects in treatment resistant patients with major depressive disorder (Celada et al., 2004). Across the board, in fact, almost all psychedelics used in treatment of disorders like PTSD, anxiety, and depression have been found to have a positive effect (Gardner et al., 2019; Luoma et al., 2020; Schenberg, 2018; Vargas et al., 2020). Many of these drugs alone are showing effects in patients who have been resistant to treatment (Celada et al., 2004; Gardner et al., 2019; Schenberg, 2018). And that’s a big deal. Roughly ⅔ of patients being treated for depression don’t respond to their first treatments and a little more than 50% of patients never experience a sustained remission from depression (Little, 2009).
To answer the last question of this article, should we be hopeful? Yes! There is strong evidence that psychedelics are making a difference in the treatment of many disorders like anxiety, depression, and PTSD (Gardner et al., 2019; Luoma et al., 2020; Schenberg, 2018; Vargas et al., 2020). And they are occurring in safe, controlled environments where the wellbeing of the patient is constantly monitored and they continue to receive treatment afterwards (Schenberg, 2018). The effects of these treatments are helping those who struggled to find help before and are offering longer lasting benefits (Celada et al., 2004; Gardner et al., 2019; Little, 2009; Luoma et al., 2020; Schenberg, 2018; Vargas et al., 2020). All this isn’t to say that everyone should use psychedelic assisted therapies to treat their disorders. Like any treatment, it depends on the patient and finding what will work best for them. But with more and better data coming out, we’re learning that this treatment is beneficial for many, so hopefully it begins to become more common in medicinal practices so that more people can receive the best treatment for them.
Celada, P., Puig, M. V., Amargós-Bosch, M., Adell, A., & Artigas, F. (2004). The therapeutic role of 5-HT1A and 5-HT2A receptors in depression. Journal of Psychiatry and Neuroscience, 29(4), 252–265.
Gardner, J., Carter, A., O’Brien, K., & Seear, K. (2019). Psychedelic-assisted therapies: The past, and the need to move forward responsibly. International Journal of Drug Policy, 70, 94–98. https://doi.org/10.1016/j.drugpo.2019.05.019
Little, A. (2009). Treatment-Resistant Depression. American Family Physician, 80(2), 167–172.
Luoma, J. B., Chwyl, C., Bathje, G. J., Davis, A. K., & Lancelotta, R. (2020). A Meta-Analysis of Placebo-Controlled Trials of Psychedelic-Assisted Therapy. Journal of Psychoactive Drugs, 52(4), 289–299. https://doi.org/10.1080/02791072.2020.1769878
Schenberg, E. E. (2018). Psychedelic-Assisted Psychotherapy: A Paradigm Shift in Psychiatric Research and Development. Frontiers in Pharmacology, 9. https://doi.org/10.3389/fphar.2018.00733
Vargas, A. S., Luís, Â., Barroso, M., Gallardo, E., & Pereira, L. (2020). Psilocybin as a New Approach to Treat Depression and Anxiety in the Context of Life-Threatening Diseases—A Systematic Review and Meta-Analysis of Clinical Trials. Biomedicines, 8(9), Article 9. https://doi.org/10.3390/biomedicines8090331
4 thoughts on “What are Psychedelic Assisted Therapies and Should We Be Hopeful?”
Hi Tommy. I really enjoyed reading this article! I think it gave a good overview of how drug-assisted therapies became popular and where they might go in the future. I would suggest possibly widening your pool of sources, as I see most of your facts are quoted from the same Gardner article. I also think some people might be a little confused without more background information such as what psychedelics are in a less sciency way etc. But overall very interesting!
Hi Tommy, I found your post really interesting and really enjoyed learning about some of the history and future directions of psychedelics in medical treatments. I like your post’s flow and liked how you included specific neural processes involved. However, I think you could include an additional sentence to explain the effect of these drugs in a more straightforward way and maybe include some research on how they compare to the medications we have today. But, overall, this was very interesting, and I really enjoyed it!
Hello Tommy. This was a super interesting article to read, especially considering the fact that I have seen psychedelic therapy more in the news recently as a valid and more mainstream therapy option. It seems that psychedelics, when used in a controlled setting, are productive in treating disorders and may be used in tandom or in place of SSRIs. I was wondering if this type of therapy is used with other medications such as SSRIs or in replace of them, and if it is done in addition to or instead of talk therapy or behavioral intervention. I was also wondering if psychedelic use is seen as a last resort, or if someone suffering from depression or PTSD would be recommended to turn to this route before trying other methods. In other words, is this method more or less extreme than others? You also talk a lot about the biological basis of psychedelics, but I am wondering what actually goes on for the user in terms of their experience under these drugs, and how that element positively or negatively affects their mental health. Overall great article, and it is interesting to see this historically practiced method grow in popularity and validity in the psychological field today.
Great article, Tommy! I’m glad that you emphasized that psychedelic assisted therapy involves ASSISTANCE from a professional because that is a common misconception.