2023-05-12 14:09:23
In April 2023, data from a phase II clinical trial conducted in Switzerland made noise in the media. And for good reason, it was a rather mind-blowing subject: the study focused on the effects of LSD consumption for patients suffering from depression, suggesting that this psychedelic substance would have significant benefits. Indeed, early results indicated that people who were given larger doses of LSD experienced an average reduction in depressive symptoms almost four times that of people who were exposed to a placebo.
These data, which have not yet been the subject of a peer-reviewed scientific publication, nevertheless brought to the fore a decades-old debate on the possible therapeutic benefits of LSD for a whole host of disorders. psychiatric disorders, from depression to anxiety,+ including post-traumatic stress. In recent years, interest in this area of research has increased and many trials have been launched around the world.
But isn’t it dangerous to treat yourself with LSD? More broadly, does research really already have solid evidence of the effectiveness of psychedelics? Detox channel make the point.
As early as the 1950s, two psychedelic substances were the subject of much research: LSD, derived from a molecule derived from a parasitic fungus of rye, and psilocybin, the active ingredient of hallucinogenic mushrooms. Doctors experiment, sometimes on themselves, with the effects of these molecules which modify the state of consciousness for several hours. They are studying in particular their effects on depression, anxiety, alcoholism, obsessive-compulsive disorders, or even as palliative care, with the hope of making drugs out of them. But LSD and psilocybin, which cause hallucinations with distortions of the senses, time and space, will eventually be considered dangerous drugs and banned. Research will stop for 30 years.
Stimulated by the limits of current treatments for psychiatric disorders, they resumed in the mid-1990s, more strictly framed, and clarified, in part, the mode of action of these molecules on the brain. They reveal in particular that LSD and psilocybin act mainly in the brain on serotonin receptors, a hormone involved in regulating behavior, mood, and anxiety.
It is also on the serotonergic system that the most prescribed antidepressants currently act, although their effect is obviously not the same.
Moreover, if antidepressants are less popular in the media than hallucinogenic substances, it should be remembered that they provide a satisfactory solution, with persistent effects over the long term, for approximately 70% of patients treated for depression.
The promises of psilocybin
Psychedelic substances are now the subject of numerous experiments, particularly in the United States, Great Britain and Canada. And so far, it is psilocybin that obtains the most interesting results in the studies already published.
For example, its use in addition to therapy sessions has thus made it possible to sustainably reduce anxiety and depression, in particular the forms resistant to antidepressants, which concern approximately 30% of patients treated. Side effects (headaches, dizziness but also anxiety) were however noted in 77% of participants in a recent study.
Psilocybin has also had interesting effects in trials on people who were trying to quit smoking or alcohol, or to support people at the end of life, by promoting communication with loved ones and allowing them to face death more serenely.
Another avenue explored: the use of psychedelic substances on obsessive-compulsive disorders or OCD, for patients who do not respond to conventional treatments. A double-blind study has started in the United States, at Yale University, to evaluate the effect of psilocybin and describe its mechanisms of action, in regarding thirty volunteers with OCD.
Finally, in the field of post-traumatic stress, publications are also beginning to emerge. A literature review recently recalled the need for innovative therapies in this field and the first promising results of studies carried out among veterans, testifying to a beneficial effect of taking psilocybin to deal with traumatic memories and reduce the associated anxieties.
Nuances to bring
Despite these advances, caution remains in order. Indeed, while most studies dedicated to psychedelic substances provide interesting results and use a rigorous “double-blind versus placebo” methodology, they are still few in number and conducted on a limited number of subjects. In addition, the mechanisms of action of these substances explaining their possible therapeutic effects remain relatively unexplored.
Furthermore, these substances need to be used in a secure medical setting: with preparation, support, an appropriate environment, an appropriate dosage, and the exclusion of certain drug interactions or certain psychological profiles incompatible with these treatments. This will also be appropriate if the substances are ever authorized outside the framework of a clinical trial.
Taking psychedelics can also be accompanied by side effects as shown by some trials, and in the most extreme cases, states of intense panic, phobias and confusion.
The presence of a health professional to ensure the physical and psychological well-being of the patient, during and following the treatment therefore seems essential. In practice, the limited number of psychiatrists in France might be a hindrance. Among the projects to be carried out, it will also be necessary to determine the ethical rules governing the administration of such substances outside clinical trials and clearly define the patients most likely to benefit from them.
So, even if the effects of these substances prove to be clearly beneficial one day, with many other studies confirming the first promising results, the idea is definitely not to generalize the taking of LSD like that of an aspirin.
D’autres travaux français et européens à découvrir À Amiens, l’équipe de Mickaël Naassila (laboratoire Inserm 1247 Groupe de recherche sur l’alcool et les pharmacodépendances) travaille en parallèle sur un autre grand projet, européen cette fois. Ce projet baptisé Psi-Alc a été lancé en 2019 pour une durée de 4 ans, et mené en partenariat avec des chercheurs allemands, italiens et suisses. Leur but est, entre autres, de décrypter les mécanismes d’action qui pourraient réduire l’envie de boire de l’alcool, après absorption de psilocybine. Lire notre article sur le sujet :
Source : Inserm, 11 mai 2023
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#Psychedelics #treatments #psychiatric #disorders
