Psychedelic treatment may offer a cure for depression and other mental illnesses

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Relief from various mental illnesses may in the not-too-distant future come from a surprising source: psychedelics.

The substance psilocybin is found in various types of mushrooms. The Center for Psychedelic and Consciousness Research at Johns Hopkins University is conducting extensive research into it as a treatment for mental illness.

“The psychedelic research that we’ve been doing has been going on for nearly two decades,” said Matthew Johnson, a professor of psychiatry and behavioral sciences at the center. “I’ve been conducting this research since 2004.”

In 2008, Johnson helped resurrect psychedelic research by publishing safety guidelines. Since then, he has conducted studies on how psilocybin can treat nicotine addiction and is currently working on research into whether it can treat opioid addiction and post-traumatic stress disorder. Other researchers at the center are focusing on psilocybin as a treatment for depression.

Johnson explained that patients go through two treatment sessions with psilocybin, which are preceded by screening sessions.

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“The actual session is going to happen after extensive screening where we check for psychotic disorders and cardiovascular disease,” Johnson said. “There is also a preparation period where they spend four to eight hours with the therapists who will be with them during their session. Often, we call them the ‘guides.’”

The patient arrives at 8 a.m. on the day of the session and fills out some paperwork. At 9 a.m., the patient will take a capsule containing a synthesized form of psilocybin. It takes between 15 minutes to an hour before the patient feels the effects. The two therapists will be in the room to guide the patient through the session. A physician will be nearby to deal with any adverse effects from the psilocybin.

“During the actual session, we put them in a relaxing environment,” said Johnson. “Before the drug takes effect, they are engaged in light conversation with the two guides.”

Once the psilocybin takes effect, the patient is advised to lay down on a couch. Eye shades are put over the patient’s eyes, and headphones that play classical music are put over the patient’s ears. The process takes about six hours.

“What we are shooting for during these sessions is a highly meaningful psychological experience that people draw insight from and changes behavior,” Johnson said. “It is that experience that has the therapeutic effect. People learn something that they don’t from, say, taking Prozac.”

As an example, Johnson pointed to a study that Johns Hopkins did with late-stage cancer patients who were experiencing severe depression and anxiety. These patients were often filled with dread about cancer to the point that they would not spend time on more routine matters such as visiting grandchildren or planning a vacation.

“They often had the realization, ‘Yes, the cancer is a real thing, but so much of my suffering I’m causing myself by my reaction to it,’” Johnson said. “They may have already known this, but with the experience, they get it on a gut level. They get it in such a dramatic way, and it changes their behavior.”

The results from the studies are encouraging. The study on cancer patients involved 51 test subjects. After six months of receiving the treatments, 79% of those who received a higher dose of psilocybin experienced significant drops in depression and anxiety. A study of 12 patients who took psilocybin for nicotine addiction found that 60% had quit smoking 16 months after the treatment.

Late last year, researchers from the center published research on psilocybin and major depressive disorder. Of the 24 patients who suffered from the disease and went through the treatment, 17 experienced declines in their depression after a month. And of those 17, 14 no longer experienced depression.

Johnson said the psilocybin works by activating the “serotonin 2a receptors” in the brain, receptors that are linked to mental illness. He described the psilocybin and its interaction with the receptors as a key that unlocks the door and then changes what is behind the door.

“There is also a massive increase in communication across the brain [after the treatment] in areas that do not normally communicate,” Johnson added.

Johnson acknowledged that there is more that physicians and scientists don’t know about how psilocybin affects the brain.

He further acknowledged that the big limitation of the studies is their very small sample sizes. He said that the center is working to secure the funding for much larger studies, studies that will have to be conducted before the Food and Drug Administration will consider psilocybin as a treatment for mental illnesses.

There are other obstacles, not least of which is the stigma associated with psychedelics. It can easily remind people of 1960s drug culture or of Timothy Leary, a clinical psychologist at Harvard who was accused of conducting unethical research involving psychedelics.

Johnson countered that the psilocybin the center uses is synthesized in a lab and that the amounts used do not cause hallucinations.

“The most a person might see is brighter colors. They won’t be seeing pink elephants,” he said.

Finally, there is the high cost of the treatment. The psilocybin itself is relatively cheap, but the sessions require two therapists to conduct, along with a physician who is nearby. The expense of that could keep the treatment from widespread use.

But Johnson suggested that savings could accrue down the road.

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“In cost-benefit analysis, an insurance company may realize that if they pay for this now, it will save on other costs such as patients showing up at the emergency room or needing other treatments or daily medication,” Johnson said.

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