Psychedelic therapy may treat depression and PTSD faster than standard medicines, which often take weeks to work. Researchers are developing psychedelic drugs with a much shorter, more controlled trip than magic mushrooms or MDMA. The goal is to keep the fast benefit without the long, intense effects.
Summary: Depression is on the rise. Major depression needs medical care, because it sharply raises the risk of self-harm. Many medicines help treat it. But they work very slowly and often take weeks to kick in. Psychedelic drugs are different. They change a person’s mental state almost at once. Many of these illegal drugs may even help treat depression. This is true mainly of psychedelics like magic mushroom, Ecstasy, or MDMA. The problem is that these drugs cause a long trip or euphoria (a high). Researchers think a much shorter, controlled trip may work for depression. So they need drugs that act for only about a couple of hours. Some researchers believe these drugs may work with no high or trip at all. So some are trying to build psychedelic look-alike drugs. These would treat depression without causing a high or addiction. They may also treat PTSD well. That could offer new options for people in opioid addiction treatment as well.
The psychedelic effect comes from psilocybin. It is a prodrug (a substance the body turns into the active drug) found in many mushrooms. Levels are very high in mushrooms of the genus Psilocybe. These are also called magic mushrooms.
Psilocybin is fairly common. It is found in more than 200 kinds of mushrooms. Once eaten, it turns into psilocin. That causes a mind-altering effect, or euphoria. Many people say eating psilocybin gives them a wonderful spiritual experience. They call it “a trip.” So there is little doubt that it may help clear depression and PTSD.
Depression and PTSD are major mental health problems in the US and around the world. What is worrying is that they keep rising. Some current drugs treat severe depression well. But there are problems. They do not work well enough, and they take a long time to help. Some take weeks before the patient’s mood gets better.
Right now, psychedelic drugs are illegal to use. In most nations, even owning psychedelic mushrooms is against the law. But their use is allowed for medical reasons or in clinical studies.
Unlike antidepressants, psilocybin works almost at once. But common psychedelic drugs like LSD have a big drawback. They act for a long time. The so-called trip can last as much as 12 hours. Researchers think such a long trip is not needed and even poses a health threat. So there is a need for psychedelic drugs that act for a shorter time1.
Of course, some substances act for quite a short time and are very safe. One is 5-MeO-DMT. Its effect lasts only about 15 minutes. But researchers think that is too short. So they are aiming for something in between. They believe the sweet spot is about two hours.
Using such drugs for depression or PTSD is not a new idea. People have long used anesthetics like ketamine to treat depression, though not legally. Then in 2019, the US FDA approved a ketamine-based nasal spray to treat depression faster. It is safe and acts fast. It also works for depression that resists other treatment. So why not consider psilocybin, which is even stronger?2
There is sound science behind using psilocybin for depression. Studies show it acts on 5-HT-2A receptors in the brain. This boosts neuroplasticity (the brain’s power to rewire itself). So the brain rewires faster. That brings fast and lasting relief from depression.
Researchers think there is no need for a trip as long as the one LSD causes. Just a couple of hours of trip is enough to cause huge changes in the brain. But they expect any such therapy to happen strictly under medical supervision. It would need psychotherapy before and after (pre- and post-psychotherapy).
Other researchers believe the mind-altering effect of psilocybin is not needed at all. They think it would work without a high or trip. So some drug makers are trying to build drugs that ease depression without causing a high or trip. Such a drug would not lead to substance abuse. It would also be much safer.
There is a real chance such a drug will be approved in the coming years. The Defense Advanced Research Projects Agency (DARPA) has even given a research grant of $26.9 million to study it3. DARPA wants a quick and powerful drug to treat psychiatric conditions. But it wants a drug that does not cause a hallucinogenic ride.
A recent study even showed that Ecstasy, or MDMA, may help treat PTSD. The so-called MDMA-assisted therapy was twice as effective as a placebo at easing PTSD symptoms. It worked for 67% of participants. These results are truly encouraging. They show psychedelic drugs could be a quick fix for many psychiatric disorders4.
Frequently asked questions
What is the psychedelic drug for depression?
The best-known one is psilocybin, the compound in magic mushrooms. The body turns it into psilocin. MDMA, also called Ecstasy, has been studied for PTSD. In 2019, the US FDA approved a ketamine-based nasal spray for faster treatment of depression. That includes depression that resists other treatment. Researchers are now building shorter-acting psychedelics and versions that cause no trip at all.
Is psychedelic therapy legal?
Psychedelic drugs are illegal to use. In most countries, even owning psychedelic mushrooms is against the law. Their use is allowed for medical reasons or inside clinical studies. Researchers expect any psychedelic treatment for depression or PTSD to happen strictly under medical supervision. It would come with psychotherapy before and after the session.
How long does a psychedelic trip last?
It depends on the drug. An LSD trip can last as long as 12 hours. Researchers consider that unneeded and even a health risk. 5-MeO-DMT acts for only about 15 minutes, which they think is too short. The sweet spot they are aiming for is about two hours. That is long enough to cause major changes in the brain.
Does MDMA therapy work for PTSD?
In a published study, MDMA-assisted therapy was twice as effective as a placebo at easing PTSD symptoms. It worked for 67% of the people who took part. Researchers see results like these as a sign of hope. Psychedelic drugs could bring relief much faster than the medicines that take weeks to work.
Related reading
Ecstasy and Magic Mushrooms for PTSD · Psychedelic Effects Through Virtual Reality · Some psychological interventions do more harm than good · Drug Addiction Treatment, St. Louis
References
- Yakowicz W. The Future Of Psychedelic Medicine Might Skip The Trip. Forbes. Accessed February 12, 2022. https://www.forbes.com/sites/willyakowicz/2021/06/23/the-future-of-psychedelic-medicine-might-skip-the-trip-rick-doblin-bryan-roth-mindmed-darpa-maps/
- Yakowicz W. Why Ketamine-Assisted Therapy Has Gone Mainstream. Forbes. Accessed February 12, 2022. https://www.forbes.com/sites/willyakowicz/2021/10/18/why-ketamine-assisted-therapy-has-gone-mainstream/
- Roth Leads $26.9 Million Project to Create Better Psychiatric Medications. Newsroom. Published June 15, 2020. Accessed February 12, 2022. https://news.unchealthcare.org/2020/06/roth-leads-26-9-million-project-to-create-better-psychiatric-medications/
- Mitchell JM, Bogenschutz M, Lilienstein A, et al. MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nat Med. 2021;27(6):1025-1033. doi:10.1038/s41591-021-01336-3