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Do psychedelics really work to treat depression and PTSD? Here’s what the evidence says

<p><em><a href="https://theconversation.com/profiles/sam-moreton-194043">Sam Moreton</a>, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p>As of July 1, authorised psychiatrists have been allowed to prescribe MDMA (the chemical found in “ecstasy”) to treat post-traumatic stress disorder (PTSD), and psilocybin (found in “magic mushrooms”) to treat depression that hasn’t responded to other treatment.</p> <p>Psychedelic therapies have researchers excited because evidence suggests they might have lasting beneficial effects on factors that cause psychological distress beyond the treatment period. These include <a href="https://link.springer.com/article/10.1007/s00213-017-4701-y">feeling disconnected from other people</a>, <a href="https://link.springer.com/article/10.1007/s00213-019-05391-0">fear of death</a>, and <a href="https://www.sciencedirect.com/science/article/pii/S2212144719301140?casa_token=OP6tKGxjPHAAAAAA:NTQ4khgsOY5wmsQ5HzCMcZ4eZ43wQV-sdhUbf5LXFiIeKWNwdonhfCxo77k7QbNk4G69EfX-">rigid ways of thinking</a>.</p> <p>This stands in contrast to most medications for psychological issues, which only directly help while people keep taking them regularly.</p> <p>But how strong is the evidence for psychedelic therapy?</p> <h2>Early promise</h2> <p>Early results from studies around the world have found psychedelic therapy <a href="https://www.ranzcp.org/getmedia/0cf57ea2-0bd7-4883-9155-d2ba1958df86/cm-therapeutic-use-of-mdma-for-ptsd-and-psilocybin-for-treatment-resistant-depression.pdf">might be effective</a> for treating a range of psychological issues.</p> <p>For instance, most studies (<a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">but not all</a>) have found patients tend to report <a href="https://pubmed.ncbi.nlm.nih.gov/37357767/">fewer depression symptoms</a> for periods ranging from several weeks to several months after psilocybin therapy.</p> <p>Similarly, studies have found <a href="https://journals.sagepub.com/doi/10.1177/0269881120965915">reductions in PTSD symptoms</a> three weeks after MDMA therapy.</p> <h2>Not so fast</h2> <p>However, as psychedelic research has grown, <a href="https://pubmed.ncbi.nlm.nih.gov/35243919/">limitations</a> of the research have been identified by researchers both <a href="https://psyarxiv.com/ak6gx/">within</a> and <a href="https://www.sciencefictions.org/p/psychedelics">outside</a> the psychedelic field.</p> <p>One issue is that we aren’t sure whether findings might be due to a <a href="https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/placebo-effect">placebo effect</a>, which occurs when a treatment works because people expect it to work.</p> <p>In clinical trials, participants are often given either a medication or a placebo (inactive) drug – and it’s important they don’t know which they have been given. However, due to the strong effects, it is difficult to prevent participants from knowing whether they have been given a psychedelic drug.</p> <p>Researchers have tried to use a range of different drugs (such as Ritalin) as a placebo in order to “trick” those participants not given a psychedelic into thinking they have received one. But this can be difficult to achieve.</p> <p>In 2021, researchers <a href="https://www.tandfonline.com/doi/full/10.1080/17512433.2021.1933434?casa_token=Dovn7x_rkdUAAAAA%3AsPzBTYNTPnNwqj9NvwN0m9ptrP4x4-c83gp3tGcshs30dWHNnmB_Vx-X5H5Y3pZJdG02IWW6X2E">reviewed</a> clinical trials involving psychedelics such as LSD, psilocybin, and dimethyltryptamine (found in animals and plants) for mood and anxiety disorders. They found trials either had not assessed whether participants guessed correctly which drug they had been given, or that this had been tested and participants tended to guess correctly.</p> <p>More recent trials <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2032994">either don’t measure this</a> or find participants have a <a href="https://journals.sagepub.com/doi/full/10.1177/02698811231154852?casa_token=VsPt344fVGwAAAAA%3AA-i1VPBE1EWyFITWNncZEt876lWMiC7rtTOLJBQnb2pHI2775imUJhrzeSZW6r9doaBeDaj61D0">pretty good idea</a> of whether they’ve had a placebo or a psychedelic drug.</p> <p>Given the publicity and excitement around psychedelic research in recent years, it is likely most participants have <a href="https://culanth.org/fieldsights/the-pollan-effect-psychedelic-research-between-world-and-word">strong beliefs</a> such therapies work. This could lead to a significant placebo effect for participants given a psychedelic dose. Additionally, participants who realise they have received a placebo could experience <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10184717/">disappointment and frustration</a>, resulting in worse symptoms. The benefits of a psychedelic may seem even greater when they are compared to the experiences of disappointed participants.</p> <h2>Translating trials to practice</h2> <p>Anecdotally, patients might be motivated to report they have gotten better, even when they haven’t.</p> <p>On a 2021 podcast, one clinical trial participant <a href="https://www.psymposia.com/powertrip/">described</a> how, in hindsight, the information they provided to the trial did not accurately capture the worsening of their symptoms. Trial participants are likely aware their results might affect whether treatments are legalised. They may not want to “ruin” the research by admitting the treatment didn’t work for them.</p> <p>There is also uncertainty about whether the findings from clinical trials mean treatments will work in private practice. There may be a lack of clarity around <a href="https://psyarxiv.com/ak6gx/">how trial participants</a> are recruited and selected. Therefore participants may not represent the typical person with PTSD or treatment-resistant depression.</p> <p>And while <a href="https://journals.sagepub.com/doi/full/10.1177/02698811211069100">the safety of psychedelics</a> within controlled contexts is often emphasised by advocates, less is known about safety of psychedelic therapy <a href="https://www.frontiersin.org/articles/10.3389/fpsyt.2021.737738/full">outside</a> clinical trials.</p> <h2>Resolving issues</h2> <p>These issues do not mean the promising psychedelic research conducted over the past several decades is worthless. Nevertheless, a <a href="https://pubmed.ncbi.nlm.nih.gov/35285280/#full-view-affiliation-1">recent review</a> of the effects of MDMA and psilocybin on mental, behavioural or developmental disorders by Australian researchers concluded the “overall certainty of evidence was low or very low”.</p> <p>Dutch researchers recently drafted a <a href="https://psyarxiv.com/ak6gx/">roadmap for psychedelic science</a> with a checklist for future research to help avoid these pitfalls. When more research is done, it might turn out psychedelic treatments help patients and don’t come with unacceptable harms – we simply don’t know that yet.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/208857/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/sam-moreton-194043">Sa<em>m Moreton</em></a><em>, Associate Lecturer, School of Psychology, <a href="https://theconversation.com/institutions/university-of-wollongong-711">University of Wollongong</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/do-psychedelics-really-work-to-treat-depression-and-ptsd-heres-what-the-evidence-says-208857">original article</a>.</em></p>

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Manipulating light can induce psychedelic experiences – and scientists aren’t quite sure why

<p>For millennia, people have used mind-altering techniques to achieve different states of consciousness, envision spiritual figures, connect with nature, or simply for the fun of it. Psychedelic substances, in particular, have a long and controversial <a href="https://theconversation.com/psychedelic-drugs-can-be-almost-as-life-altering-as-near-death-experiences-189325">history</a>. But for just as long, people have been having these experiences without drugs too, using <a href="https://www.mdpi.com/2076-3425/11/1/101">rhythmic techniques such as rocking, chanting or drumming</a>.</p> <p>Perhaps the most powerful technique of this kind is flickering light, called “ganzflicker”. Ganzflicker effects can be achieved by turning a light on and off, or by alternating colours in a rapid, rhythmic pattern (like a strobe). This can create an instant psychedelic experience. </p> <p>Ganzflicker elicits striking visual phenomena. People can see geometric shapes and illusory colours but sometimes also complex objects, such as animals and faces – all without any chemical stimulants. Sometimes ganzflicker can even lead to altered states of consciousness (such as losing a sense of time or space) and emotions (ranging from fear to euphoria).</p> <p>Although its effects are little known today, ganzflicker has influenced and inspired many people through the ages, including the two of us. We are an art historian and brain scientist working together on an interactive showcase of ganzflicker techniques used in science and art. Our collaboration has culminated in the museum exhibition <a href="https://reshannereeder.com/ganzflicker-exhibit">“Ganzflicker: art, science, and psychedelic experience”</a>, which is part of the 2022 <a href="https://www.beinghumanfestival.org/">Being Human festival</a>.</p> <p>Ganzflicker’s effects were first documented in 1819 by the physiologist <a href="https://www.karger.com/Article/FullText/235945">Jan E. Purkinje</a>. Purkinje discovered that illusory patterns could appear if he faced the sun and waved his hand in front of his closed eyelids.</p> <p>Near the end of the 19th century, an English toymaker and amateur scientist, <a href="https://www.nature.com/articles/051200c0">Charles Benham</a>, produced the first commercially available flicker device: a top with a monochrome pattern that, when spun, produced illusory colours that swirled around the disc. </p> <p>Modified versions of Benham’s “artificial spectrum top” were used in experiments well into the 20th century. William Grey Walter, a pioneering neurophysiologist and cybernetician, <a href="https://link.springer.com/chapter/10.1007/978-3-642-70911-1_17">pushed flicker effects further</a> by using electric strobe lights, synchronised with the brain’s rhythms.</p> <p>Fascinated by the mind-altering potential of Walter’s machinery, the artist Brion Gysin, in collaboration with writer William S. Burroughs and mathematician Ian Sommerville, invented the <a href="http://mindcontrol-research.net/wp-content/uploads/2016/12/14_2_dream-machine-plans.pdf">Dreamachine</a> (1962).</p> <h2>The swinging 60s of drug-free psychedelics</h2> <p>A Dreamachine consists of an upright cylinder with patterns cut into it and a lightbulb suspended at its centre. When spun on a turntable at 78rpm, the flickering patterns (viewed through closed eyelids) can cause trance-like hallucinations.</p> <p>Gysin thought of the Dreamachine as a new kind of artwork – “the first art object to be seen with the eyes closed” – and a form of entertainment, which he believed could replace the television. Others saw the Dreamachine’s potential to be a source of spiritual inspiration.</p> <p>Burroughs thought it could be <a href="https://faroutmagazine.co.uk/brion-gysin-the-pioneering-artist-who-invented-the-dreamachine/">used to</a> “storm the citadels of enlightenment”. The poet Alan Ginsberg said: “It sets up optical fields as religious and mandalic as hallucinogenic drugs – it’s like being able to have jewelled biblical designs and landscapes without taking chemicals.”</p> <p>Flicker experiments in art did not stop with the Dreamachine. Others included Tony Conrad’s groundbreaking structuralist film <a href="https://fourthree.boilerroom.tv/film/flicker-tony-conrad">The Flicker</a> (1966), which was the first artwork to include the warning “may induce epileptic seizures or produce mild symptoms of shock treatment in certain persons”. </p> <p>The conceptual artist James Turrell’s <a href="https://jamesturrell.com/work/bindu-shards/">Bindu Shards</a> (2010) was an enclosed globe that bombards the observer with strobe light. And, more recently, Collective Act created its own <a href="https://dreamachine.world/">Dreamachine</a> (2022) , a public planetarium-style artwork inspired by Gysin’s which toured the UK.</p> <h2>The science of ganzflicker</h2> <p>Two hundred years after Jan Purkinje documented the physiological properties of ganzflicker, scientists still do not have a definitive explanation for how it works. </p> <p>A recent theory proposes that visual phenomena may be the result of interactions between external flicker and the brain’s natural rhythmic electrical pulses, with more intense images manifesting <a href="https://theconversation.com/pseudo-hallucinations-why-some-people-see-more-vivid-mental-images-than-others-test-yourself-here-163025">when the frequencies of flicker and the brain are closest</a>.</p> <p>It is also likely that a strong visual flicker influences brain states. Meaningful visions, altered conscious states and heightened emotions may be the result of <a href="https://www.nature.com/articles/s41467-020-18591-6">imaginative suggestion</a>, which is amplified by the trance-inducing properties of <a href="https://www.mdpi.com/2076-3425/11/1/101">rhythmic stimulation</a>.</p> <p>What is perhaps most powerful about ganzflicker is its universality. Engineers, mathematicians, artists, historians and scientists have all been united by this modest, drug-free means of eliciting dramatic changes in consciousness. The new wave of popularity on this topic will undoubtedly lead to illuminating discoveries in the coming years.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/manipulating-light-can-induce-psychedelic-experiences-and-scientists-arent-quite-sure-why-192885" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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New psychedelic treatment for PTSD discovered

<p><span style="font-weight: 400;"> A new study has found that the key ingredient in the illicit drug known as Ecstasy or Molly could ease the symptoms of post-traumatic stress disorder.</span></p> <p><span style="font-weight: 400;">When combined with intense talk therapy, the study reports that MDMA significantly eased symptoms in those struggling with severe PTSD.</span></p> <p><span style="font-weight: 400;">“This is a big deal,” Steven Gold, a clinical psychologist in Fort Lauderdale and professor emeritus at Nova Southeastern University in Florida told </span><a href="https://www.sciencenews.org/article/mdma-ecstasy-ptsd-symptoms-psychedelic-psychology?utm_source=email&amp;utm_medium=email&amp;utm_campaign=latest-newsletter-v2&amp;utm_source=Latest_Headlines&amp;utm_medium=email&amp;utm_campaign=Latest_Headlines"><span style="font-weight: 400;">ScienceNews</span></a><span style="font-weight: 400;">. “All other things being equal, the use of psychedelic medication can significantly improve the outcome.”</span></p> <p><span style="font-weight: 400;">Though </span><a href="https://www.nature.com/articles/s41591-021-01336-3#citeas"><span style="font-weight: 400;">the findings</span></a><span style="font-weight: 400;">, published in </span><span style="font-weight: 400;">Nature Medicine</span><span style="font-weight: 400;">, are preliminary, they offer hope to the millions of people with PTSD who are in desperate need of new treatments. Antidepressants such as Zoloft and Paxil are often prescribed to these patients, but don’t work for an estimated 40 to 60 percent of people with PTSD.</span></p> <p><strong>How did they test it?</strong></p> <p><span style="font-weight: 400;">The study involved 90 people across 15 sites in the United States, Canada, and Israel. All participants received 15 therapy sessions with therapists who were trained to guide people experiencing the drug.</span></p> <p><span style="font-weight: 400;">Of the 90 participants, half received MDMA in three eight-hour therapy sessions while the other half received placebos.</span></p> <p><span style="font-weight: 400;">MDMA, true to its nickname Ecstasy, evokes feelings of bliss and social connectedness. Those who took either the drug or the placebo wore eye covers, listened to music, and occasionally talked to their therapist about their experience during the sessions.</span></p> <p><span style="font-weight: 400;">By the end of the 18-week trial, most participants showed fewer PTSD symptoms such as unwanted, intrusive memories.</span></p> <p><span style="font-weight: 400;">But, those who took MDMA experienced the best benefits.</span></p> <p><span style="font-weight: 400;">By the trial’s end, 67 percent of the participants taking MDMA had improved so much they no longer qualified for a PTSD diagnosis.</span></p> <p><span style="font-weight: 400;">In comparison, 32 percent of those taking the placebo no longer met the criteria for a PTSD diagnosis by the end of the study.</span></p> <p><span style="font-weight: 400;">Many participants had been living with severe PTSD for years.</span></p> <p><span style="font-weight: 400;">“Typically, we see PTSD as a disorder for life. Now, we may begin to let that go,” said Eric Vermetten, a psychiatrist at the Leiden University Medical Centre in the Netherlands who works with veterans and military members with PTSD and was not involved in the study.</span></p> <p><span style="font-weight: 400;">Though it isn’t exactly clear how the drug changes the brain, some imaging studies suggest MDMA dampens activity in the amygdala, a structure in the brain involved in fear. Other results from studies in mice suggest the drug may heighten social learning, which may strengthen the relationship between a patient and their therapist.</span></p> <p><span style="font-weight: 400;">The study did require a significant amount of emotional work before, during and after the MDMA sessions too.</span></p> <p><span style="font-weight: 400;">“[MDMA] is not a magic pill,” co-author Amy Emerson said.</span></p> <p><span style="font-weight: 400;">Since more than 75 percent of the cohort were white, Gold said it is unclear whether the effects would be similar with a more diverse group of people. Nor is it clear how long the effects might last.</span></p> <p><span style="font-weight: 400;">Another clinical trial is in the works, but restrictions on MDMA in the United States have complicated future research.</span></p> <p><span style="font-weight: 400;">“There are a lot of barriers to break down related to this treatment,” Emerson said. “And there is a lot of hope.”</span></p>

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