The therapeutic benefit of using psychedelics in treating various mental illnesses is controversial. Despite the potential of psychedelics to help the patient, there is a risk to make things worse as the drugs of this type might be dangerous for the patient’s mental state. This work critically analyzes five studies exploring the effects of a specific psychedelic (psilocybin) in treating a specific mental health disorder (depression). This work is a literature review that aims to discuss the topic and compare and contrast psychedelics with traditional forms of psychological treatment.
First of all, it is essential to understand the general effects of psilocybin on the brain that are present in the current literature. According to Kuypers (2020), small doses of psilocybin can positively affect cognitive processes, including time perception and divergent and convergent thinking, and the corresponding brain regions. However, the same study has found that using psilocybin increases anxiety and may create a cycling pattern of depression and euphoria (Kuypers, 2020). Therefore, it may be dangerous to administer small doses of psilocybin to patients suffering from depression as it does not guarantee a positive effect and can contribute to the development of another severe mental illness. Compared to the traditional psychological treatments, psilocybin may provide similar improvements, but it is also associated with high risks, meaning that more scientific knowledge is required to support psilocybin’s therapeutic value.
The risks of using psychedelics in treating patients with mental health disorders cause the related question concerning the reasons to use them instead of traditional psychological treatments. According to Roseman et al., (2018), psychedelic therapy may be more appropriately thought of as a distinct form of (drug-assisted) psychotherapy than as a pure pharmacotherapy. However, the current treatments have limited effectiveness and adherence (Davis et al., 2021). That is why new methods and techniques, including the usage of psilocybin, are constantly explored to find more effective ways of treating mental illnesses such as depression.
The importance of studying the positive effects of psilocybin is explained in recent studies. They suggest that 1 or 2 administrations of psilocybin with psychological support produce antidepressant effects (Davis et al., 2021). The research of Hibicke et al. (2020) has also provided evidence to that suggestion. The randomized clinical trial conducted by Davis et al. (2021) shows that psilocybin with therapy is efficacious in treating major depressive disorder. The trial consisted of two sessions, using 20 mg and 30 mg of psilocybin (Davis et al., 2021). Therefore, conducting more clinical trials may lead to discoveries and provide more evidence of the positive effects of psilocybin in treating mental illnesses.
As it is known, depression is a complex mental illness, meaning that it can be associated with complicated treating. It is questionable whether psychedelics can be effective in such cases. For instance, the study of Roseman et al. (2018) explores the effects of psilocybin in treating patients with treatment-resistant depression (TRD). The study describes another clinical trial which involved twenty patients with treatment-resistant depression underwent treatment with psilocybin (two separate sessions: 10 and 25 mg psilocybin) (Roseman et al., 2018). Another specificity of this study is that it aims to test the effectiveness of psilocybin in treating TRD in the long term (Roseman et al., 2018). Although the study shows psilocybin’s contribution to the long-term positive outcomes, it also reveals the psychedelic’s association with increased anxiety (Roseman et al., 2018). That fact has also been discussed in another study reviewed in this work, meaning that future work is necessary to determine psilocybin’s efficacy more accurately and consider ways of reducing anxiety symptoms.
Another critical point regarding exploring psilocybin effects is understanding its therapeutic mechanisms, which were not addressed in the studies reviewed previously. The study conducted by Carhart-Harris et al. (2017) measures cerebral blood flow and resting-state functional connectivity (RSFC) dependent on the blood oxygen level in patients before and after a psilocybin treatment. The researchers collected data from 19 patients using functional magnetic resonance imaging (fMRI) (Carhart-Harris et al., 2017). According to the researchers’ findings, all patients demonstrated reduced depressive symptoms correlated with decreased cerebral blood flow and increased RSFC (Carhart-Harris et al., 2017). Further exploration of psilocybin’s therapeutic mechanisms can help understand its similarities and differences with the medications used in current psychological treatments.
Overall, the current literature demonstrates the positive effects of using psilocybin in treating depression. The studies analyzed in this review provide evidence that small doses of psilocybin can decrease the symptoms of depression. However, several studies also report that psilocybin might be associated with increased anxiety. Compared to the traditional psychological treatments, psilocybin can have similar positive effects, but the current literature lacks the knowledge to address the corresponding risks. Therefore, further exploration of the subject and conducting more clinical trials are advisable to better understand the effects of psilocybin.
References
Carhart-Harris, R. L., Roseman, L., Bolstridge, M., Demetriou, L., Pannekoek, J. N., Wall, M. B., & Nutt, D. J. (2017). Psilocybin for treatment-resistant depression: FMRI-measured brain mechanisms. Scientific reports, 7(1), 1-11.
Davis, A. K., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N. D., Johnson, M. W., & Griffiths, R. R. (2021). Effects of psilocybin-assisted therapy on major depressive disorder: a randomized clinical trial. JAMA psychiatry, 78(5), 481-489.
Hibicke, M., Landry, A. N., Kramer, H. M., Talman, Z. K., & Nichols, C. D. (2020). Psychedelics, but not ketamine, produce persistent antidepressant-like effects in a rodent experimental system for the study of depression. ACS chemical neuroscience, 11(6), 864-871.
Kuypers, K. P. (2020). The therapeutic potential of microdosing psychedelics in depression.Therapeutic advances in psychopharmacology, 10, 1-15.
Roseman, L., Nutt, D. J., & Carhart-Harris, R. L. (2018). Quality of acute psychedelic experience predicts therapeutic efficacy of psilocybin for treatment-resistant depression. Frontiers in pharmacology, 8, 974.