Psychedelics – the future of depression treatment

After decades of prohibition and bad reputation, psychedelics are again starting to attract the attention of doctors and scientists. More and more research suggests that these substances, sometimes connected with counterculture, can have strong therapeutic effects. What was once taboo is now studied as a possible key for new and more efficient treatments.

What are psychedelics?

Psychedelics are a type of psychoactive substances which cause changes in the perception of time and space, mood and cognitive processes. They are also called hallucinogens and psychotomimetics because they can cause hallucinations and mental states similar to psychoses.

Many are found in nature, but today many of them are of synthetic origin. The most famous psychedelics are:

• psilocybin – isolated from mushrooms, also known as magic mushrooms
• LSD (lysergic acid diethylamide) – synthesised from lysergic acid found on rye mould
• mescalin – extracted from dried peyote cactus
• DMT (dimethyltryptamine) – an ingredient of ayahuasca
• MDMA (3,4-methylenedioxymethamphetamine) – also known as ecstasy
• ketamine – dissociative anaesthetic

Effects of psychedelics

Other than the already mentioned effects, many more exist, which vary from substance to substance: feeling of euphoria, visual and auditory hallucinations, increased heart rate, sweating or the feeling of coldness, rapid breathing, vomiting, relaxation, blurred vision, increased body temperature, increased sweating, loss of appetite and uncoordinated movements.

The effect of a psychedelic depends on a multitude of factors, such as the amount and strength of the substance, the environment of the individual at the time of consumption, as well as their weight and general state of health. Because of that, we differentiate good and bad drug “trips”. Bad trips include terrifying and disturbing hallucinations. Those can lead to panic and unpredictable behaviour. Good trips can lead to expanding the boundaries of awareness. Good trips may have been responsible for the creation of music by iconic rock bands such as The Doors and Pink Floyd.

The most common long–term effect of psychedelic consumption is the “flashback”. Flashbacks are repeated experiences and are known to last days, weeks, months and maybe years since the last consumption of psychedelics. They can be induced with the use of other drugs, stress, fatigue and physical activity. That experience can vary from a pleasant to an extremely unpleasant experience with pronounced anxiety and panic.

The repeated usage of psychedelics develops tolerance relatively quickly, which means that with time, it is necessary to take larger doses to achieve the same effect. Some people can also develop psychological addiction however, physical addiction is rare, and there are no withdrawal effects associated with quitting.

Positive side of psychedelics

Although the use of psychedelics is understandably prohibited due to their aforementioned effects, the existence of good trips during which the users experience intensive emotions, introspective states and the feeling of connectiveness with inner self and the environment have prompted scientists on the possibilities of their usage in psychiatry because they allow patients to rethink their staties from a new perspective and start deep emotional processes.

Psychedelics as a treatment for depression

Most of the psychedelics stimulate the serotonergic system. Serotonin, often referred to as the happiness hormone, is a neurotransmitter that plays a key role in regulating mood, appetite and pain perception. Its deficiency in the synapses is linked to the development of depression.

The primary site of action of psychedelics is the 5-HT2A serotonin receptor. By stimulating it, they can induce long-lasting changes in neurons, influence gene expression, and enhance neural plasticity. Particularly important is their ability to promote the expression of BDNF, which is reduced in depression, anxiety, and various addictions.

It is precisely these facts that have led to the idea that psychedelics could be an effective method for treating depression.

What does the research say?

An increasing number of studies and meta-analyses suggest that psychedelics may have a significant antidepressant effect, even in patients for whom standard therapies have failed. The results show a rapid reduction in depressive symptoms, along with more lasting improvements in emotional regulation and quality of life; in some cases, remission has even been achieved. However, given that most of the studies conducted so far have involved small sample sizes, short durations, and variable protocols, it is important to emphasise the need for further research.

Are psychedelics the future of treatment?

Psychedelics are showing an increasing potential as a new therapeutic option for depression and other mental states, such as anxiety, anorexia and PTSP. Although current research shows promising results, it remains crucial to exercise caution — more evidence is required, along with clearer protocols and expert supervision. Their integration in everyday clinical practice demands a thorough, controlled and responsible approach. We are at the dawn of a potential revolution in mental health, but this path must be navigated with care and responsibility.

Translated by: Dea Radek