Psychedelic Therapies Show Promise for Depression, Anxiety and Addiction

Psychedelic substances including psilocybin, LSD, and MDMA are showing significant promise in clinical trials for treating depression, anxiety, addiction and other mental health conditions. Research indicates these substances, when combined with therapy, can produce lasting therapeutic effects with fewer doses than traditional medications, though their legal status remains a barrier in many countries.

The clinical potential of psilocybin centers on several small but solid studies that combine therapy with doses of the drug. Unlike traditional SSRIs that require daily dosages to keep symptoms at bay, two doses of psilocybin with therapy has shown the potential to keep depression symptoms away for a month, and in one study, cancer patients had less anxiety and depression for years after a single dose. Modern clinical trials appear to support this, with several studies suggesting that the intensity of a "mystical-type experience" during a psychedelic session predicts the degree of improvement in depression, anxiety or addiction.

Research is focused on the treatment of depression, with clinical trials already in phase III. Psilocybin is also being studied for anxiety and depression associated with end of life or serious illness, addictions, or anorexia. There are several phase III trials for MDMA for post-traumatic stress disorder. MDMA is also being investigated for the treatment of anxiety, addictions, eating disorders, or emotional distress and existential angst in seriously ill and terminally ill patients.

LSD is currently being studied primarily for the treatment of depression and anxiety. For generalized anxiety, there are already phase III trials. Some other uses being explored include the treatment of pain and headaches or insomnia. DMT and 5-MeO-DMT are being explored for depression and other conditions, such as anxiety, post-traumatic stress, alcoholism, and trauma, although there is still less solid scientific evidence.

Ketamine is in phase III trials for the treatment of alcoholism and, in less advanced phases, for depression. Esketamine has already been approved for treatment-resistant depression by the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA) and is also being studied for alcohol abuse. Ibogaine is mainly in trials for the treatment of addictions.

The main reason for renewed interest is that there has been no innovation in psychopharmacology for more than 50 years, that the effectiveness of current treatments is limited, with side effects that are becoming increasingly apparent; and there is renewed interest in the medical properties of psychedelics, which show remarkable progress with low doses without chronic treatments.

Researchers routinely measure whether participants have had a "mystical-type experience" using a standardised questionnaire known as the mystical experience questionnaire, or MEQ. Participants are asked to rate statements such as "I had an experience of unity with ultimate reality" or "I had an experience which cannot be described adequately in words". The higher the score, the more likely someone is classified as having had a full mystical experience.

However, the problem remains that psilocybin is illegal under U.S. federal law — classified as a Schedule I substance under the Controlled Substances Act, which prohibits its use, sale and possession. In general, the study of these substances is in the clinical trial phase, with very few drugs authorized and only in some countries.