The landing of psychedelic medicine: "it is as revolutionary as antidepressants were"
Allan Malievsky was studying in his second year at George Washington University (USA) in 2012 when one day he noticed that he lacked the strength to continue living. She couldn't breathe, had no energy to get out of bed, and the light in her world went out.. She took a break from the course and went to visit her parents, Ekaterina Malievskaia and George Goldsmith.. The months passed but Allan did not improve, he had depression and obsessive-compulsive disorder (OCD), but the medication was not having any effect. Eakaterina, who was a doctor, was relentlessly looking for what could help her son get out of that dark pit, and that is how she came across a very small clinical trial that showed that psilocybin – a substance that is obtained of hallucinogenic mushrooms – worked in the treatment of OCD. They took Allan to a session with a shaman-therapist who had been recommended to them by trusted research circles and, in a session of about six hours, with the help of psilocybin- administered in tea, the young man stopped feeling anguish and returned to his interest in life
The change was so shocking that Ekaterina and her husband decided to continue their research with psilocybin.. In 2016 they founded their own company, Compass Pathways, which is currently conducting the largest and most ambitious clinical trial to date to test the effects of psilocybin on depression.. “At the moment, psilocybin is the psychedelic substance that is closest to being approved for therapeutic use in Europe.. What has been seen is that it has a beneficial effect on depression, which is not only immediate – unlike treatment with antidepressants, which can take up to a month – but that the improvement can last for weeks, and even months, with a single dose, unlike esketamine – the first advance against depression in 30 years whose financing in Spain has recently been approved for the treatment of depression resistant to treatment (DRT) – which must be administered two or three times a day. week to ensure that its effect is maintained- explains Víctor Pérez-Sola, president of the Spanish Society of Psychiatry and Mental Health Foundation (Fepsm) and director of the Psychiatry Service of the Hospital del Mar, in Barcelona.
Microdoses don't work
The expert points out that for the administration of psilocybin there are two fundamental strategies: microdoses (“which have no scientific evidence”), and 'full doses' (“the highest doses are those that have been shown to work”). Your hospital has participated with eight patients – the only Spanish ones – in a trial recently published in the New England of Medicine scientific journal that has demonstrated the efficacy of this substance as monotherapy in the treatment of DRT – that which does not improve with treatment with antidepressants, and which, in Spain, affects 35% of people with this mental disorder-. Another essential aspect is the professional and safe environment in which these substances must be administered to ensure that the patient does not have a “bad trip”.. “Due to the great hallucinogenic effect they have, there must always be two psychologists trained in this therapy accompanying the patient who, before being administered the dose of psilocybin, is shown a video of a ship sailing through natural landscapes of great beauty so that trust that the experience is going to be pleasant”, he emphasizes.
Another of those known as psychedelic drugs that is in advanced stages of research is MDMA (or angel dust), which has shown its benefit as an adjuvant in psychotherapy sessions for the treatment of post-traumatic stress disorder (PTPD).. In fact, the United States Food and Drug Administration (FDA) is expected to approve it this year.. “We do not know what requirements the European Medicines Agency (EMA) will request to approve MDMA, because it does not have patent coverage- what is patented is not the substance but the training of therapists to work with it-. In the US, it is not financed by the industry, but by private funds from donors, people with a lot of money who want to help improve the treatment of TPEP, which is a big health problem there,” says Pérez-Sola.
“We have known for decades that memories related to trauma are not remembered and kept intact, but that each time we bring them to light in front of a therapist, their emotional component changes.. That is where MDMA comes in, since it favors the reprocessing of traumatic memories and emotional participation in the therapeutic process.. In this way, it is achieved that, when it is put back in a safe situation, it fades until, to put it in some way, it stops hurting.. The groups that are working on these drugs are aware that they are as revolutionary as antidepressants were at the time,” he says.
Finally, the psychedelic substance that is at an earlier stage of investigation is dimethyltryptamine (DMT), a potent hallucinogenic drug nicknamed the “spirit molecule” or “God molecule.”. “Phase II clinical trials are now being carried out to verify its effect in the treatment of PTSD. The mode of administration is similar to that of psilocybin, but in this case by aspiration, instead of in pills,” the psychiatrist describes.
have risks
The big question that arises with the advancement of psychedelic medicine is that if these substances have been known for centuries, and their effect on mental health can be so revolutionary, why have they not been investigated before using a scientific method? “For the risks, mostly, which are very important. On the one hand, there are the psychodysleptic effects that they can have – that is, that they can give us a ‘bad trip’ – and that make it essential that they are always taken as part of a therapeutic protocol, in a safe environment and accompanied by qualified professionals. On the other hand, although these substances have a low risk of dependence compared to others such as cocaine, heroin or tobacco, in people with a tendency to addiction they can lead to misuse. In these cases, which are very rare, the effects are catastrophic,” he warns.