Friday, October 4, 2019

A Trip to Better Health


Although clinical research involving psychedelics showed great promise over 60 years ago when it began, false information peddled by the media and throughout popular culture framed many of these plant-based chemicals as drugs of abuse or even as the cause of rebellions. As a result, the clinical studies evaluating their potential for good dried up as the drugs became tightly regulated and funding for research became increasingly scarce.
Fortunately, studies began to re-emerge around the 1990’s and this time the potential of these substances could no longer be ignored. Part of what is great about these unique substances is that they can be administered in animal models, allowing us to not only gain greater insight into their efficacy as a method of treatment, but they also help us to learn more about the mechanisms that may be underlying these various mental/emotional disorders.
For example, repeated administration of LSD activates feel-good receptors in the front of our brains, which eventually leads to their down-regulation—making us more sensitive to future feel-good moments (Buckholtz et al., 1990). Post-mortem brain samples of people with major depression showed an increase in these same receptors (Shelton et al., 2008), and mice genetically engineered to have a low amount of these receptors showed a significant decrease in anxiety-like behavior (Weisstaub et al., 2006). This research along with many other studies suggests that LSD could really help people with depression and anxiety disorders!
Currently, the theory is that these receptors may normally play a role in modulating the activity of other brain structures like the amygdala (Weisstaub et al., 2006), which is known for its function in fearful memory-associations (this part of the brain tends to be enlarged in people with PTSD for example (Kuo et al., 2012)), so if down-regulating these receptors can cause a decrease in the bad mojo feelings that come from the amygdala, this could lead to some promising avenues for treating a disorder that we still don’t really understand.
Right now the goal of this research is to break the stigma that these drugs currently hold so that we can finally pursue some novel (and promising!) approaches to the many mental/emotional disorders that are currently plaguing our society. Also by deepening our understanding of the underlying mechanisms of these disorders, we can seek to develop other effective treatments that have less psychoactive symptoms, potentially allowing us to treat even more people.



References:
Buckholtz NS, Zhou DF, Freedman DX, Potter WZ. (1990) Lysergic acid diethylamide (LSD) administration selectively downregulates serotonin2 receptors in rat brain. Journal of Neuropsychopharmacology. 137-148
Kuo JR, Kaloupek DG, Woodward SH. (2012). Amygdala Volume in Combat-Exposed Veterans With and Without Posttraumatic Stress Disorder: A Cross-sectional Study. Archive of General Psychiatry. 69(10),1080–1086. doi:10.1001/archgenpsychiatry.2012.73

Shelton, R.C., Sanders-Bush, E., Manier, D.H., & Lewis, D.A. (2008). Elevated 5-HT 2A receptors in postmortem prefrontal cortex in major depression is associated with reduced activity of protein kinase, A. Journal of Neuroscience. 158,1406-1415

Weisstaub, N.V. et al. (2006). Cortical 5-HT2A receptor signaling modulates anxiety-like behaviors in mice. Journal of Science. 313, 536-540

5 comments:

  1. I find this topic incredibly interesting, I actually recently watched a series on Netflix called “Explained” and in one of the episodes it discusses the use of psychedelics as treatment for depression, anxiety and obsessive-compulsive disorder (OCD). A topic, when beginning to think of using a hallucinogenic as a form of therapy, is the idea of using the therapist as a “guide” during the trip. Since people can have good or bad experiences while under the influence of these types of drugs. Do you think having a mental health professional present would be imperative on the effects of the drug as a form of therapy?
    I know that you mention LSD as a possible treatment method but was wondering if there are any other types of hallucinogenic that could have positive effects on the patient as well? I found an article that involves the use of Ketamine, which is usually used as an anesthetic, to treat alcoholism. Ketamine effects the monoaminergic and opioidergic neurotransmitter metabolism (Krupitsky et al., 1997).
    Citation:
    Krupitsky, E. M., & Grinenko, A. Y. (1997). Ketamine psychedelic therapy (KPT): a review of the results of ten years of research. Journal of psychoactive drugs, 29(2), 165-183.

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  2. If I remember correctly, they have actually started some testing on participants to have microdoses of LSD under the watch of a trained doctor. I know several people (all college students of course) who are very excited about this potential treatment. Just like how marijuana was intended for medical use and is now legal for recreational use in some states, do you think that if macrodosing is legalized for treatment it will eventually be legalized recreationally?

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  3. McKenna,

    I'm very glad that you blogged about this topic as it is something I've been keeping tabs on for a while now. I have a good friend who is a PhD Psychiatrist who operates a clinic in California doing trials on LSD, psilocybin, and ketamine therapies for disorders ranging from depression to addiction (including smoking cessation), all of which have been showing extremely promising results! In fact I believe there is a ketamine nasal spray that is now being prescribed to individuals with depression that don't respond well to conventional medications.

    Something else that you might find interesting is that research is now being done on other hallucinogenic compounds like ayahuasca, a traditional Amazonian tribal drink containing the psychoactive compound N,N-diemethyltryptamine (DMT) which is currently classified as a schedule I substance (Hamill et al., 2019). In controlled studies with ayahuasca SPECT and MRI imaging showed "increased blood perfusion to and activation of the nucleus accumbens, right insula, amygdala, and oparahippocampal gyrus, a structure involved in emotional arrousal". Additionally, participants in numerous studies scored significantly lower on "psychopathology measures, cognative tests, and higher on the Purpose in Life Test, Spiritual Orientation Inventory, and Psychosocial Well-Being Test" (Hamill et al., 2019). I think the most interesting thing to point out is that DMT is an endogenous compound to the human body!

    Here's the link to the research, you might find it interesting!

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343205/

    Hamill, J., Hallak, J., Dursun, S. M., & Baker, G. (2019). Ayahuasca: Psychological and Physiologic Effects, Pharmacology and Potential Uses in Addiction and Mental Illness. Current neuropharmacology, 17(2), 108–128. doi:10.2174/1570159X16666180125095902.

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  4. This comment has been removed by the author.

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  5. McKenna,

    I have always been fascinated in this topic for implications as treatment for psychiatric, physical and/or neurologic conditions. I agree, there is a strong stigma around it but if repeatedly shown to have medicinal benefits, hopefully that stigma can be softened. I think the recent decriminalization of Psilocybin mushrooms (“Magic Mushrooms”) was a big move towards exploring potential medicinal uses.

    I don’t really have a question for you, but rather would like to add more food for thought…

    Not only has it been shown that serotonergic psychoactive drugs (LSD and magic mushrooms) work in treating depression and anxiety, as you said, they have also been shown to effectively treat people with cluster headache as well as migraine headache (Andersson, M, Persson, M & Kjellgren, A, 2017). Cluster headaches are extremely debilitating and are commonly known as ‘suicide headache’ because it is so excruciating that it drives some people to kill themselves (Torelli, P, Castellin, P, & Cucarachi, L, 2006). Unfortunately, there aren’t many effective treatments for cluster headaches and a lot of people aren’t responsive to the traditional treatments for cluster headache, such as Imitrex, an acute medication to take during an attack (Andersson, M, Persson, M & Kjellgren, A, 2017). People suffering from cluster headache and migraine become so desperate for relief that it “sometimes spurred risky behavior” which goes for depression and anxiety as well (Andersson, M, Persson, M & Kjellgren, A, 2017).

    Because human research on the effects of psychoactive drugs for medicinal purposes is not permitted, Martin Andersson, Mari Persson and Anette Kjellgren performed an analysis in 2017: Psychoactive substances as a last resort—a qualitative study of self-treatment of migraine and cluster headaches, that was derived from numerous personal testimonies found on blogs, forums and group chats. Through this collection of information, they concluded that LSD and psilocybin were effective treatments for cluster headaches and migraines with the majority of testimonies saying psychedelics worked better than pharmaceuticals as form of treatment.

    Torelli, P, Castellini, P, Cucurachi, L. (2006). Cluster headache prevalence: Methodological considerations. A review of the literature. Acta Biomedica, 77(1). Retrieved from http://www.mattioli1885journals.com/index.php/actabiomedica/article/view/1979

    Andersson, M., Persson, M., & Kjellgren, A. (2017). Psychoactive substances as a last resort—A qualitative study of self-treatment of migraine and cluster headaches. Harm Reduction Journal, 14(1), 60. https://doi.org/10.1186/s12954-017-0186-6

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