LSD and ecstasy to treat mental illness

Du LSD ou de l’ecstasy pour traiter la maladie mentale

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Therapy psychedelic philosophy is to help people adopt a new outlook on their health and way of life.

A stamp, a session, effects that persist over time. Grosso modo, this is the promise of the psychiatrists who are working on the development of treatments through the use of psychedelic drugs to treat mental health disorders. Rather than soothe the symptoms of mental illness, these substances serve to “reconnect” the brain. If they were legalized in a medical context — and it is this that seems to be taking shape, a small revolution could shake the psychiatry.

At the end of October, the Food and Drug Administration (FDA) granted the status of “revolutionary treatment” to the psilocybin (the active ingredient in magic mushrooms) to treat depression recalcitrant. In 2017, it was the MDMA (see ecstasy) that had the same classification designed to expedite the regulatory processes, this time to combat the states of post-traumatic stress disorder. Of clinical studies of phase 3, the latest pre-market, are currently underway with MDMA in several cities of the world, including in Montreal. The LSD has been the subject of a clinical trial a few years ago in order to assess its potential to mitigate cases of anxiety serious.

In short, we are witnessing currently, “on a resurgence of the therapy, the psychedelic” in the world of research, ” observes Jean-Sébastien Had a professor in psychoeducation at the Université de Montréal and specialist in addiction. “Looking at the stories, but especially the studies, you see amazing results, he says. What impresses me the most is the extent of the effectiveness of the treatment in some patients previously recalcitrant to care. “

What impresses me the most is the extent of the effectiveness of the treatment in some patients previously recalcitrant to care

— Jean-Sébastien Necessary

Taking on the causes

MDMA, LSD or psilocybin are administered during psychotherapy sessions of several hours, during which therapists accompany the patient in his thoughts psychedelic. In theory, after only one, two or three flights supervised, the patient is rid of his affection. Thus, contrary to what happens with the conventional medications for anxiety or depression consumed on a daily basis, the patient is not experiencing adverse side effects. In addition, the psychedelic drugs do not produce physiological dependence, and rarely of psychological dependence.

“The MDMA and psilocybin facilitate psychotherapy because they allow the patient to be more connected to their emotions,” says Gabriella Gobbi, a professor in the Department of psychiatry of McGill University. The substance is not a substitute for psychotherapy, it multiplies the effects, ” she explains.

MDMA boosts the empathy in patients. It causes the release of oxytocin, a hormone involved in social bonding, and of serotonin, a neurotransmitter that regulates the mood. In addition to this, it reduces brain activity in the amygdala, a brain region associated with fear. The combination of effects allows the patient suffering from post-traumatic stress disorder to reconsider his memory disturbing without being overwhelmed by negative emotions.

Psilocybin, it blocks a receptor for serotonin, which has as a result effective to increase the concentration of the neurotransmitter in the brain. It follows a disturbance of the senses, euphoria, and decreased activity in the amygdala — which helps to restore the optimism of the depressed patient. The action of LSD, which also binds to the serotonin receptors, is similar.

Storm controlled

While antidepressants or anxiolytics interfere with certain neurotransmitters, in daily life, LSD, psilocybin and MDMA cause a storm in the mind, which, if it is tamed, gives a renewed perspective. “The therapy psychedelic seems to resolve the cause of the problems rather than the symptoms,” explains Jean-Sébastien Necessary.

“With the substances psychodyslexiques [that alter perceptions], the brain becomes more receptive, in a creative mode, was open to new experiences. They can create positive experiences, when there is normally self-destruction, ” says Philippe Vincent, clinical associate professor at the Faculty of pharmacy of the University of Montreal and researcher at the Institut universitaire en santé mentale de Montréal. “The patient can then refer to these new positive experiences, these new reflexes. However, it may skid too, warns the pharmacist. The choice of dose is very important. “

In effect, the taking of substances, psychedelics can trigger psychosis if the dose is inadequate or if the person is naturally predisposed to these crises. “Last week, one of my patients* came to see me after being made in the United States to follow a therapy psychedelic where she was given MDMA, tells the story of Gabriella Gobbi. However, she had not informed the psychiatrist there that she had previously suffered from a psychosis. As a matter of fact, a new psychosis is triggered because of the substance and the patient had to be hospitalized. “

“If a person is predisposed, the risk of triggering a psychosis are very large,” notes the specialist. In addition, she adds, the people who already have mental health problems are more often vulnerable to psychosis than the average person. These risks invite you to the utmost caution, think Gabriella Gobbi.

The people who already have mental health problems are more often vulnerable to psychosis than the average person. If a person is predisposed, the risk of triggering a psychosis are very large.

— Gabriella Gobbi

The psychiatrist believes that therapy psychedelic should be confined to diagnostics for the moment, incurable. “Personally, I don’t think you should encourage therapy psychedelic for diseases for which we already have an effective treatment, such as anxiety or depression. However, for the states of post-traumatic stress disorder or alcoholism-severe, to where nothing really works, it can be more interesting. “

“In psychotherapy, people want to better understand their emotions, develop empathy, relieve their suffering, advance the dr. and a professor at McGill University. However, some people have an intrinsic difficulty to do so. MDMA and psilocybin could help them get there, but it should not be the use of these substances with patients who do not really need. “

Change his mode of life

If the therapy psychedelic philosophy is to help people adopt a new outlook on their health and way of life, is it really necessary to resort to drugs to get there ? “Is this doable without the use of substance ? This is what the studies are trying to tell us, and that is why they include sub-groups that are given placebos, responds Jean-Sébastien Necessary. But this questioning applies to all the pharmacopoeia, anyway. “

In fact, the mechanism of action of the therapy psychedelic is hard to define. Is this the change of mentality that leads to therapy that allows the patient to free himself of his demons, or the reorganization of its connections in the brain ? “We don’t have an answer to this question, and we will probably never really, think Mr Had. It is difficult to separate the psyche and the brain. This is surely a combination of the two. “

“When sick people are going to spend six months in the amazon rainforest, they take ayahuasca [hallucinogenic drug] and they do the meditation, it is difficult to say if this really is the active substance that has resolved their mental health problems “, he adds.

 

 

* This is an example of potentially altered by the intervener in order to preserve the confidentiality of its patients, under the code of conduct of the College of physicians.

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