- Hi, I'm Dr. Tracy Marks, a Psychiatrist
and I make mental health education videos.
This is a follow-up of a video that I did last year
on using mushrooms to treat depression.
The chemical compound found in the mushrooms
that give it its therapeutic benefit is psilocybin.
Although psilocybin shows the most promise,
it's not the only psychedelic being studied.
Here's a rundown of the different psychedelics
and why people are excited about this.
Psychedelics activate the serotonin 5HT2a
receptor in the brain,
antidepressants and the atypical anti-psychotics
also affect this receptor but in different ways.
Psychedelics or a class of drugs
that cause hallucination experiences
and altered states of consciousness,
when you consume a normal dose of them.
And this is in contrast to alcohol
where you have to consume a lot of it and become intoxicated
to have an altered state of consciousness.
The common psychedelics are psilocybin found in mushrooms
N, N dimethyltryptamine or DMT for short.
This is a compound that's found in Ayahuasca.
Hopefully I'm pronouncing that right.
Ayahuasca is a tea found in the Amazon forest,
not the online retailer.
One of the plants that makes up the tea
has monoamine oxidase inhibitor properties.
The MAOIs are an older type of antidepressant
that are very good,
but they have certain food interactions.
So just be aware of this
if you decide to drink some of this tea on your own.
That you make sure that you're not eating foods
or taking medications that could interact with the tea.
Another plant-based psychedelic as Mescaline
found in the peyote cactus and a few other cacti.
These three are naturally occurring psychedelics.
A synthesized drug is lysergic acid diethylamide
known as LSD.
Ketamine is a psychoactive drug
that was originally approved for anesthesia
and is now being used to treat depression.
Ketamine causes altered states of consciousness
and hallucinatory experiences
but the effect is very temporary
lasting maybe hours on average.
So it's not included in the list of classic psychedelics.
Ecstasy is the compound MDMA.
The FDA granted approval for it to be studied
in the treatment of PTSD.
So among this list, psilocybin has led the pack
in the push to get it approved for clinical use.
Currently psilocybin is a schedule one drug
which means that it's illegal to use and possess.
It can only be used for research purposes.
Drugs are classified in the United States
by a schedule system rating the drugs
by addiction and abuse potential.
The next level down is scheduled too
which includes drugs like opioid pain medications
and the stimulants that we use for ADHD.
The drugs on this schedule are legal
but they're highly regulated by the drug enforcement agency.
As an aside, cannabis is also a schedule one drug
that's illegal on the federal level.
So we don't have any FDA approved formulations for it.
But individual states have made it legal
allowing for the distribution of medical cannabis
only in the state where it's legal.
But because it's not FDA approved and illegal to prescribe,
doctors can't write prescriptions for it
that give you a dose frequency
and information on how to take it.
Instead, doctors can only approve the dispensing of it
from a state authorized dispensary.
It's a complicated situation.
But back to the psychedelics, LSD and Ayahuasca
have had quite a few studies for various disorders
such as depression, anxiety, and alcohol use disorder
but psilocybin has made the most progress.
Today, there's 59 trials registered
with the food and drug administration.
You can see the trials by going to clinicaltrials.gov
and search for psilocybin.
Some of the trials are currently recruiting volunteers
or will be recruiting soon.
The companies Usona Institute and Compass Pathways
were granted FDA breakthrough therapy designation
to get the drug approved for depression.
Breakthrough therapy designation
means that the approval process will be shortened
and fast tracked.
Here's why psychedelic research has gone viral
with viral being relative to the research space.
Psilocybin behaves
like no other medication treatment we have
after one or two doses,
people in the studies reported positive changes
in mood, attitude and behavior that lasts months, to years.
In a 2008 study, many people reported 14 months later
that the psilocybin was the most personally meaningful
and spiritually significant experience of their lives.
That's profound.
Some people have referred to the treatment with psychedelics
as having an inverse PTSD effect.
With PTSD, you have a single exposure or something traumatic
that has long lasting negative mental effects
because of the way the experience rewires your brain.
Your Medulla gets activated
to respond to triggers with intense fear.
Similarly, the psychedelics or with the psychedelics,
one dose has shown to have long lasting positive effects
on your worldview, your attitude, mood, and behavior.
It almost feels unfair to talk about this
when it seems so good yet it's not available.
The only way around this is to participate in the trials
if there is one in your area, and if you're eligible.
You can inquire about the various trials
by going to the clinicaltrials.gov site
and search for studies that are recruiting
and enter the drug that you're interested in.
You can even search by your country.
These trials are not the same
as the trials use to get FDA approval.
These are research studies that contribute
to the body of knowledge
that's used to support the use of a drug
for a certain purpose.
One positive study doesn't establish clinical use.
These studies have to be replicated
and most of the studies are done by universities
and institutions and not drug companies,
but once a treatment approach has been shown to be effective
in multiple large trials,
then there's a push to make that treatment a standard.
Then a drug company has to apply
for a new drug authorization and conduct their own trials
to build on the research that's already out there.
So that's how it works.
Compass Pathways is one such company that is doing trials
to get their version of psilocybin approved for treatment.
You'll see their trials on the clinical trial site
but you can also visit their website
to see what they're doing
and apply to participate in their trials.
Usona Institute is another company
that's pushing to get approval
and you can go visit their site as well.
So I'm hopeful
that as we see more long-term psychiatric effects
of COVID infection and pandemic effects,
that this drug will get approved
and make a world of difference very quickly
with long lasting impact.
So fingers crossed on seeing some real change here.
See you next time.