Rediscovering the Light: Psychedelics for PTSD

MDMA is proving to be a bastion of hope for thousands of war veterans suffering from Post-Traumatic Stress Disorder (PTSD), who have a 50% higher suicide rate than the general US population. An analysis of six phase two trials using MDMA found a PTSD remission rate of 66.2%, which may well mean it is saving lives.

Even the Food and Drug Administration (FDA) has recognized MDMA’s incredible potential, granting it Breakthrough Therapy Designation in 2017, which will speed up the approval process for the use of MDMA outside of clinical trials. It also indicates that the evidence so far is showing that MDMA demonstrates significant improvement over the other currently available treatments. This potentially paves the way to moving it from the experimental and alternative treatment categories closer to standard treatment. Doing so would mark a huge shift in attitudes towards psychedelic drugs and add to the body of evidence that they are not only for recreational use, but that psychedelics are powerful treatments for a variety of difficult-to-treat mental illnesses.

Psychedelics for Depression and Anxiety 

There is growing evidence that psychedelics like magic mushrooms and LSD can help people deal with the anxiety often confronted during terminal illness. A 2021 systematic review that included substances such as psilocybin, LSD, ketamine, and MDMA found that psychedelics had positive effects on end-of-life patients’ well-being, quality of life, and easing of anxiety and depression. Furthermore, there were few adverse effects, none of which were serious.

‍A 2020 meta-analysis of eight studies found that psychedelics provide a safe and rapid alleviation of depressive symptoms.

Psilocybin, a psychoactive compound found in magic mushrooms, has also been granted Breakthrough Therapy Designation because of the promise it is showing in treating major depressive disorder.

Ketamine, though not regarded by all as a traditional psychedelic and certainly different in its non-serotonin-focused pharmacology, is already being used to treat depression. Ketamine is a special case because, unlike LSD or MDMA, which were mistakenly labeled as drugs of abuse with no medical use, or peyote and ayahuasca, which are categorized similarly but available to a few through religious exemption, ketamine has a long history of medical use as an effective anesthetic and even holds a place on the World Health Organization’s essential medicines list. 

Thanks to doctors’ ability to prescribe drugs for off-label use, ketamine was already being used for its antidepressant effects. In 2019, ketamine even received full FDA approval as a treatment for major depressive disorder and treatment-resistant depression when given alongside traditional oral antidepressants.

It seems there has been a great shift in the tides. From the promising research conducted in the 50’s and 60’s to the war on drugs, and now to today’s psychedelic renaissance, the research is finally getting done and the potential of these substances is being explored. Up against mistakes in drug scheduling, a public full of fear, and without the promise of patentable and profitable drugs, brave, passionate people have poured their energies into making what are now Breakthrough Therapies more accessible to those they can help.

We cannot view psychedelic therapies as a panacea for mental health problems. Indeed, they are generally not recommended for people with schizophrenia, bi-polar disorder, or family histories of said illnesses. As promising as the research looks so far, there is more to be done. That being said, it will be a relief for many patients, families, and doctors to have more tools in the toolbox to battle with an array of mental health problems.