trauma

Psilocybin and an array of Entheogens are the wave of the future

Unresolved Trauma is a key factor in a vast range of traumatic life events such as sexual abuse, life-threatening problems, war events, sudden accidents with unresolved childhood events, etc. Not all people exposed to traumatic events will have mental health issues, but most will have lingering triggers and  mental health issues. However,  many Traumatic experiences  lead to Post-Traumatic Stress Disorder (PTSD) in the future. PTSD is diagnosed by the symptoms below:

  1. Negative thoughts and depressive feelings may result in isolation and self-blame.
  2. Hyper-arousal such as aggressive manner.
  3. Re-experiencing, such as recurring nightmares or flashbacks to negative memories.
  4. Increased risk of suicide.

In 2018, World Health Organization (WHO) revised the classification of traumatic illnesses. The new list also consists of Complex Post-Traumatic Stress Disorder (CPTSD). In CPTSD, all PTSD symptoms are met by the following:

  1. Affective dysregulation (the lack of ability to manage emotions and tolerance while facing problems or doing daily work.)
  2. Lack of self-esteem and negative thought about oneself (worthlessness, self-blame. etc.)
  3. Non-sustained relationships.

Major Depressive Disorder (MDD) is another psychiatric problem of people exposed to trauma. Yet PTSD and MDD are hardly dissociable as they are common in trait. However, many factors affect the outcome of traumatic experiences such as gender, the severity of the traumatic experience, etc.

One of the challenges in the treatment of diseases followed by traumatic experiences is the coexistence of PTSD and MDD in a subject. Among the disorders, MMD is the most common comorbid in PTSD patients. Half of PTSD patients are comorbid with MDD. Diagnosis of comorbid MDD and PTSD is feasible by the symptoms such as larger functional disabilities and more severe suicide behaviors.

Few medications are produced for the treatment of PTSD. But even after treatment by a psychiatrist, PTSD still exists alongside a chronic disorder or comorbid psychiatric illness. A promising solution for PTSD treatment is the use of psychedelic drugs. Four types of psychedelics are used as a promising solution for the treatment of PTSD:

  • Classical psychedelics (Such as psilocybin and Lysergic Acid Diethylamide, known as LSD.)
  • 3, 4-methylenedioxymethamphetamine (Known as ecstasy among the public.)
  • Ketamine
  • Cannabinoids

In the 50-60th decades, many scientists introduced classical psychedelics as an effective means while combining with tasks of psychotherapy. After the 60th, psychedelics became taboo in medical society because of their non-medical usage and abuses. Since 2000, the necessity of finding new solutions for trauma-related disorders forced medical researchers to consider psychedelics a solution again. Although classical psychedelics are allowed to be analyzed as a solution for PTSD by FDA, there are a few numbers of comprehensive research in this field. In this article, we will investigate recent studies in brief.

Psilocybin and Classical Psychedelics        

 In ancient times, shamans used psilocybin for the treatment of diseases, mental disorders and spiritual experiences. In the book: “The Great Encyclopedia of Ancient Persia,” Hashem Razi explains a beverage derived by Persians from the plant of Haoma. They used this beverage for spiritual experiences. Yet, Haoma beverage is produced by Zarathustrians. Hashem Razi explains that the Haoma plant in ancient Persia was a plant that is extinct in our time. Yet Zarathustrians derive a similar beverage for spiritual experiences from a cannabinoid with the same name, Haoma.

Brain plasticity is defined as the connection of neurons in the brain. One of the interesting effects of classical psychedelics is their effect on the brain and increasing neural plasticity. Classical psychedelics also show an amygdala reactivity decrease during the processing of emotions. PTSD patients suffer from the reactivity of the amygdala and processing of traumatic memories, therefore this drug can address this problem in future studies.

As mentioned, the main usage of psilocybin was because of its spiritual and mystical experiences. The same experienced occurred in the therapy of depression, and nicotine addiction. However, it is not described whether these experiences affect the treatment process or not. Also, the effect of spiritual experiences is not interpreted for PTSD treatment.

Oral prescriptions of psilocybin and LSD are usual at the beginning of treatment. The initial dose of psilocybin varies from 10 to 25 milligrams. For LSD, the initial is between 50 to 200 micrograms. The lifetime of the mentioned dose is 8-10 hours for LSD and 3-6 hours for psilocybin. So, the trade-off makes sense if they are used for PTSD treatment under the supervision of experts.

Yet, few peer-reviewed types of research are published for investigation of the effect of classical psychedelics on PTSD patients, but still, it is a promising solution for these patients.

Elimination of Depression among Cancer Patients

30-40% of cancer patients suffer from anxiety and depressive symptoms. These symptoms result in various problems such as hopelessness, decreases in survival rate, reduced social function, reduction of life quality, etc. Pharmacotherapeutics are commonly used for the treatment of depression in cancer patients but limited efficacy results. Single-dose psilocybin (0.3 mg/kg) in conjunction with proper psychotherapy led to anxiety and depression removal for at least 7 weeks. A mix of psychotherapy and psilocybin results in spiritual well-being, and the mystical experience was also beneficial for the patients. This study was a randomized research on 29 cancer patients and larger studies may demonstrate the efficacy of this method for future promising treatments of cancer-related depression.

MDMA and PTSD Treatment

  MDMA drug is known as Ecstasy among the Rave crowd. In 2017, FDA allowed the usage of this drug as “Break Through Therapy” for the treatment of traumatic-based illnesses. It had been used for years by trauma therapist during the 1980’s with amazing results.  The government banned it tho during the “war on drugs” and it was not released to clinical therapist until 2017.

MDMA acts as a catalyst and increases the effectiveness of psychotherapy. This effect has resulted from the ability of MDMA in reducing the fear response of negative traumatic memories.  Like classic psychedelics, MDMA reduces amygdala activity. This activity attenuation results in anxiety removal in PTSD patients. Oxytocin is a factor that enhances interpersonal trust and MDMA increases the level of this hormone. The effectiveness of this psychedelic is demonstrated in various animals including mice, and future studies may demonstrate the same effects in humans.

In contrast to classic psychedelics, some researchers expressed their concern about the toxic effects of MDMA, however no toxic effects have happened in a controlled environment.   Any issues such as  the increase in blood pressure and cardiovascular problems are dose-dependent. However, its positive effect is demonstrated in clinical trials for the treatment of PTSD.

Ketamine

Ketamine is a dissociative psychedelic. They are also known as hallucinogenic drugs that cause hallucinations. The effectiveness in the treatment of heroin and alcohol addiction is demonstrated. in 2018, FDA approved the usage of ketamine for the treatment of severe and treatment-resistant depression. A suited hypothesis in the medical society, explains PTSD in terms of Synaptic Disconnection Syndrome. As ketamine has a rapid effect on glutamatergic pathways and signaling in the brain, its ability to increase synaptic and neural plasticity can erase PTSD symptoms.

Ketamine is used orally, nasal spray or IV.  A dose of 0.5 mg/kg is taken over 40 minutes. As it causes hallucinations, it must be used very carefully, but the positive effects of ketamine on severe depression are demonstrated. Yet, improvements in PTSD symptoms are shot-time compared to MDMA and classical psychedelics. Future studies might open new doors to ketamine-based PTSD therapy.

Cannabinoids

 Cannabis has been used in ancient times by spiritual leaders and shamans. An example was the Haoma plant, mentioned in the sanction of classical psychedelics. In Asia, it was used thousands of years ago, but in western society since the 19th century is used for the treatment of diseases such as rheumatism.  In recent decades several governments have legalized cannabis for medical purposes and WHO rescheduled it for medical purposes. The potential of cannabinoids for the treatment of PTSD relies on their ability to reduce the presence of negative memory, fear, and elimination of sleep problems such as insomnia. In contrast to other psychedelics, synthetic and medical cannabinoids are home-taken drugs. The effect of cannabinoids on the treatment of PTSD is demonstrated in various studies. Yet, some side effects are dizziness, dry mouth, nausea, and in toxic high doses,  vomiting.

 Trauma exposure may lead to various psychopathological problems in the future such as PTSD, anxiety, severe depression, MDD, etc. The necessity of finding new solutions for these problems forced researchers to consider psychedelics as a potential solution instead of a taboo. several studies showed the efficacy of psilocybin and psychedelics in trauma-related illnesses. The future is on the cusp of achieving legal and medical certainty for  the general usage of these drugs worldwide. Entheogens are clearly a key component in the future of mental wellness.