Therapeutic psychedelics: Science and benefits

Research on psychedelics is experiencing a remarkable renaissance in modern science. Compounds that for decades were stigmatized as dangerous recreational substances are now being studied in university laboratories for their therapeutic potential. Psilocybin, LSD, MDMA, and other psychedelics show real promise for treating severe mental disorders that affect millions of people.

This transformation is partly due to methodological advances that allow rigorous clinical studies with placebo and adequate controls. Researchers like Matthew Johnson at Johns Hopkins have demonstrated that these compounds can offer lasting relief for conditions that don't respond well to conventional treatments.

What are psychedelics?

Psychedelics constitute a diverse class of compounds that share the ability to profoundly alter the perception of reality and sense of self. This definition goes beyond molecular chemistry to focus on subjective and therapeutic effects.

Classic psychedelics, also called hallucinogens, include substances like LSD, psilocybin (in magic mushrooms), and DMT. These compounds act primarily as agonists of the 5-HT2A serotonin receptor, which explains many of their perceptual and cognitive effects.

Another important class includes NMDA receptor antagonists, such as ketamine and PCP. These compounds block glutamate activity in the brain, producing dissociative effects that can be therapeutic for treatment-resistant depression.

MDMA represents a unique category, acting as an empathogen that simultaneously increases serotonin and dopamine levels. This dual action explains its effectiveness for treating post-traumatic stress disorder (PTSD) by facilitating emotional processing of trauma.

Mechanism of action in the brain

Psychedelics exert their effects through specific neurotransmitter systems, fundamentally altering how we process reality. Serotonergic compounds like psilocybin bind to 5-HT2A receptors, triggering a cascade of changes in brain activity.

This activation produces a state of "dishabituation" where everyday perceptions become extraordinarily vivid. A finger we normally ignore becomes a miracle of evolution, revealing the plasticity of our minds to reevaluate the familiar.

Psychedelics also alter the predictive models our brain uses to interpret the world. These models, built through experience, can become rigid in pathological conditions. Psychedelics offer an opportunity to "reset" these models, allowing new perspectives on the self and relationships.

Current therapeutic applications

Clinical research has demonstrated significant therapeutic effects for several mental disorders. Studies with psilocybin have shown substantial reductions in depressive symptoms that persist months after a single session, often surpassing the results of conventional treatments.

In addiction treatment, psychedelics facilitate profound changes in self-perception. Patients with tobacco dependence have achieved abstinence rates exceeding 80% after psilocybin sessions, compared to traditional treatments.

MDMA has shown promising results for PTSD, especially in cases related to sexual or war trauma. Patients experience reduction in hypervigilance and avoidance symptoms, with improvements lasting more than a year in some cases.

Cancer patients facing existential anxiety have reported greater acceptance of their condition and reduction in depression after psilocybin treatments. These effects suggest that psychedelics can help process deep existential issues.

Microdoses vs high doses

There is significant debate about the effects of low doses (microdoses) versus high doses of psychedelics. Microdosing, typically 1/10 of a recreational dose, is promoted to improve mood, creativity, and concentration, but scientific evidence is limited.

Controlled studies on microdoses have not demonstrated consistent benefits for cognition or mood. Some researchers suggest that perceived effects could be due to placebo or the slight state of intoxication that accompanies these doses.

In contrast, high doses (20-30 mg of psilocybin) produce profound experiences that can catalyze lasting therapeutic changes. These effects require careful preparation and a controlled environment to maximize benefits and minimize risks.

Risks and precautions

Psychedelics are not without risks, especially for people with certain conditions. Individuals with psychotic disorders such as schizophrenia or the manic component of bipolar disorder should avoid these compounds, as they can exacerbate symptoms.

"Bad trips" represent a significant risk, even in controlled environments. These episodes of intense anxiety or panic can occur in anyone, although adequate preparation reduces their frequency. In clinical contexts, approximately one-third of participants experience some degree of discomfort during high-dose sessions.

Research emphasizes the importance of a safe therapeutic "container." This includes experienced guides, exhaustive psychological preparation, and a comfortable physical environment. Cardiovascular effects are generally modest, but are closely monitored during sessions.

Potential for neurological injuries

Preliminary research suggests that psychedelics could have applications for neurological injuries. Anecdotes from athletes with repetitive head trauma indicate cognitive improvements after psychedelic experiences, although these reports require scientific validation.

Animal studies show that compounds like psilocybin can promote neuroplasticity, potentially helping in recovery from brain injuries. This plasticity could explain benefits in conditions like strokes or neurodegenerative diseases.

However, these applications remain speculative. Rigorous clinical studies are needed to determine if psychedelics can actually repair neuronal damage or simply alleviate psychiatric symptoms associated with brain injuries.

Conclusion

Psychedelics represent an exciting frontier in modern medicine, offering hope for conditions that have resisted conventional treatments. The accumulated scientific evidence suggests that these compounds can catalyze profound changes in perception of self and relationships, with lasting effects on mental health.

However, their use should remain within controlled clinical contexts, with professional supervision and adequate preparation. Ongoing research promises to refine our understanding of these powerful compounds and optimize their therapeutic applications.