Psychedelics: A game-changer in treating depression?

Elon Musk, who regularly uses ketamine to treat depression, consumes a full dose at parties. Google co-founder Sergey Brin consumes magic mushrooms. Apple’s late CEO, Steve Jobs, was an open supporter of LSD. And billionaire Peter Thiel has invested millions in ATAI Life Science, a company aiming to use hallucinogens in medicine.

Psychedelics are increasingly being accepted as a legitimate form of mental health treatment.

More and more celebrities are speaking out about their experiences with psychedelics. Prince Harry reveals in a new 60 Minutes interview that he used psychedelics to treat mental health issues. Aaron Rodgers, the NFL quarterback, has attributed his success to hallucinogenic tea. Kristen Bell, The Good Place star, revealed that she had taken hallucinogenic mushrooms (magic mushrooms) on a birthday. She claimed she became interested in psilocybin, the active ingredient in magic mushrooms, after reading Michael Pollan’s book How to Change Your Mind.

What is it about psychedelics that makes them so effective in the treatment of mental health disorders? They are widely thought to make those who consume them feel happy, light and motivated.

Psychedelics have, in fact, been a part of Indian culture for centuries. “Indigenous tribes in India, holding a lot of sacred knowledge, have used entheogens in their rituals. Those rituals still remain secret in India,” says Amituofo Kumar, Somaa Foundation.

“The Psychedelic Society of India, Somaa Foundation, and other organisations and people around the world are calling on the Indian Government to reschedule certain  psychedelics/entheogens, which are natural compounds found in hundreds of plant species and have been seen as ‘breakthrough’ treatment for mental health,” adds Amituofo Kumar.

Promising outcomes

Because some of the most prosperous people in the world are praising psychedelics, it has opened people’s minds to their possibilities. Psychedelics like ketamine have garnered attention in recent years for their potential to treat various mental health conditions. “While more research is needed to fully understand their mechanisms, several studies suggest promising outcomes,” according to Dr G V Rao, Director & Chief of Gastrointestinal & Minimally Invasive Surgery, Asian Institute of Gastroenterology. “Ketamine, for instance, has shown effectiveness in cases of treatment-resistant depression. A study published in JAMA Psychiatry in 2017 demonstrated that a single intravenous infusion of ketamine rapidly reduced depressive symptoms in individuals who had not responded to traditional antidepressant medication. Another study published in the American Journal of Psychiatry in 2018 said repeated doses of ketamine over several weeks produced sustained antidepressant effects,” he says. Moreover, ketamine has shown potential in managing post-traumatic stress disorder (PTSD). “A randomized controlled trial published in JAMA Psychiatry reported that ketamine administration significantly reduced PTSD symptom severity compared to a placebo. The effects were observed within 24 hours and lasted up to two weeks,” says Dr Rao.

Short-term treatment

Dr Charan Teja Koganti, neuropsychiatrist at Kims says,  “Ketamine is only to be used in a certified doctor's office or clinic under the supervision of a healthcare provider. It provides rapid relief from depression. Rather than waiting for an SSRI (Selective serotonin reuptake inhibitors (SSRIs) are a widely used type of antidepressant) to provide relief over the course of 4-6 weeks, people can begin to feel the benefits of ketamine within about 40 minutes. However, unlike traditional antidepressants, the effects may be short-lived,” he says adding, “There are also some contraindications to ketamine therapy. So, before we offer this treatment option, we take a detailed history and conduct a thorough evaluation. We strongly advise patients not to self-microdose,” adds Dr Charan.

The flip side

Despite their potential benefits, psychedelics such as ketamine can have negative side effects. “Abuse of ketamine, for example, can result in addiction, cognitive impairment, and bladder dysfunction. A 2019 review article in Current Opinion in Psychiatry highlighted the potential long-term cognitive deficits associated with ketamine abuse, including memory and attention deficits. Ketamine-induced psychedelic experiences can be intense and unsettling, potentially leading to psychological distress in vulnerable individuals. A 2018 study in the Journal of Psychopharmacology warned of adverse psychological reactions during and after ketamine sessions. While psychedelics show promise as therapeutic tools, their use should be strictly regulated and guided by medical professionals to mitigate potential risks and maximize their beneficial effects,” stresses Dr Rao.

Dr Prerna Kohli (MPhil, PhD), Clinical Psychologist and Founder, MindTribe.in, points to the fact that such substances are illegal in large parts of the world. “There are organisations conducting research and campaigns to decriminalise it for mental health reasons. These organisations’ primary goal is to educate the general public about the benefits of such drugs. There is currently very little discussion of psychedelic retreats in the mental health field,” she says.
“Paranoia, confusion, visual or auditory hallucinations, dissociation and depersonalization, as well as distressing automatic thoughts, are a few adverse effects that have been scientifically proven. Additionally, patients run the risk of being punished if they are caught consuming such drugs in a prohibited location,” says Dr Kohli.

She concurs that extensive training would be necessary for mental health professionals before being qualified to provide psychedelic therapy.