"They broke my mental barriers": magic mushrooms could they be the answer to depression? | Science

TheDrinking psilocybin capsules, the active ingredient of magic mushrooms, at London's Hammersmith Hospital, Michael had no idea what would happen next. The 56-year-old part-time website developer from County Durham, in northern England, had been battling depression for 30 years and had unsuccessfully tried speech therapies and many types of speech therapies. # 39; antidepressants. His mother's death from cancer, followed by a friend's suicide, left him at one of his lowest points. Searching online to find out if the mushrooms growing in his garden were a hallucinogenic variety, he had discovered an innovative medical essay at Imperial College London.

Listening to music and surrounded by candles and flowers in the decorated clinic room, Michael waited impatiently for the drug to come in. After 50 minutes he saw bright lights heading off and boarded a room. five-hour trip in his head. where he would relive a range of childhood memories and confront his sorrow. Over the next three months, her depressive symptoms decreased. He felt optimistic and accepting, enjoying hobbies for which he was apathetic, like walking in the Yorkshire countryside and taking pictures of nature.

"I became a different person," says Michael. "I could not wait to get dressed, enter the outside world, see people. I was supremely confident – more like when I was younger, before depression began and worsened. "

The trial, completed in 2016, was the first modern study to target treatment-resistant depression with psilocybin, a psychedelic drug naturally present in about 200 species of fungi. To varying degrees, Michael and the other 18 participants saw their symptoms alleviate one week after two treatments, including a high dose of 25 mg. Five weeks later, nine out of 19 patients found that their depression was still significantly reduced (by 50% or more) – results that remained stable for three months. They had been suffering from depression for 18 years on average and had all tried other treatments. In January of this year, the trial launched its second phase: an ambitious effort to test psilocybin on a larger group and with increased scientific rigor (including a control group, which Michael's study did not was not), comparing the performance of the drug with escitalopram, a common antidepressant. The team has now treated about one-third of the 60 patients and says the first results are promising for psilocybin.

Imperial's current work is part of a series of new studies that a group of professors, activists and investors hope will lead to the medical approval of psilocybin as a processing treatment. Other upcoming projects include a study conducted by Usona Institute on 80 people, a nonprofit medical center based in Wisconsin, and a test at King's College London, as well as an essay 216 people already in the United States and Europe. and Canada, run by London-based Compbad Pathways, a life sciences company. Robin Carhart-Harris, director of Imperial's Psychedelic Research Center and Compbad's scientific advisor, believes that psilocybin could be a licensed drug within five years, if not sooner. "At about this point," he says, "it would be like an irresistible and indefensible force to ignore the weight of the evidence."

Psilocybin mushrooms have been part of religious rituals for thousands of years. The Aztecs of Mexico have called the mushroom teonanácatl, or "flesh of God", as a tribute to his presumed sacred power. In 1957, Albert Hoffman, a Swiss chemist working for the pharmaceutical company Sandoz, isolated psilocybin from the fungus. Fifteen years earlier, he had accidentally ingested LSD, was stunned at work and had suffered psychedelic effects when he returned home. In the 1960s, Sandoz sold psilocybin and LSD for research purposes in medical trials, but these substances were soon banned after being badociated with the counterculture of the 1960s.

Psilocybin remains today in the most restricted category under the United Nations Convention on Psychotropic Substances, the 1970 US Controlled Substances Act, and the 1971 UK Usage Act. drug abuse, among others. David Nutt, professor of neuropsychoparmacology at the Imperial, who oversees ongoing trials, challenges the evidence, claiming that severely restricting the drug (and other psychedelic substances) has hindered research and propelled "lies" about his risks and his medical potential. For him, this decision is "one of the most atrocious examples of censorship of science and medicine in the history of the world".

If successful, the new wave of research could continue to change the reputation of psilocybin after decades of prohibition. Carhart-Harris believes the drug offers a better and more comprehensive treatment than current antidepressants and that it could very well be a powerful new treatment for a host of other mental illnesses, including anxiety and dietary disorders. A 2016 study by Johns Hopkins University of 51 patients with life-threatening cancer showed that high doses of psilocybin significantly reduced depression and anxiety. end of life for six months in 80% of cases and helped patients to accept death; a study from the University of New York that year showed similar results. Ongoing trials are looking more closely at the potential of psilocybin in reducing tobacco dependence and alcohol dependence, after the first pilot projects yielded convincing results. (Johns Hopkins researchers have shown in a small study, for example, that 80% of heavy smokers have not smoked for at least a week, six months after psilocybin treatment.)

Carhart-Harris thinks that part of the reason the drug has been effective in treating depression during clinical trials so far here is that it can help people see their lives more clearly. When he looks at patients stumbling, he often feels that they see a truer version of reality than the sober therapists who guide them: "It's almost like being in the presence of someone particularly wise, in terms of what comes out of their mouths. "It is unclear to what extent the mitigation of depression comes from the psychiatric support that surrounds the treatment.What ever, several patients have obtained supplements independently since the first trial because their depression has returned.

The neuroscience of psychedelics remains poorly understood, but fMRI scans of the brain of patients after taking psilocybin showed a reduction in blood flow and resting activity in the amygdala, often overactive in cases of depression and anxiety . They also show looser connections between the networks of the brain, which then reintegrate into what the imperial team suggests as part of the brain "reinitializing" on psilocybin. This may explain why the drug causes some patients to rethink their entrenched beliefs and break down their thought patterns and compulsive behaviors. Imperial researchers believe that psilocybin works differently from current treatments. While common antidepressants soften emotions to help people cope, they theorize, psilocybin acts on our serotonin system to increase emotional responses and encourage people to actively deal with their depression, which can lead to lasting changes in spirit.

For Kirk Rutter, a 48-year-old university design technician, that's why psilocybin seems to work – and why he hopes it will be available medically. He sees the drug not as a miracle solution, but as a drug that shows patients deep truths and forces them to apply lessons of this type. Some other treatments, such as cognitive-behavioral therapy, also seek to reshape thought patterns, often in combination with antidepressants, but for many of them, the current options do not work. According to the World Health Organization, more than 300 million people suffer from depression worldwide, but according to researchers, many of the most serious cases do not respond to antidepressants.

Rutter was part of this group, having tried to consult and take two prescription drugs during the five years preceding the imperial trial, the depression having worsened after the death of his mother. After the psilocybin, he broke down catastrophic thought cycles and had the confidence to make profound changes in life, such as selling his home and moving away from abusive neighbors, reorganizing his finances and traveling for pleasure. after years without leaving the country. He says of psilocybin: "It removes all the barriers and allows you to treat what you need in an almost alluring way. You are inevitably and irresistibly trained. A week after treatment, he found a renewed optimism in his life. "Good God," he thought, "I have not had it that long."

Even the fiercest proponents of psilocybin agree that more evidence of its efficacy on larger groups in controlled settings, as well as research on potential adverse effects, will be needed before the drug can be used. Ongoing trials exclude people with a family history of psychosis for fear that the drug may trigger latent schizophrenia. And there are questions about the impact of psilocybin. Some patients say they hardly feel the psychedelic effects, while others, like Michael, have reacted strongly to lower doses but less at higher doses. James Rucker, who participated in the first imperial study and currently conducts psilocybin testing at King's College London, remains agnostic about the fact that this drug is a reliable treatment.

"It's an illusion that we know as much about psilocybin," says Ekaterina Malievskaia, co-founder of Compbad, who hopes to sell the drug as part of an approved treatment. "We really do not do it. We know that this can cause deep personal experiences; it can also cause all kinds of complications.

But Malievskaia hopes that the Compbad trials will provide the necessary evidence to obtain medical approval of the drug for treatment-resistant depression. She founded the company with her husband, George Goldsmith, three years ago, after her son fell into a serious depression and OCD got worse while he was being treated with traditional antidepressants in a hospital reputed American. He then recovered with psilocybin treatment. The company says it has raised about £ 28 million, including from venture capitalist Peter Thiel, and has patented a process to make psilocybin on a large scale. Some former Compbad badociates are concerned that the company is seeking to monopolize the psilocybin market and control medical access, criticized last year by the US Quartz website, although Malievskaia denies it.

There are already signs that the authorities are starting to change. In October, US regulators awarded Compbad state-of-the-art treatment, a new drug that could improve the treatment of serious conditions, which means the authorities will speed up the examination of evidence. This decision was followed in May by Denver's vote to decriminalize magic mushrooms, making it the first American city to do so, followed last week by a similar measure for several psychedelic plants in Oakland, California. Activists are pushing next year in Oregon for a vote on the legalization of psilocybin for medical purposes. Meanwhile, Compbad hopes to apply for a marketing authorization for the drug within three years if its trials succeed. The procedure is progressing slowly, having treated about six people since the start of trials in January, and Mr Malievskaia said the process could take a decade or so to be approved. She wants to accelerate progress by recently opening new treatment sites at Columbia University, as well as in New Orleans and the Netherlands, among others.

Licensing is not the only obstacle to the transformation of the drug into a standard medicine. Taken several hours in a clinical environment with expert guides, treatment with psilocybin is not cheap. Imperial's new treatments cost more than £ 2,000 each, including doctors and therapists, and many patients may need multiple treatments each year to continue benefiting. Malievskaya did not want to say how much Compbad was going to ask, but she wants to maximize the number of people who can access the drug. Carhart-Harris says psilocybin therapy would cost significantly more than antidepressants and potentially more than counseling. "There is a cold reality for which selective serotonin reuptake inhibitors [antidepressants] dominate mental health care and that's because they are cheap, "he says.

Scientific, legal and commercial challenges can take years to resolve. But for many already treated patients and for some therapists guiding them, there is no doubt that it's only a matter of time before psilocybin and similar psychedelics reshape how we treat the suffering and understand our mind.

Melissa Elwin, 40-year-old director of operations, is one of them. After a first unpleasant treatment in which she felt trapped, during her second psychedelic journey to Hammersmith Hospital, she felt as though she had left her body and saw her problems objectively. . Psilocybin helped her cope with her depression, fueled by a difficult relationship, a difficult breakup, and the anxiety she had felt since her childhood. Under the drug, she began to find resistance that has since helped her to cope with the death of her dying father and a protracted legal battle with her ex-partner. His descriptions of the trip are similar to the fear and unity that Hoffman sometimes experienced in psychedelic tests while testing them: he saw a powerful ability to put himself in perspective and to worry about his problems.

"I was literally everywhere [during the psilocybin trip], "Said Elwin. "In the most amazing nature scenes, like the globe of light twinkling through the trees, into the ocean, into the waterfalls. I did not remember the time and I just wanted it to last forever. For so long, I felt that my depression was part of me, I could not do anything to change it. Antidepressants only made me sleepy and stopped worrying about things. It made me completely break my mental chains. I went back to work [after being unemployed] and I was euphoric. I felt: I can do that, I can change my situation. "