Latest trials demonstrating the effectiveness of using Psilocybin ( a hallucinogen ) as a treatment for depression.
This isn’t new, there have been many studies for many years now showing its effectiveness, but it’s another significant step along the way to offering a new treatment for depression.
Need for more treatments
There are many treatments for depression but each only has a degree of effectiveness for each individual. The more treatments we can offer, the better chance we have of finding an effective treatment for everyone.
Method of action
It’s thought that hallucinogens might help with depression by freeing up fixed negative thought patterns.
Effectiveness
The trial compared three different doses and was able to show a significant effect in the highest dose. One out of three participants was no longer diagnosed as depressed at just three weeks. One in five saw a significant improvement at 12 weeks.
It might be thought of as disappointing that the treatment effect didn’t last for some. There may be a need for a number of repeated treatments to get lasting remission.
The results represent a significant new tool in the treatment of depression, but it’s not without associated costs and risks.
Costs
To provide the treatment, therapists need extensive training, in addition, a single treatment episode can last 6 to 8 hours requiring a controlled environment with a lead therapist plus an assistant. All of this is considerably more expensive than supplying an alternative medication such as an SSRI which doesn’t require supervision.
Side effects
Risks included 77% having adverse experiences on the day of treatment such as headaches and nausea and six people experienced suicidal ideation in the three weeks following the treatment versus three in the lowest dose group. The researchers didn’t identify this as abnormal and perhaps with 79 subjects in the treatment cohort, it might be considered to be within a normal range for this clinical group.
Risks
There are other risks associated with using hallucinogens. In a study from 2016, 1993 individuals who had an experience of using hallucinogens completed an online survey about their most challenging experiences ( bad trips).
39% of them rated it among the top five most challenging experiences of their lifetime, 11% put themselves or others at risk of physical harm. 2.6% behaved in a physically aggressive or violent manner and 2.7% received medical help. In the year following this bad experience, 7.6% sought treatment for enduring psychological symptoms.
Further words of caution
Depression, like nearly all mental health problems, has many elements, some biological, some psychological and some social. In recent years it has become common to think of depression as if it were some sort of biological imbalance in the brain that needs amending with medication.
Biology may be one factor but it would be a big mistake to ignore the equally significant parts that psychology and social factors have to play. If someone is in a hopeless situation in their lives, simply giving them a ‘happy’ pill may not be the best way of helping them. Changing their circumstances may be far preferable and offer them a longer-term solution but invariably this is a costlier option.
Summary
In spite of these potential risks and words of caution, it has to be said that enduring deep depression also has high risks, costs and consequences and so the possibility of a new effective treatment has to be weighed up against all the potential risks of not finding an effective treatment.
It will likely be a few years yet until this is a widely available treatment but the continuing good results from clinical trials mean this is very likely to be a regular treatment soon.
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