The Great Psychedelic Renaissance

Before the pharmaceutical industry existed, individuals relied on the knowledge of shamans, medicine men, and apothecaries to relieve them of their ailments. The salves, potions and elixirs produced by early medical practitioners were typically plant-based, and often administered under careful supervision due to their potency and complexity.

The knowledge behind plant medicine is still passed down from generation to generation in many indigenous cultures today, but the Internet has allowed modern Western civilizations to adopt these practices as well. Over the past decade, more people have turned towards alternative medicine for acute ailments (such as headaches) and chronic conditions (like depression) than ever before.

Many homeopathic products and alternative remedies are not FDA approved, and some are considered controlled substances (such as medical marijuana). Interestingly, there are a small number of alternative treatments the FDA permits. Some of these treatments involve compounds that fall within the “psychedelic” class of substances. Although certain psychedelics are FDA approved (and in certain states, recreationally legal), strict guidelines must be followed. 

When most people hear the word “psychedelics,” two substances often immediately come to mind: Magic Mushrooms and LSD. Made popular in the 1960’s, psychedelics helped drive a generation of music, style, and culture by allowing the user to “expand their mind” - but how? Psychedelics are a class of psychoactive substances that produce changes in perception, mood and cognitive processes. Although both substances affect the brain’s chemistry, their active compounds are quite different, and thus elicit different experiences and long-term effects.

Not to be confused with nutraceutical mushrooms (such as Lion’s Mane), psychedelic mushrooms contain a substance called psilocybin. Psilocybin is the psychoactive compound found in "magic mushrooms" that is responsible for producing hallucinogenic effects when taken in higher doses. Medical researchers have shown increased interest in exploring the use of psilocybin for addictions, depression, and other mental and psychological disorders due to its potential to stimulate certain areas of the brain, even when taken in smaller doses (called microdosing). Several studies led by Johns Hopkins University have demonstrated the positive effects of psilocybin on major depressive disorder, especially when paired with supportive psychotherapy. People use psilocybin for alcohol use disorder, other addictions, anxiety, depression, migraines, PTSD, and many other conditions.

First thought to only provide short-term benefits, a recent follow-up study conducted in 2022 by Johns Hopkins University found measurable therapeutic effects up to one year following treatment. Although this type of psychedelic mushroom is often used in shamanic rituals, spiritual practices and ceremonies in the United States, it is still considered a Schedule I controlled substance and illegal under federal law. Alternatively (and unknown to most) there are legal psychedelic mushrooms called Amanita muscaria, which contain the psychoactive compounds muscimol & ibotenic acid, but these mushrooms are highly dangerous and can be fatal if used improperly.

2022 was a big year for another psychedelic compound - LSD. Lysergic Acid Diethylamide (LSD) has been shown in clinical trials to help the brain grow cells and form new connections in regions that typically exhibit cell death from mental health disorders. Mind Medicine (MindMed Inc.), a clinical-stage biopharmaceutical company that develops psychedelic-inspired therapies for the treatment of brain-based disorders, was permitted by the FDA to move forward with clinical trials of LSD for general anxiety disorder (GAD). Anxiety, in the simplest of forms, is the body’s reaction to a perceived threat. By forming new connections for information to travel within the brain, it is believed that previous events (or triggers) that may have elicited a negative response in the past are allowed to be relearned and interpreted appropriately. Patients are able to form new associations and remain in a calm state of mind.

Despite its reputation as a party drug, methylenedioxy­methamphetamine (MDMA) is now being studied to treat PTSD by the FDA. Also known as Molly or Ecstasy, MDMA induces a massive release of the neurotransmitter serotonin, a signaling molecule that regulates mood. Once released, serotonin acts on the receptors of nearby neurons to improve one’s emotional state by allowing serotonin to sit in the synapses between neurons. This signals the chemical’s release for longer than usual, causing an often jovial demeanor.

One psychedelic compound has proven itself in clinical trials and has become the first FDA approved psychedelic - Ketamine. In 2019, the FDA approved production of esketamine - a nasal spray containing ketamine - after 70 percent of patients with treatment-resistant depression improved, compared to just over half in the group that did not receive the medication in a study conducted by Yale University. Psychiatrists often prescribe this medication in conjunction with an oral antidepressant.

Ketamine is also available as an IV infusion in licensed offices around the country. Similar to LSD, ketamine fosters new pathways to grow between the brain’s cells (neurons) by increasing glutamate production. This makes the brain more adaptable and able to create new connections, giving patients the opportunity to develop more positive thoughts and behaviors associated with each event. Traditional antidepressants do not stimulate regrowth of neural pathways; this phenomenon has driven interest in neuromedical research exponentially and shows hope for potential applications against other brain illnesses such as dementia..

Several studies on psychedelic compounds are currently being conducted around the country. As research is obtained and confirmed, new medications will likely be approved by the FDA. Unlike products currently available, these boast the ability to repair damaged areas responsible for brain-based disorders.