LSD, ecstasy, hallucinogenic mushrooms… Effective treatments for treating certain mental disorders?

LSD, ecstasy, hallucinogenic mushrooms… For you, it is surely about drugs. But for some people with mental disorders, it is a treatment. Popular since the 1960s by hippie communities, psychedelic substances are now being introduced into hospitals. The resulting therapies are now legal in Switzerland, Canada, Australia and the US state of Oregon. Although classified as drugs since 1971 by the convention on psychotropic substances of the UN, these products would make it possible to treat many psychic disorders such as depression, anxiety, addictions or post-traumatic stress. In any case, this is what several studies carried out around the world suggest.

This type of therapy, tested as early as the 1970s, consists of taking a dose of psychotropic substance – in this case LSD, ecstasy or psilocybin, the active ingredient of certain hallucinogenic mushrooms – under the control of a doctor, in the hospital. And unlike an antidepressant treatment that must be taken daily over several months, a single dose of a hallucinogenic substance would be enough to considerably and lastingly improve the symptoms of a person with a mental disorder.

A single dose with long-lasting effects

Lucie Berkovitch, psychiatrist and neuroscience researcher, with her colleague Bruno Roméo, analyzed the results of 25 studies on the subject published between 1990 and 2020. “The scientific results are extremely promising”, rejoices the researcher. First of all, when it works, the effects are immediate. Unlike antidepressants, whose effectiveness occurs after several weeks, patients feel “immediately better” after ingesting the psychedelic substance. “It’s a real time saver for patients.” The effects would also be long-lasting.

Since 2020, numerous studies have attested to the effectiveness of these therapies. The largest was carried out in 2022 on 230 people. Published in the New England Journal of Medicine, it tends to show the effectiveness of psilocybin in the treatment of resistant depression. Of the three groups given 1mg, 10mg, and 25mg of psilocybin, respectively, those given the highest dose, the one considered to be used recreationally, were more likely to experience a sustained strong improvement in symptoms.

Another study, published in 2021 in the same journal, compares the effects of psilocybin with those of a commonly used antidepressant, escitalopram. Patients receiving the psychedelic are given a placebo the rest of the time. “No significant difference was observed between the two groups,” explains the psychiatrist. An overall improvement was observed in both cases. “This result is still very interesting, because it means that with a single dose of psilocybin, we do as well as with several weeks of antidepressants. »

New connections between neurons

“The therapeutic results seem positive, but we are still at the very beginning”, wishes to qualify Zoé Dubus, historian of medicine and author of a thesis on the use of psychotropic drugs in medicine, from the 19th century to the present day in France. . “These studies are not yet numerous enough and above all, they have only been carried out on small panels of patients”. Another problem according to her: “on certain studies, we see that after six months or a year, the depressive effects go back. It may therefore take a second session to completely eliminate them. And for good reason, these trials are only carried out on patients resistant to other forms of treatment. It is therefore difficult to completely eliminate in one take the depressive symptoms that have sometimes been present for decades.

How to explain that these substances alleviate the psychological suffering of many people? “These molecules improve cerebral neuroplasticity,” explains Swiss psychology doctor Federico Seragnoli, who performs psychedelic-assisted therapies. “They allow the brain to create new connections between different neurons. Thanks to them, people would once again be able to make certain decisions and see several aspects of their lives positively. Psychedelics also make it possible to play on serotonin, this neurotransmitter involved in particular in the regulation of mood and anxiety. Most antidepressants cause the serotonin already present in the brain to stay there longer. “Psychedelics, in a way, simulate the action of serotonin. It’s a bit like adding more to the brain”, simplifies Federico Seragnoli.

But the explanation is not only neuronal. It is also psychological. Because psychedelic-assisted therapy is, as its name suggests, above all a therapy, which takes place in three sessions. The first to question the patient – and potentially exclude him from therapy. The second to take the substance in a supervised way. And the last session, the so-called “integration” session, to work on the psychic material that emerged during the psychedelic experience. “The substance can amplify the effectiveness of psychotherapy, summarizes Federico Seragnoli. It creates an altered state of consciousness, which is not attainable without substance. »

Substances that are neither toxic nor addictive

Can this experience be badly lived? “The belief that we will stay perched does not correspond to what is observed when the substance is taken in a therapeutic setting”, according to the psychiatrist. “If you take a really strong dose, you can completely lose track of reality or have the feeling of being dying,” admits Federico Seragnoli. But with the doses we give, that can’t really happen. To reduce this risk, the doctor asks the patient beforehand about his possible predispositions to certain psychotic disorders, such as schizophrenia. “People are prepared before and supervised during,” recalls the Swiss psychologist. If they feel unwell after taking, they can seek medical help. »

The risk of becoming addicted to these substances is negligible, according to the professionals interviewed. “These molecules do not have the same addictive potential as other substances at all,” explains the psychiatrist. Psychedelics are not toxic to the body either. Some headaches, nausea or even vomiting have been identified. But no serious side effects requiring the use of medication were found.

If France has fallen behind on this type of therapy, clinical tests should soon see the light of day there. Lucie Berkovitch will soon supervise several of them at Sainte-Anne Hospital. In the meantime, Zoé Dubus regrets that “following the media frenzy around these therapies, some patients finding themselves in a therapeutic impasse are turning to underground therapists to gain access to these therapies illegally. Still a little patience, then.

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