Psychedelics and the Evolution of Mental Health Care

The article Psychedelics and the Evolution of Mental Health Care was originally published on Microdose.

In a post-pandemic era, it goes without saying that we’ve seen a massive shift in the way that we perceive mental health. Long gone are the days of us viewing mental health as black and white, either being mentally healthy or mentally ill.  Mental health exists on a complex continuum, with varying experiences ranging from an optimal state of well-being to states of exacerbated emotional pain. Just as someone can have a physical health condition and still be psychically fit, so can people live with a mental health condition and still have high levels of mental well-being. 

The prevalence of different mental health disorders varies with gender, age, sex and underlying health conditions. Recent statistics from Mental Health America had estimated that 21% of adults were experiencing a mental illness in any given year.  That is equivalent to over 50 million Americans.  What is even more staggering is that almost one third of all adults with a mental illness reported that they were not able to receive the treatments they needed, either due to the cost of the treatment or resistance to current drugs on the market (the most widely used currently are selective serotonin reuptake inhibitors (SSRI) found in drugs such as Citalopram and Prozac).

SSRIs are the most common antidepressants, but not because they are the most effective. In fact, recent studies have shown they have perhaps the weakest therapeutic effects on depression, and do very little to relieve depression symptoms, but have the mildest side effects.  Patients typically find that it’s often a matter of trial and error until an effective dosage or drug can be found.  After all, the brain is vastly different from one patient to the next and there are many forms of mental illness. Some forms of these are very hard to tackle with your typical medication and even more bothersome, these drugs are not meant to “cure” the condition, but simply mask the symptoms. This has given rise to the alternative medicine movement, specifically psychedelics. 

We’ve all seen the recent headlines in the past few years, making you do a double take to make sure you read them correctly.  Yes, those headlines did and continue to say “psychedelics for mental health!”  If you are anything like me, reading those headlines produces flashbacks of your parents drilling, “psychedelics are bad and don’t do drugs,” into your mind over and over again.  

A renewed interest by start-ups such as Wellbeing Digital Sciences into psychedelics as a potential blockbuster treatment has fueled media and medicinal interest in magic mushrooms, MDMA, DMT, LSD and Ketamine. 

“For the majority of the 50’s and early 60’s a vast number in the psychiatric field viewed psychedelics as a potential wonder drug for treating a host of mental health conditions,” stated Najla Guthrie, CEO of Wellbeing Digital Sciences and KGK Science. 

“However, with the adoption of these drugs in counterculture in the 60’s and lack of oversight began to unravel gave way to a so-called “moral panic.” What we are seeing now is a radical pendulum swing back to the medicinal potential of these once ill-regarded drugs.”

Researchers from well-established institutions such as Johns Hopkins, UC Davis, Yale and Berkley have begun researching these drugs’ potential in treating conditions ranging from depression to addiction and everything in between. 

“Mental healthcare is rarely about curing or fixing the condition, because such things are usually beyond our current understanding. It’s more about managing, adapting, lessening, and so on. However, current research has shown that psychedelics could potentially treat the root cause of the condition. Making investors take note with over $1 billion in cumulative investments made into psychedelic start-ups in 2020 and 2021,” added Najla.  Although these investors are betting on the long game, one drug has been on the market for decades and provides a glimpse into the future of psychedelics.

Ketamine, opening doors for access to psychedelic therapy

Ketamine got its start in Belgium in the 1960s as an anesthesia medicine and was primarily used as a fast-acting anesthetic and painkiller in treating injured soldiers in the Vietnam War. Fast forward to the 1990s, researchers at Yale University exploring ketamine’s cognitive effects serendipitously found that it had mood-enhancing properties. In addition to providing relief for typical depressive symptoms, ketamine has also been shown to have therapeutic effects for treating specific subtypes of depression or other psychiatric comorbidities. Clinical evidence supports its use for treating depression, anxiety, PTSD, bi-polar disorder, postpartum depression and more.

“How ketamine affects you depends on several factors, including your age, body weight, how often you take it and how much, the environment you’re in and whether or not you have certain pre-existing medical or psychiatric conditions,” states Dr. Michael Ho, Medical Director at Mindscape Ketamine & Infusion Therapy in Houston Texas. 

“At controlled low doses, ketamine can have stimulant effects. Patients report a sense of floating and dissociation in the body. While ketamine affects multiple neurotransmitter systems—including opioid, monoaminergic, glutamatergic, muscarinic, substance P, and sigma receptors—the leading theories of its antidepressant properties implicate N-methyl-D-aspartate (NMDA) receptor antagonism, glutamate surge, and AMPA receptor activation.”

A growing amount of medical studies have demonstrated off-label Ketamine Infusion Therapy offers hope to those with severe depression, bipolar depression, anxiety, PTSD, chronic pain conditions and more. One strategy explored to extend ketamine’s antidepressant effects has been to administer repeated intravenous doses over time. “At Mindscape Ketamine we begin with a series of 6 infusions over several weeks followed by maintenance treatments typically every 3 to 5 weeks to maintain response. The total length of treatment is highly dependent on each individual’s unique circumstances and results,” added Dr. Ho. 

“These medical issues can greatly affect everyday life, strain important relationships, take a toll on an individual’s career, and increase feelings of hopelessness. Our objective at MindScape Ketamine is to offer those struggling with these debilitating mental disorders a new way to find relief in a calming and safe environment.” 

As research into the therapeutic potential of these potential blockbuster drugs rapidly increases, we will be able to better understand the long-term effectiveness, the safeguards needed and potential applications of these treatments.  

Given ketamine’s efficacy in treating mental health and pain conditions, it’s undeniable that its effects could potentially be lifesaving for those who have lost hope in traditional treatments. Nevertheless, one thing is for certain, ketamine and psychedelic therapies are here to stay. In what form or setting, remains to be seen. 

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