Psychedelic drugs could be commonly used to treat mental health patients in as little as half a decade, according to a leading expert in the field.
David Nutt, professor and neuropharmacologist at Imperial College London and former U.K. government drug adviser, told Newsweek he believes we are "less than five years" away from such drugs being given to patients.
Nutt made the forecast after co-authoring a commentary in the journal Cell, which explores the resurgence of research investigating the potential benefits of using drugs such as LSD and magic mushrooms in controlled medical settings to treat mental disorders like depression, anxiety and PTSD.
During the 1950s and 1960s, LSD was researched widely and considered a potential breakthrough drug by psychiatrists, according to the team, but work ground to a halt after such substances were taken recreationally and subsequently banned.
In the article, Nutt and colleagues argue that the war on drugs, which ended such research, was "one of the worst examples of censorship of human research in the history of science."
"In the past decade, research on these compounds has been re-established by a few groups around the world, culminating in new centers for psychedelic research at Imperial College London and Johns Hopkins University," they said.
For instance, after "battling" with regulators to use the schedule 1 drug psilocybin, the active ingredient in magic mushrooms, researchers found "remarkable" effects on patients who were given it alongside psychological support. Two experiences with the drug appeared to ease symptoms of depression in some people for weeks, and even years "positioning it as one of the most powerful therapeutics for treatment-resistant depression," the team wrote.
Nutt and colleagues will soon finish a trial comparing psilocybin with the antidepressant drug escitalopram on patients with depression.
The writers said psychedelics may have a profound effect on participants in such trials, as patients suffering from conditions like anxiety and depression often dwell too much on negative thoughts, such as their own failings, and the combination of these drugs and therapy sessions seem to break these cycles.
"Standard antidepressants protect against the stressors that lead to and perpetuate depression, but don't directly access and remedy underlying biopsychosocial causes," the team wrote.
"In contrast, psychedelic therapy harnesses a therapeutic window opened up by the brain via the effects of the drugs to facilitate insight and emotional release and, with psychotherapeutic support, a subsequent healthy revision of outlook and life-style."
However, more work is needed, they said, to explain the mechanism behind the effects of these drugs.
The writers also cast doubt on microdosing, where drugs are taken at small enough doses not to change a person's state in any conceivable way but which some claim can balance a person's mood. A study last year concluded there is no evidence to show the practice works. Nutt and colleagues questioned how, for instance, microdosing psilocybin three times a week could elicit the same effect as a "macrodose" used in trials where participants have experiences that are "variously called breakthrough, peak, or mystical."
Nutt and his co-authors also argued that regulators should consider rescheduling psychedelics drugs, particularly psilocybin, in order to make it easier for them to be studied by researchers.
"The resurrection of research into the neuroscience and therapeutic application of psychedelics represents one of the most important initiatives in psychiatry and brain science in recent decades," they wrote.
The team concluded: "What is now needed is a combined, multi-level, multidisciplinary program of research into the mechanisms underpinning" recent finding on psychedelics."
Ravi Das of the UCL Clinical Psychopharmacology Unit, who did not work on the commentary, told Newsweek: "I am in complete agreement with Professor Nutt that we need more robust research into whether these drugs are effective and particularly into how they produce beneficial changes."
Das said he agreed that it could be beneficial to reschedule certain psychedelics so they are easier to research and gather "proper empirical data" on.
"The way drugs are currently classified legally has little relation to their underlying pharmacology, toxicity, or potential for harm or benefit," said Das. "The psychedelic drugs Nutt reviews are far less toxic than alcohol and tobacco, for example, with much greater potential for benefit."
Asked how many years he predicts will pass before psychedelics are commonly used to treat patients, Das said: "Owing to the stagnation in psychiatry that Nutt and colleagues note in their review, research scientists and psychiatrists tend to get excited about new 'step-change' developments in treatment approaches."
Das said there was a tendency, particularly in private clinics in the U.S. to offer treatments too prematurely, before mechanisms are properly understood.
"I have no doubt that we will see private clinics offering such treatments in the next few years, albeit without a solid empirical grounding. Nutt and colleagues highlight the need for mechanistic research into these drugs and I think this is critical to ensuring they are used most effectively and safely in disorders where they are likely to have most benefit," said Das.
The take-home message for the general public is clear, according to Das and Nutt.
Nutt told Newsweek it is unsafe for the general public to experiment with psychedelic drugs at home, as the powerful therapies require trained medical supervision. Drugs like LSD, for instance, can trigger mental health problems, according to health officials.
Das said many people use psychedelics recreationally and do not experience the lasting, or "life-changing" insights some study participants report.
"There is therefore no guarantee that experimenting at home will have effects remotely like those seen in carefully controlled studies," he said. "Given that the leading researchers in the field still don't really understand how psychedelics work to improve mental health, those choosing to experiment at home would be truly 'flying blind'. As with all potential psychiatric treatments, potential psychedelic therapies should be overseen by a qualified healthcare professional."
Das concluded: "I do think there is real promise in psychedelic therapies and agree with Nutt et al's recommendations on almost all fronts.
"I would like to stress, however, that we're really still at the very early stages of this research and understanding how these drugs work. Whether they truly represent the 'revolution' in psychiatry some tout them to be still needs to be shown by research."
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