Marisa Peryer

Long thought to be a recreational drug that only induces hallucinations, psychedelics are now being eyed by Western researchers as a therapeutic intervention that can also treat psychiatric disorders.

Scientists have found that psychedelic drugs such as MDMA, or “molly,” and psilocybin, or “magic mushrooms,” may effectively treat disorders such as post-traumatic stress disorder when combined with behavioral therapy. To bolster education about and promotion of new advances in psychedelic science, Yale researchers formed the Yale Psychedelic Science Group in 2016 to increase conversation on the topic within Yale’s medical community and discuss how psychedelics may change the treatment of psychiatric disorders.

“This is a radically different model of care that is about integrating therapy with medicine in a way that will be really healing for the person and would drastically reduce the amounts of medication they might actually need,” said Robert Krause, a lecturer at the School of Nursing and a faculty adviser for the group.

Krause has high hopes for the use of MDMA to treat patients with PTSD. Antidepressants are a common pharmaceutical intervention used to treat PTSD, but they have limited efficacy for this purpose, must be taken daily for an indefinite amount of time and come with negative side effects such as weight gain.

But according to Krause, researchers have found that between one and three sessions of therapy combined with MDMA dramatically decrease PTSD symptoms over several months with minimal side effects. Use of the drug for this purpose is currently under review in a phase three clinical trial — the last stage before a treatment can receive approval for widespread use.

Krause noted that researchers are also testing psilocybin’s ability to decrease anxiety in patients with terminal illnesses.

“When we give MDMA or we give psilocybin, it’s not the drug that we think is actually fixing a person, but it’s a combination of the medication within the context of a therapeutic modality,” he said. “That, and the person’s innate ability to heal.”

Psychedelics act on the body’s serotonin system to produce a high. But Krause said that researchers have found evidence that these drugs may also increase a chemical in the brain called brain-derived neurotrophic factor that acts like a neuron fertilizer, helping the neurons form new pathways.

For patients with PTSD who process traumatic events in the amygdala — the brain’s emotional center — taking a psychedelic may allow the patient to instead process their trauma in other parts of the brain, like the prefrontal cortex. When this happens in conjunction with counseling, patients are able to face their trauma without re-experiencing negative emotions associated with the event.

Psychedelic interventions for PTSD are performed in a clinical setting with two therapists present. The patient ingests the drug and enters an altered state of consciousness for five to six hours, during which the therapists help the patient reprocess their trauma by talking through their experiences.

Currently, psychedelics such as psilocybin and MDMA are classified as Schedule I drugs, which have “no currently accepted medical use” and are of “high potential for abuse,” according to the U.S. Drug Enforcement Administration.

In a chapter of a book about psychedelic use in clinical settings, Yale Psychedelic Science Group member and Yale psychiatry resident Jordan Sloshower MED ’14 wrote that evidence of psilocybin’s safety and medical benefit “has grown significantly to the point where their eventual rescheduling and incorporation into formal psychiatric practice seems increasingly likely.”

Krause noted that researchers are concerned that patients will seek out psychedelics for recreational purposes, although there is no evidence to support this concern. He also said that these drugs are difficult to develop dependencies on and are “not nearly as habit-forming” as alcohol. For patients who undergo psychedelic therapy, Krause said, “It’s not a fun experience, it’s an experience in which the person is confronting their inner demons.”

“I’m very interested in how you can study these things,” Peter Addy, a Yale Psychedelic Science Group organizer, told VICE in 2016. “This early work that’s been done suggests potential for a number of clinical applications, but we need to learn more about how the brain works, and perhaps how consciousness works. There’s some promise, but it’s not really a subject that a lot of people are experts in.”

Marisa Peryer | marisa.peryer@yale.edu