Psychedelic drugs now used as psychiatric medications are a wave of the future. Psychopharmacology is effective and safe for many people, but there is still a significant number of people who get little or no benefit from this form of treatment. Any new direction for helping people with mental illness is intriguing and important.
Ketamine is already available and can be used by infusion, nasal spray, intramuscular injection or lozenge. Psilocybin should be available at some point in 2023.
The early data about both medications are very promising. People with many mental illnesses including depression, OCD and PTSD appear to derive benefit from the psychedelics. Although people who work with these medications report benefit for even more disorders, there isn’t enough known yet to substantiate the claims.
Unlike psychiatric medications, psychedelics don’t directly reduce symptoms. Instead, they increase brain plasticity—the flexibility of the brain to break stuck routines and change automatic thoughts and reactions. The effect of the medications is more effective when the program includes mental exercises or writing that enhances and focuses on changing certain patterns in the brain. For instance, trauma therapy using psilocybin shows significant promise.
Of note, there is no clear benefit for these medications for people with eating disorders, though any peripheral benefit for other psychiatric symptoms can benefit eating disorder treatment.
It’s crucial to note that psychedelic medications don’t follow the typical FDA method of approval for new drugs. And once approved, there is no clear method of treatment either. Psychiatrists cannot just prescribe the medications and pharmacies do not dispense the drugs. Ketamine is prescribed in specific clinics and can even be ordered as a lozenge on various websites without medical supervision at all.
The lack of regulation, unclear medical follow-up and minimal guidelines for use make it important for anyone using these medications to find a reputable source for attaining and using them. The patient has the responsibility to search for the safe and effective way of trying the medications and of assessing its benefit.
Psychedelic medications are an exciting new direction for psychiatry. The holes in care for mental illness demand new options to help those undertreated by the current available options. As long as a patient is educated and clear about their decisions, these new medications can be a very effective alternative. However, it’s important for patients to heed the risks and work with knowledgeable doctors through the process.
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