Depression and Anxiety Treatment

Treating Depression and Anxiety using Psilocybin

Microdosing on psilocybin, a hallucinogenic drug, through regular ingestion has seen an explosion in popularity in recent years when it comes to treating depression. Although there are not enough clinical trials that are yet conducted to prove the efficiency of this psychedelic drug to cure depression or at least keep it at bay, individual reports indicate long-term general health and well-being benefits with minimal acute effects. This article will discuss the potential benefits of using microdoses of psilocybin to treat depression and highlight why current treatment methods are not adequate in the long-term.

Prevalence of Depression and Anxiety in Canada

Statistics suggest that one in five Canadians are prone to depression any given year. Depression is quite pervasive in Canada, to the extent that one in two Canadians have or have had depression or related mental illness by the time they reach the age of 40. Approximately, 70 percent of mental health problems, mainly depression and anxiety, start from early childhood and adolescence.

According to the Canadian Study of Health and Aging (CSHA), which conducted a study comprising 2,341 participants, reported that depression is a significant mental health problem among elderly Canadians, particularly those who have physical disabilities. The prevalence of major depression was shown to be 2.6 percent and were higher for females than males. Also, Canadians with low socioeconomic status are three to four times more likely to developing anxiety and depression. For example, studies in numerous cities in Canada have shown that between 23 to 67 percent of homeless Canadians have high levels of depression. Depression can lead to an array of other problems and inhibit an individual’s psychosocial functioning. Therefore it is important to have it treated immediately. Usually anti-depressants are used.

Current Methodologies to Treat Anxiety and Depression

Apart from behavioural therapy, anti-depressant medications are also often used to treat depression and anxiety in Canada. Several new anti-depressants have been approved in Canada, Antidepressant therapy includes the use of two types of medications (among others), SSRI (selective serotonin reuptake inhibitors) and SNRI (serotonin-norepinephrine reuptake inhibitor). Both SNRI and SSRI medications prevent the re-uptake of certain neurotransmitters in the nerve terminals of the brain. While SNRIs prevent the reuptake of both serotonin and norepinephrine, SSRIs only stop the reuptake of serotonin. SSRIs are considered the first-line treatment for child and adult patients suffering from major depressive disorder. Although a number of studies have shown the efficacy of SSRIs in the context of MDD relapse prevention, there remain certain gaps in the existing literature particularly regarding the comparison of SSRIs with other clinical modalities.

There are several side effects of using SSRIs to treat depression. Some patients consuming SSRI medication can develop insomnia, skin rashes, joint/muscle pain, headaches, upset stomach, diarrhea, and nausea. A more serious problem that might occur is blood clotting capacity due to decreased serotonin in platelets. Also, patients are at risk of for internal bleeding, especially if they are taking aspirin or NSAID. According to Ferguson (2001), gastrointestinal disturbances along with anxiety, agitation, and insomnia are the most frequently reported side effects of using SSRIs.

Another notable side effect of SSRIs is the stimulation of postsynaptic 5-HT2 receptors, which can cause interference in sexual functioning. Clinically, this can manifest in decreased libido, male impotence, delayed ejaculation, and anorgasmia. Studies have revealed depressed women tend to experience a greater reduction in sexual desire and increased difficulties achieving an orgasm. Similarly, men are likely to experience prolonged sexual inhibition and overall sexual dysfunction as a result of SSRI side effects.

Psilocybin Microdosing Treatment 

Microdoses of psilocybin have risen to popularity when it comes to treating depression. Microdosing means ingesting only a fraction of a dose that triggers a full-blown psychedelic experience, informally known as a ‘trip’. Although no empirical studies have been conducted so far, research based on qualitative models and patient self-reports seem to indicate that psilocybin microdoses may be an effective long-term solution to curing depression. Therefore, an emerging body of research is making the case for using psychedelic drugs (in small doses) to treat depression. This is because typical antidepressants seem to have way too many side effects as discussed above. Also, the beneficial effects of SSRIs are known to be short-term which is why depressed patients have to take antidepressants for a long period of time. In addition, their tolerance level increases gradually which is why they have to keep increasing their dosage if the effects seem to wear out with time. So, the benefits of SSRIs are rather short-lived and in many aspects, the drugs end up doing more harm and make a person more dependent on them for improving their psychosocial functioning. Instead, microdosing of psychedelics, particularly psilocybin is a popular treatment strategy currently undergoing various trials.

In the study by Anderson et al. (2019), the authors examined the effects of microdosing psilocybin to treat depression. The results, according to the codebook, spanned across a range of categories, which are also covered by a CBC article, according to which, microdosing on the drug improved focus by 14.8 percent, improved energy by 10.5 percent, and had cognitive and social benefits of around 5.8 percent and 7.6 percent respectively. In addition, it improved creativity by 12.9 percent, reduced depressive symptoms and anxiety by 1.1 percent and 4.2 percent respectively, improved mood by 26.6 percent, enhanced self efficacy and focus by 11.3 percent and 14.8 percent, respectively.

In another study, researchers gave rodents 1 mg/kg dose of DMT, the compound responsible for inducing a hallucinogenic experience and is also found in psilocybin, for 3 days over a period of 2 months. The researchers found that DMT helped the rats overcome their fears in an assessment used to model post-traumatic stress disorder (PTSD) and depression. Also, the rodents exhibited a significantly less freezing response (which makes them immobile) in the face of fear as well as a neuronal growth, though the latter result is contestable. Even so, the current results seem promising as researchers can separate psychedelic effects from therapeutic ones, i.e, producing positive behavioural changes without dramatically altering perception.

In one double-blind trials where neither the researchers nor the participants knew who got the placebo, the authors concluded that in people with low-grade anxiety and depression, microdoses of psilocybin induced significant mood improvements. In another literature review comprising 14 experimental studies, findings indicated that a 10-20 mcg LSD microdose of less than 1-3 mg have subtle positive effects on cognitive processes including convergent and divergent thinking and time perception, as well as brain areas involved in effective processes.

In another study by Davis et al. (2020), the authors conducted by randomized clinical trial consisting of 24 participants with major depressive disorder. Participants who receive immediate psilocybin-assisted therapy as compared to those who received delayed treatment, showed significant improvement in blinded clinicians rater-assessed depression severity tests as well as self-reported secondary outcomes after a one-month follow-up. In another research studying adults with major depression, Johns Hopkins Medicine researchers found that two doses of psilocybin coupled with supportive psychotherapy significantly reduced depressive symptoms and microdosers tended to score higher on creativity and wisdom and lower on negative emotions and dysfunction. The illicit nature of psilocybin makes it a difficult subject to research. Nevertheless, microdosing psilocybin shows a lot of promise as not only a sustainable treatment alternative to treat depression but to replace SSRIs and eliminate their adverse side effects.

 

Bibliography

Anderson, Thomas. Petranker, Rotem., Christopher, Adam. Rosenbaum, Daniel. Weissman,     Cory. Williams, Le-Anh. Hui, Katrina. Hapke, Emma. “Psychedelic microdosing benefits     and challenges: An empirical codebook.” Harm Reduction Journal, 16(43). 2019

Clevenger, Steven. Malhotra, Devvrat. Dang, Jonathan. Vanle, Brigitte. IsHak, Waguih. “The        role of selective serotonin reuptake inhibitors in preventing relapse of major depressive     disorder.” Therapeutic Advances in Psychopharmacology, 8(1), 49-58. 2018

Davis, Alan. Barrett, Frederick. May, Darrick. “Effects of psilocybin-assisted therapy on major     depressive disorder: A randomized clinical trial.” JAMA Psychiatry. 2020.

Ferguson, James. “SSRI antidepressant medications: Adverse effects and tolerability.”     Primary Care Companion Journal of Clinical Psychiatry, 3(1), 22-27. 2001.

Ghosh, Ilina. “How and why people microdose tiny hits of psychedelic drugs.” CBC.     https://www.cbc.ca/news/health/microdosing-pschedelics-study-1.4771647

What are the real risks of antidepressants? (2014). Harvard Health Publishing.     https://www.health.harvard.edu/mind-and-mood/what-are-the-real-risks-of-    antidepressants#:~:text=SSRI%20antidepressant%20side%20effects,temporary%20or%2    0mild%20or%20both.

Ostbye, Truls. Kristjansson, Betsy. Hill, Gerry. Newman, Stephen. Brouwer, Rebecca.     McDowell, Ian. “Prevalence and predictors of depression in elderly Canadians: The     Canadian study of health and aging.” Chronic Diseases Canada, 26(4), 93-99. 2005

Psychedelic treatment with psilocybin relieves major depression, study shows. Johns Hopkins     Medicine. https://www.hopkinsmedicine.org/news/newsroom/news-releases/psychedelic-    treatment-with-psilocybin-relieves-major-depression-study-shows

Kuypers, Kim. “The therapeutic potential of microdosing psychedelics in depression.”    Therapeutic Advances in Psychopharmacology – From Drug Misuse to Useful Drugs.     2020

Pearson, Caryn. Janz, Teresa. Ali, Jennifer. “Mental and substance use disorders in Canada.”     Statistics Canada. Catalogue No. 82-624-X. 2013                 https://www150.statcan.gc.ca/n1/en/pub/82-624-x/2013001/article/11855-    eng.pdf?st=nD03R7Xx

Polito, Vince. Stevenson, Richard. “A systematic study of microdosing psychedelics.” PLos One,     14(2). 2019.

Sandoiu, Ana. “Psychedelics: Risks and benefits of microdosing revealed.” Medical News     Today. 2019. https://www.medicalnewstoday.com/articles/324609

Smetanin, P., Briante, C., Stiff, D., Ahmad, S., Khan, M. “The life and economic impact of     major mental illnesses in Canada.” Risk Analytica – Mental Health Commission of     Canada. 2011.     https://www.mentalhealthcommission.ca/sites/default/files/MHCC_Report_Base_Case_F    INAL_ENG_0_0.pdf

Thomsay, Hannah. “How microdosing psychedelic drugs affects mental health.” Brain Facts.     2020. https://www.brainfacts.org/diseases-and-disorders/mental-health/2020/how-    microdosing-    psychedelic-drugs-affects-mental-health-062420

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