1 Efficacy of psychedelic therapy for treatment-resistant depression Ethan Sit Faculty of Health, Wellness and Sciences, Georgian college – Barrie COMM1016: Communication Essentials Professor Vali Stone Date: 10/2/2023 2 Thesis Statement Treatment-resistant depression (TRD) is a type of depression that does not respond to standard treatments such as antidepressant medications and psychotherapy. Despite ongoing research and the development of new medications and therapies, up to 30% of individuals with depression do not respond to traditional treatments. (Voineskos et al., 2020) This has led to the exploration of alternative treatment options, including psychedelic therapy. Psychedelic therapy has shown promising results in treating treatment-resistant depression and should be further researched and considered as a legitimate treatment option. Topic Sentence #1 Psychedelic therapy has shown promising results in the treatment of treatment-resistant depression. 1."The new results, taken from two combined studies, reveal that people who responded to psilocybin-assisted therapy showed increased brain connectivity not just during their treatment, but up to three weeks afterwards. This “opening up” effect was associated with self-reported improvements in their depression." (Magic Mushroom Compound Increases Brain Connectivity in People With Depression, 2022) 2."Recent evidence suggests that 1 or 2 administrations of psilocybin with psychological support produces antidepressant effects in patients with cancer and in those with treatment-resistant depression."(Davis et al., 2021) 3."Relief from TRD with ketamine happens rapidly. Instead of waiting for an SSRI to hopefully provide some relief over the course of weeks, people who are suffering under the crushing 3 weight of depression can start to feel the benefits of ketamine within about 40 minutes."(Grinspoon, 2022) The efficacy of psychedelic therapy for TRD is promising, but more research is needed to fully understand its safety and effectiveness, as well as the potential long-term effects. Topic Sentence #2 Despite the promising results of psychedelic therapy for TRD, there are concerns surrounding the use of these substances in a clinical setting. 1."Some of these drugs, such as MDMA, are considered to be potential drugs of misuse, given the euphoria they can cause. Possible adverse effects of some psychedelics could include dizziness, drowsiness, extreme dissociation from reality, panic attacks, and nausea. Their illegality makes them more dangerous, and people using street drugs can suffer medical complications from taking contaminated drugs."(Grinspoon, 2021) 2."Health Canada expects that, for all CTAs involving psychedelic drugs, therapists would be properly trained on evidence-informed protocols for psychedelic-assisted psychotherapy and be licensed to provide psychotherapy by a regulatory body (if applicable in their jurisdiction)."(Notice to Stakeholders: Health Canada’s Expectations Regarding Riskmanagement Measures for Clinical Trials Involving Psychedelic-assisted Psychotherapy, 2022) 4 3."Overall, psilocybin mushrooms were ranked as the least harmful drug, followed by LSD and the addiction drug buprenorphine, which had the same score. Alcohol was ranked most harmful (more than ten times as harmful as mushrooms or LSD), followed by heroin, then crack. Referring to mushrooms and LSD"(What Do We Know About the Risks of Psychedelics? Michael Pollan, 2020) While there are concerns surrounding the use of psychedelic substances in a therapeutic setting, measures can be taken to mitigate potential risks and ensure patient safety. . Topic Sentence #3 Despite the promising findings on the potential benefits of psychedelic therapy for the treatment of TRD, there are several challenges that must be addressed in order to fully realize the potential of this treatment approach. 1."Currently, international drug control scheduling classifications and popular misconceptions about the relative risks and harms of psychedelic drugs make research involving humans difficult."(Tupper et al., 2015) 2."Scaled delivery of psychedelic psychotherapy to the community may prove difficult if training and accreditation are inappropriate or insufficient to meet demand – as is the case with other modalities. Key questions include appropriate candidates, capacity of training providers, educational content, certification, and ongoing regulation."(Williams et al., 2021) 5 3. "There is a growing body of evidence to suggest some psychoactive substances have immense therapeutic potential, especially when it comes to tackling serious, hard-to-manage mental health issues such as post-traumatic stress disorder (PTSD), depression, alcoholism and eating disorders. (Psychedelics Paired With Therapy Could Treat Chronic Mental Health Conditions, n.d.) While there are significant challenges to the use of psychedelic therapy for the treatment of TRD, the potential benefits of this treatment approach are significant. By addressing regulatory barriers, standardizing treatment protocols, and expanding research, we can fully realize the potential of psychedelic therapy and develop new treatments for individuals with TRD and other mental health conditions. Conclusion In conclusion, psychedelic therapy for the treatment of TRD has shown promising results. Even though there are potential risks of this treatment, measures and expertise can help to mitigate these risks and ensure patient safety. It is important to recognize this approach as a supplementary treatment option to the more traditional approach. With further research and development in this field, psychedelic therapy will definitely help more individuals that have treatment-resistant depression as a legitimate treatment option. 6 References Voineskos, D., Daskalakis, Z. J., & Blumberger, D. M. (2020). <p>Management of TreatmentResistant Depression: Challenges and Strategies</p> Neuropsychiatric Disease and Treatment, Volume 16, 221–234. https://doi.org/10.2147/ndt.s198774 Magic mushroom compound increases brain connectivity in people with depression. (2022, April 11). Imperial News. https://www.imperial.ac.uk/news/235514/magic-mushroomcompound-increases-brain-connectivity/ Davis, A. T., Barrett, F. S., May, D. G., Cosimano, M. P., Sepeda, N. D., Johnson, M. P., Finan, P. H., & Griffiths, R. R. (2021). Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder. JAMA Psychiatry, 78(5), 481. https://doi.org/10.1001/jamapsychiatry.2020.3285 Grinspoon, P., MD. (2022, August 9). Ketamine for treatment-resistant depression: When and where is it safe? Harvard Health. https://www.health.harvard.edu/blog/ketamine-fortreatment-resistant-depression-when-and-where-is-it-safe-202208092797 Grinspoon, P., MD. (2021, June 22). Back to the future: Psychedelic drugs in psychiatry. Harvard Health. https://www.health.harvard.edu/blog/back-to-the-future-psychedelicdrugs-in-psychiatry-202106222508 Notice to stakeholders: Health Canada’s expectations regarding risk-management measures for clinical trials involving psychedelic-assisted psychotherapy. (2022, December 5). Canada.ca. https://www.canada.ca/en/health-canada/services/drugs-health-products/drugproducts/announcements/expectations-risk-management-measures-clinical-trialspsychedelic-assisted-psychotherapy.html 7 What do we know about the risks of psychedelics? - Michael Pollan. (2020, December 21). Michael Pollan. https://michaelpollan.com/psychedelics-risk-today/ Tupper, K. W., Wood, E., Yensen, R., & Johnson, M. P. (2015). Psychedelic medicine: a reemerging therapeutic paradigm. Canadian Medical Association Journal, 187(14), 1054– 1059. https://doi.org/10.1503/cmaj.141124 Williams, M. a. K., Korevaar, D., Harvey, R., Fitzgerald, P. B., Liknaitzky, P., O’Carroll, S., Puspanathan, P., Ross, M., Strauss, N., & Bennett-Levy, J. (2021). Translating Psychedelic Therapies From Clinical Trials to Community Clinics: Building Bridges and Addressing Potential Challenges Ahead. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.737738 Psychedelics paired with therapy could treat chronic mental health conditions. (n.d.). Horizon Magazine. https://ec.europa.eu/research-and-innovation/en/horizonmagazine/psychedelics-paired-therapy-could-treat-chronic-mental-health-conditions
