The Acid Test
Can psychedelics cure the crisis of mental illness, asks Dr. Franklin King 鈥�05, a psychiatrist and clinical instructor at Harvard Medical School.
The notion of psychedelic drugs becoming mainstream might sound like some violet-eyed hallucination of 1960s icon Timothy Leary.
But what the late Harvard psychologist and psychedelics evangelist must have vividly imagined for mushrooms, ecstasy and more may finally be taking shape.
In spring, The New York Times, among other publications, reported about how 鈥渢he psychedelic revolution is coming [and] psychiatry may never be the same,鈥� with psilocybin and MDMA (ecstasy) 鈥減oised to be the hottest new therapeutics since Prozac.鈥�
Those reports followed the opening in February of the Center for the Neuroscience of Psychedelics, which works to understand how psychedelics can improve the treatment of mental illness, at Massachusetts General Hospital.
The authorized prescription of psychedelic drugs for mental illness鈥攕upplemented with therapy鈥攎ay only be a few years away, according to Dr. Franklin King 鈥�05, a psychiatrist and the director of training and education at the Mass General center. King, also a clinical instructor at Harvard Medical School, said about the growing acceptance of psychedelics in medicine: 鈥淭here鈥檚 a crisis of mental illness in this country, and crisis necessitates new ways of thinking.鈥�
Fungi and plants
Leary was among the early researchers into the use of psychedelics, at a time when their risks were not well known. Initially, his work was well-regarded, but he was criticized for taking psychedelics himself during his research and was fired by Harvard for giving a psychedelic to an undergraduate student off campus.
That helped lead to many years in which psychedelics were disregarded and little studied.
Psychedelics, also known as hallucinogens, are found in plants and fungi or are synthetically produced, and they are among the oldest known group of drugs used for their ability to alter human perception and mood, according to the U.S. Drug Enforcement Administration (DEA).
Lysergic acid diethylamide (LSD) may be the best known, but the Center for the Neuroscience of Psychedelics sees three compounds as 鈥減romising treatments that may increase the brain鈥檚 capacity for change鈥� and eliminate mental suffering. They are psilocybin, sometimes simply known as 鈥渟hrooms鈥� or 鈥渕agic mushrooms,鈥� a hallucinogenic chemical obtained from certain types of mushrooms; 3,4-methylenedioxymethamphetamine鈥擬DMA or ecstasy鈥攁 pill or a powder known as a party drug; and N,N-dimethyltryptamine (DMT), the active ingredient in a brew called ayahuasca.
The center鈥檚 initial research focuses on how psilocybin can be used for patients with treatment-resistant depression, and MDMA for patients with treatment-resistant post-traumatic stress disorder (PTSD). The drugs mainly affect serotonin, a 鈥渃hemical messenger鈥� in the brain that affects mood and memory, among other things.
A study led by a University of California, San Francisco researcher and published in May concluded that MDMA-assisted therapy is 鈥渉ighly efficacious in individuals with severe PTSD.鈥� A study by King鈥檚 colleague, Dr. Sharmin Ghaznavi, is examining how psilocybin affects brain circuits in patients with treatment-resistant depression. She says that for many mental health patients, current treatments 鈥渁re either inadequate or don鈥檛 help at all, and so we owe it to those patients, specifically, to explore the promise that these compounds have.鈥�
King鈥檚 role at the center is devising education products for clinicians and working on the MDMA study for PTSD. To him, the term 鈥減sychedelic-assisted psychotherapy鈥� is crucial鈥攖hat is, therapy before and after supervised dosing sessions.
鈥淭hat鈥檚 a really, really different entity than simply taking LSD at a concert recreationally,鈥� he said.
King drawn to psychiatry at 糖心TV
King鈥檚 interest in psychedelics stemmed from his interest in psychiatry, which itself was nurtured by courses he took at 糖心TV from Marijan Despalatovic, now a senior lecturer emeritus at 糖心TV. Despalatovic taught Russian and central European literatures, 鈥淭he Philosophical Novel,鈥� 鈥淚ntellectual History of Russia,鈥� Chekhov and modern dramaturgy, film theory, and Marxism.
鈥淭he force of his intellect and the way he just really encouraged us to be discerning and to think deeply and comprehensively about any problem, and not just to take the low-hanging fruit of a problem ...鈥� King said. 鈥淚 think that鈥檚 really important in medicine and psychiatry.鈥�
In medical school at the University of Massachusetts, King began to learn about psychedelics.
鈥淚t was just kind of the awareness that psychedelics elicit this very different and powerful state of consciousness. The experience itself can be perceived as being very powerful and memorable; it leaves a very durable impact,鈥� he said.
What psychedelics do and how they work, King said, 鈥渋s that they elicit a change in consciousness, a very profound change in consciousness.鈥� Therefore, the patient who has had the experience feels as though 鈥渟omething very profound and transformative has happened, oftentimes with the feeling that it was spiritually important or mystically important, and very personally meaningful to
the individual.鈥�
Learning about the use of these drugs was a watershed moment for King. He saw how intense and how powerful MDMA-assisted therapy was for people, many of whom were veterans, and others who had experienced major trauma.
鈥淪eeing how different the therapy was, the way of interacting鈥攅verything was completely different than anything I had experienced in psychiatry. And then seeing the changes in these folks, and how much insight and how much benefit they were able to gain鈥� is paradigm shifting in terms of treatment-resistant PTSD and depression.
