Ketamine, LSD, Magic Mushrooms: When are Drugs Medicine?

“Under the influence of such substances I was able to leave behind the rigid conceptions of the world.” Beyond his “massively filtered perception” lies another world that is just as real but twice as beautiful. British Prince Harry reports in his biography “Reserve” on experiences with psychedelic drugs. Experimenting with it played a central role in overcoming his mental health problems. The 38-year-old said that in a conversation with the Canadian trauma expert Gabor Maté, addressing a topic that has been hyped for some time. Illegal substances such as psilocybin (magic mushrooms), MDMA (ecstasy) and LSD do harbor hopes: do they have the potential to help against various mental illnesses? Against depression, anxiety, obsessive-compulsive disorders and addictions or post-traumatic stress disorders?

How does LSD affect the psyche?

According to the official guideline on depression, the current findings are not sufficient to justify its use outside of clinical studies. However, the topic is not really new: the effects of LSD and psilocybin on the psyche were already being studied in the 1950s and 1960s.

Subsequent bans then interrupted research for a long time. In any case, Harry’s statements attracted severe criticism in Great Britain. In the book, Harry mentions mushrooms and the hallucinogenic potion Ayahuasca (DMT). He calls the application “purely medical”, but the substances are illegal in many countries.

This brings back memories of 2009: Two men died of an ecstasy overdose during an illegal “drug therapy” in Berlin. The convicted doctor had weighed the drug wrong at the time.

Various researches are currently being carried out in Europe on the subject: Scientists want to know, for example, how long possible effects last and how undesirable side effects influence the risk-benefit ratio.

For example, a study by the Central Institute for Mental Health in Mannheim, in which the Charité in Berlin is also involved, is being conducted on psilocybin. It is about depression, the treatment of which has so far been unsuccessful. According to the study website, the substance triggers a state similar to a daydream for a few hours, often associated with heightened emotions. There is no evidence that the substance is addictive. Results are expected to be available in 2024, said Charité study coordinator Michael Koslowski.

The use of the anesthetic and painkiller ketamine, also known as a “party drug”, is more advanced. In people with treatment-resistant depression, it can be administered under certain conditions. The advantage is that the effect occurs quickly. As a result of the gift, patients are virtually disconnected from their environment for a while. “We have had amazing success with ketamine in those affected. I see it as a valuable addition to the therapeutic options,” says Andreas Reif, Director of the Clinic for Psychiatry, Psychosomatic Medicine and Psychotherapy at the University Hospital in Frankfurt. “But such therapies must always be embedded in an overall psychiatric treatment.”

Dangerous self-experiments

In other words, you should never think of a self-directed drug trip as a simple solution to complex psychological problems. On the contrary. That could backfire. Self-experiments increasingly appeared on portals such as YouTube, reports Koslowski from the Charité. Imitators ran the risk of suffering dangerous complications: anxiety reactions, psychoses, accidents and risks to the heart, for example if too much is taken or a mixture of several substances is taken.

According to current knowledge, the substances are not a savior for all patients, says Reif, who is on the board of the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology. “But you shouldn’t demonize them either. We should be happy about every additional drug that we have available.” From Reif’s point of view, further psychedelics should be added in the future for use in the psychiatric field. Experts expect that with psilocybin, for example, it will still be a question of several years.